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Dai HD, Buckley J, Leventhal AM. Correlates of using E-cigarettes with high nicotine concentrations among U.S. adults who exclusively vape E-cigarettes or dual use with cigarettes. Addict Behav 2024; 153:107986. [PMID: 38432013 DOI: 10.1016/j.addbeh.2024.107986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 02/11/2024] [Accepted: 02/12/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Identifying the correlates of using e-cigarettes with high nicotine concentrations in exclusive and dual-using vapers can elucidate which subpopulations might be most impacted by e-cigarette regulatory activities related to nicotine concentration. METHODS Data are drawn from Wave 5 (December 2018-November 2019) of the Population Assessment of Tobacco and Health (PATH) study. Self-reported nicotine concentration was grouped as high (5.0 %+), moderate (1.8-4.9 %), low (0.1-1.7 %), 0 %, and "I don't know." Multivariable logistic regressions estimated associations of sociodemographic factors, tobacco use status, and e-cigarette use patterns of high nicotine concentration vs. other nicotine levels, stratified by current exclusive e-cigarette use and dual use of e-cigarettes and cigarettes. RESULTS In the study samples (exclusive e-cigarette use [n = 1,755], dual-use [n = 1,200]), higher proportions of exclusive e-cigarette users reported using high nicotine concentrations than dual users (18.3 % vs. 8.6 %). Among exclusive e-cigarette users, never vs. former smokers and daily (vs. someday) e-cigarette users were more likely to use high vs. low nicotine. In both exclusive and dual users, younger (vs. older) adults were more likely to report using high nicotine concentration e-cigarettes than most other nicotine levels. Current dual users who did vs. did not report using e-cigarettes to quit smoking had higher odds of using high vs. 0 % nicotine concentrations. CONCLUSIONS High-nicotine e-cigarette use might be elevated in subpopulations that face greater risks for vaping (e.g., never smokers, young adults) than groups who benefit from the potential harm reduction. Regulatory restrictions on high-nicotine products may selectively affect some subgroups adversely impacted by vaping.
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Affiliation(s)
- Hongying Daisy Dai
- College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States.
| | - James Buckley
- College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
| | - Adam M Leventhal
- Institute for Addiction Science and Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA, United States
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Galimov A, Leventhal AM, Hamoud J, Meza L, Unger JB, Huh J, Baezconde-Garbanati L, Sussman S. Adult harm perceptions, purchase, and use related to synthetic vs. tobacco-derived nicotine vaping products: A mixed-methods study. Prev Med Rep 2024; 41:102692. [PMID: 38524276 PMCID: PMC10960099 DOI: 10.1016/j.pmedr.2024.102692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/19/2024] [Accepted: 03/15/2024] [Indexed: 03/26/2024] Open
Abstract
Objective Synthetic nicotine (SN) e-cigarettes emerged on the market as an alternative to tobacco-derived nicotine (TDN) vaping products. It is critical to understand the harm perceptions, purchase, and use of SN vs. TDN e-cigarettes. Methods From November 2021 to February 2023, we conducted intercept interviews with 263 adult customers at 37 vape shops in Southern California. Self-reported use and harm perceptions towards SN vs TDN e-cigarettes were examined. A qualitative analysis of researcher-obtained photographs of vaping items just purchased by customer participants was conducted. Results Past 30-day SN e-cigarette use was reported by 44 (16.7 %) customers. Past 30-day SN e-cigarette users vs. non-users reported vaping on more days in the past month (29.3 vs. 26.1 days, p = 0.02). Overall, 23.8 % of participants perceived SN e-cigarettes as less harmful than TDN ones; never-smoking vapers and dual users perceived SN e-cigarettes as less harmful than salt-based TDN e-cigarettes. Among 44 customers who purchased SN products (verified through qualitative analysis of photographs), only 13 (29.6 %) self-reported using SN products in the past month, while 5 (11.4 %) indicated they were not aware of the existence of SN products. Most SN vaping products (71.4 %) displayed a modified "tobacco-free" warning label. Conclusions Misperceptions about SN e-cigarettes were documented in this study, including the perception that SN is either less or more harmful than TDN. Further, some customers may be unknowingly purchasing and using SN e-cigarettes. Regulating "tobacco-free nicotine" terminology in SN vaping products marketing is suggested. SN product labeling should not imply that SN is safe/safer than TDN.
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Affiliation(s)
- Artur Galimov
- Institute for Health Promotion and Disease Prevention, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, USA
| | - Adam M. Leventhal
- Institute for Health Promotion and Disease Prevention, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, USA
| | | | - Leah Meza
- Institute for Health Promotion and Disease Prevention, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, USA
| | - Jennifer B. Unger
- Institute for Health Promotion and Disease Prevention, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, USA
| | - Jimi Huh
- Institute for Health Promotion and Disease Prevention, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, USA
| | - Lourdes Baezconde-Garbanati
- Institute for Health Promotion and Disease Prevention, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, USA
| | - Steve Sussman
- Institute for Health Promotion and Disease Prevention, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, USA
- Department of Psychology, University of Southern California, USA
- School of Social Work, University of Southern California, USA
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Han DH, Cho J, Vogel EA, Harlow AF, Tackett AP, Eckel SP, McConnell R, Barrington-Trimis JL, Leventhal AM. Longitudinal Transitions Between Use of Combustible, Noncombustible, and Multiple Cannabis Products From Adolescence to Young Adulthood and Intersections With Nicotine Use. Am J Epidemiol 2024; 193:617-625. [PMID: 37981712 DOI: 10.1093/aje/kwad230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 10/14/2023] [Accepted: 11/15/2023] [Indexed: 11/21/2023] Open
Abstract
Understanding transitions across use of different types of cannabis products and multiple cannabis products and how they intersect with nicotine use in young people can inform etiology and prevention. In this study, we examined transitions across use of combustible and noncombustible forms of cannabis and multiple types of cannabis from adolescence to young adulthood and the role of nicotine use in transitions. In a Southern California longitudinal cohort study (n = 3,298; baseline mean age = 16.1 (standard deviation, 0.4) years) with 9 semiannual survey waves (2015-2021), we used Markov multistate transition modeling to estimate short-term (2-wave) and long-term (9-wave) probabilities of transition across 5 cannabis use states: never use of any product, prior use with no past-6-month (P6M) use of any product, and P6M use of exclusively noncombustible products, exclusively combustible products, and multiple (noncombustible + combustible) products. Sizable transition probabilities from prior and exclusive P6M noncombustible or combustible cannabis use to P6M poly-cannabis-product use were observed in short-term (10.7%-38.9%) and long-term (43.4%-43.8%) analyses. P6M nicotine use increased risk of transitioning from never and prior use to exclusive P6M noncombustible and combustible cannabis use. Cannabis use in any form, even temporary use, during midadolescence may often be followed by poly-cannabis-product use. Nicotine use may amplify the probability of future cannabis use onset or recurrence.
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Han DH, Harlow AF, Feldstein Ewing SW, Audrain-McGovern JE, Unger JB, Sussman SY, McConnell R, Barrington-Trimis JL, Leventhal AM. Disposable E-Cigarette Use and Subsequent Use Patterns in Adolescents and Young Adults. Pediatrics 2024; 153:e2023063430. [PMID: 38463010 PMCID: PMC10979299 DOI: 10.1542/peds.2023-063430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/12/2023] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Disposable electronic cigarettes (e-cigarettes) are widely used by adolescents and young adults (AYAs). Whether using disposable devices is associated with future e-cigarette use patterns is unknown but important for informing e-cigarette regulation. METHODS Prospective longitudinal study combining data from adolescent (14-17 years) and young adult (21-24 years) cohorts from Southern California surveyed at baseline and approximately 8-month follow-up during 2021 to 2022. The analyses included AYAs who used e-cigarettes in the past 30 days at baseline and had exposure and outcome data (N = 403; adolescent n = 124, young adult n = 279). RESULTS In the pooled sample of AYAs who used e-cigarettes at baseline (57.2% cis-gender female, 56.2% Hispanic), 278 (69.0%) reported past 30-day disposable e-cigarette use, and 125 (31.0%) used only nondisposable e-cigarettes. Baseline use of disposable (versus only nondisposable) devices was associated with higher odds of continued e-cigarette use (adjusted odds ratio = 1.92; 95% confidence interval = 1.09-3.42) and a greater number of times used e-cigarettes per day at follow-up (adjusted incidence rate ratio = 1.29; 95% confidence interval = 1.02-1.63). In supplemental analyses, disposable e-cigarette use was associated with greater odds of no changes (versus reductions) in e-cigarette use frequency and puffs per episode from baseline to follow-up but was not associated with increases in use frequency and intensity. No differences in e-cigarette use outcomes were found between those with poly-device (disposable and nondisposable) versus only disposable device use. CONCLUSIONS Use of disposable e-cigarette devices among AYAs may be associated with higher risks for persistent e-cigarette use patterns, which should be considered in tobacco product regulation designed to protect AYAs.
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Affiliation(s)
- Dae-Hee Han
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California
- Institute for Addiction Science, University of Southern California, Los Angeles, California
| | - Alyssa F Harlow
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California
- Institute for Addiction Science, University of Southern California, Los Angeles, California
| | | | | | - Jennifer B Unger
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California
- Institute for Addiction Science, University of Southern California, Los Angeles, California
| | - Steve Y Sussman
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California
- Institute for Addiction Science, University of Southern California, Los Angeles, California
- Department of Psychology
- School of Social Work, University of Southern California, Los Angeles, California
| | - Rob McConnell
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California
- Institute for Addiction Science, University of Southern California, Los Angeles, California
| | - Jessica L Barrington-Trimis
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California
- Institute for Addiction Science, University of Southern California, Los Angeles, California
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California
- Institute for Addiction Science, University of Southern California, Los Angeles, California
- Department of Psychology
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Harlow AF, Miech RA, Leventhal AM. Adolescent Δ8-THC and Marijuana Use in the US. JAMA 2024; 331:861-865. [PMID: 38470384 PMCID: PMC10933714 DOI: 10.1001/jama.2024.0865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/19/2024] [Indexed: 03/13/2024]
Abstract
Importance Gummies, flavored vaping devices, and other cannabis products containing psychoactive hemp-derived Δ8-tetrahydrocannabinol (THC) are increasingly marketed in the US with claims of being federally legal and comparable to marijuana. National data on prevalence and correlates of Δ8-THC use and comparisons to marijuana use among adolescents in the US are lacking. Objective To estimate the self-reported prevalence of and sociodemographic and policy factors associated with Δ8-THC and marijuana use among US adolescents in the past 12 months. Design, Setting, and Participants This nationally representative cross-sectional analysis included a randomly selected subset of 12th-grade students in 27 US states who participated in the Monitoring the Future Study in-school survey during February to June 2023. Exposures Self-reported sex, race, ethnicity, and parental education; census region; state-level adult-use (ie, recreational) marijuana legalization (yes vs no); and state-level Δ8-THC policies (regulated vs not regulated). Main Outcomes and Measures The primary outcome was self-reported Δ8-THC and marijuana use in the past 12 months (any vs no use and number of occasions used). Results In the sample of 2186 12th-grade students (mean age, 17.7 years; 1054 [48.9% weighted] were female; 232 [11.1%] were Black, 411 [23.5%] were Hispanic, 1113 [46.1%] were White, and 328 [14.2%] were multiracial), prevalence of self-reported use in the past 12 months was 11.4% (95% CI, 8.6%-14.2%) for Δ8-THC and 30.4% (95% CI, 26.5%-34.4%) for marijuana. Of those 295 participants reporting Δ8-THC use, 35.4% used it at least 10 times in the past 12 months. Prevalence of Δ8-THC use was lower in Western vs Southern census regions (5.0% vs 14.3%; risk difference [RD], -9.4% [95% CI, -15.2% to -3.5%]; adjusted risk ratio [aRR], 0.35 [95% CI, 0.16-0.77]), states in which Δ8-THC was regulated vs not regulated (5.7% vs 14.4%; RD, -8.6% [95% CI, -12.9% to -4.4%]; aRR, 0.42 [95% CI, 0.23-0.74]), and states with vs without legal adult-use marijuana (8.0% vs 14.0%; RD, -6.0% [95% CI, -10.8% to -1.2%]; aRR, 0.56 [95% CI, 0.35-0.91]). Use in the past 12 months was lower among Hispanic than White participants for Δ8-THC (7.3% vs 14.4%; RD, -7.2% [95% CI, -12.2% to -2.1%]; aRR, 0.54 [95% CI, 0.34-0.87]) and marijuana (24.5% vs 33.0%; RD, -8.5% [95% CI, -14.9% to -2.1%]; aRR, 0.74 [95% CI, 0.59-0.94]). Δ8-THC and marijuana use prevalence did not differ by sex or parental education. Conclusions and Relevance Δ8-THC use prevalence is appreciable among US adolescents and is higher in states without marijuana legalization or existing Δ8-THC regulations. Prioritizing surveillance, policy, and public health efforts addressing adolescent Δ8-THC use may be warranted.
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Affiliation(s)
- Alyssa F. Harlow
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles
- Institute for Addiction Science, University of Southern California, Los Angeles
- USC Norris Comprehensive Cancer Center, Los Angeles, California
| | - Richard A. Miech
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | - Adam M. Leventhal
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles
- Institute for Addiction Science, University of Southern California, Los Angeles
- USC Norris Comprehensive Cancer Center, Los Angeles, California
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Gimbrone C, Packard SE, Finsaas MC, Sprague NL, Jacobowitz A, Leventhal AM, Rundle AG, Keyes KM. Sex-Specific Depressive Symptom Trajectories Among Adolescents in Los Angeles County, 2013 to 2017. JAACAP Open 2024; 2:55-65. [PMID: 38469457 PMCID: PMC10927262 DOI: 10.1016/j.jaacop.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Objective After remaining stable for many years, the prevalence of depression among adolescents increased over the past decade, particularly among girls. In this study, we used longitudinal data from a cohort of high school students to characterize sex-specific trajectories of depressive symptoms during this period of increasing prevalence and widening gender gap in adolescent depression. Method Using data from the Health and Happiness Cohort, a longitudinal 8-wave study of high school students residing in Los Angeles County from 2013 to 2017 (N = 3,393), we conducted a multiple-group, latent class growth analysis by sex to differentiate developmental trajectories in depressive symptoms scores measured by the Center for Epidemiological Studies- Depression (CES-D) scale (range, 0-60). Results A 4-class solution provided the best model fit for both girls and boys. Trajectories among girls included low stable (35.1%), mild stable (42.8%), moderate decreasing (16.2%), and high arching (5.9%). Trajectories among boys included low stable (49.2%), mild increasing (34.7%), moderate decreasing (12.2%), and high increasing (3.9%). Average scores consistently exceeded or crossed the threshold for probable depression (≥16). Across comparable sex-specific trajectory groups, the average CES-D scores of girls were higher than those of boys, whose average scores increased over time. Conclusion In a diverse cohort of students in Los Angeles County, depressive symptom trajectories were comparable to prior time periods but with a higher proportion of students in trajectories characterized by probable depression. Trajectories differed by sex, suggesting that future research should consider differential severity and onset of depression between boys and girls.
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Affiliation(s)
- Catherine Gimbrone
- Ms. Gimbrone, Mr. Packard, Mr. Sprague, Ms. Jacobowitz, Dr. Rundle, and Dr. Keyes are with Columbia the Mailman School of Public Health, Columbia University. Dr. Leventhal is with the Institute for Addiction Science, University of Southern California. Dr. Finsaas is with the City College of New York
| | - Samuel E Packard
- Ms. Gimbrone, Mr. Packard, Mr. Sprague, Ms. Jacobowitz, Dr. Rundle, and Dr. Keyes are with Columbia the Mailman School of Public Health, Columbia University. Dr. Leventhal is with the Institute for Addiction Science, University of Southern California. Dr. Finsaas is with the City College of New York
| | - Megan C Finsaas
- Ms. Gimbrone, Mr. Packard, Mr. Sprague, Ms. Jacobowitz, Dr. Rundle, and Dr. Keyes are with Columbia the Mailman School of Public Health, Columbia University. Dr. Leventhal is with the Institute for Addiction Science, University of Southern California. Dr. Finsaas is with the City College of New York
| | - Nadav L Sprague
- Ms. Gimbrone, Mr. Packard, Mr. Sprague, Ms. Jacobowitz, Dr. Rundle, and Dr. Keyes are with Columbia the Mailman School of Public Health, Columbia University. Dr. Leventhal is with the Institute for Addiction Science, University of Southern California. Dr. Finsaas is with the City College of New York
| | - Ahuva Jacobowitz
- Ms. Gimbrone, Mr. Packard, Mr. Sprague, Ms. Jacobowitz, Dr. Rundle, and Dr. Keyes are with Columbia the Mailman School of Public Health, Columbia University. Dr. Leventhal is with the Institute for Addiction Science, University of Southern California. Dr. Finsaas is with the City College of New York
| | - Adam M Leventhal
- Ms. Gimbrone, Mr. Packard, Mr. Sprague, Ms. Jacobowitz, Dr. Rundle, and Dr. Keyes are with Columbia the Mailman School of Public Health, Columbia University. Dr. Leventhal is with the Institute for Addiction Science, University of Southern California. Dr. Finsaas is with the City College of New York
| | - Andrew G Rundle
- Ms. Gimbrone, Mr. Packard, Mr. Sprague, Ms. Jacobowitz, Dr. Rundle, and Dr. Keyes are with Columbia the Mailman School of Public Health, Columbia University. Dr. Leventhal is with the Institute for Addiction Science, University of Southern California. Dr. Finsaas is with the City College of New York
| | - Katherine M Keyes
- Ms. Gimbrone, Mr. Packard, Mr. Sprague, Ms. Jacobowitz, Dr. Rundle, and Dr. Keyes are with Columbia the Mailman School of Public Health, Columbia University. Dr. Leventhal is with the Institute for Addiction Science, University of Southern California. Dr. Finsaas is with the City College of New York
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Bello MS, Schulte AR, Ring CR, Cho J, Barrington-Trimis JL, Pang RD, Jao NC, Colby SM, Cassidy RN, Leventhal AM. Effects of mint, menthol, and tobacco-flavored e-cigarettes on tobacco withdrawal symptoms in adults who smoke menthol cigarettes: A laboratory pilot study. Drug Alcohol Depend 2024; 256:111110. [PMID: 38359606 PMCID: PMC10906679 DOI: 10.1016/j.drugalcdep.2024.111110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Menthol cigarette smoking has remained stable or increased in certain groups, despite an overall decline in cigarette smoking rates in the U.S. Understanding whether e-cigarettes alter patterns of menthol cigarette use is critical to informing efforts for reducing the public health burden of menthol cigarette smoking. This 2019-2020 laboratory pilot study evaluated whether self-administration of mint-, menthol-, or tobacco-flavored e-cigarettes would differentially impact tobacco withdrawal symptoms in e-cigarette-naïve adults who smoke menthol cigarettes daily. METHODS Participants (N=17; 35.3% Female; mean age=51.8) attended three laboratory sessions after 16-hours of tobacco abstinence. Participants self-administered a study-provided JUUL e-cigarette (0.7mL with 5% nicotine by weight) at each session in which flavor was manipulated (mint vs. menthol vs. tobacco; order randomized). Participants completed pre- and post-e-cigarette administration self-report assessments on smoking urges, nicotine withdrawal, and positive and negative affect states. Multilevel linear regression models tested differences between the three flavor conditions for individual study outcomes. RESULTS Following overnight tobacco abstinence, vaping either a mint or menthol (vs. tobacco) flavored e-cigarette led to significantly greater reductions in smoking urges over time; menthol (vs. tobacco) flavored e-cigarettes also suppressed urges to smoke for pleasure. Notably, no differences in nicotine withdrawal, positive affect, or negative affect were observed. CONCLUSIONS In this laboratory pilot study, mint and menthol (vs. tobacco) flavored e-cigarettes provided some negative reinforcement effects via acute reductions in smoking urges during tobacco abstinence, yet only menthol flavored e-cigarettes demonstrated suppressive effects on smoking urges for pleasure in adults who smoke menthol cigarettes daily.
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Affiliation(s)
- Mariel S Bello
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA.
| | - Alison R Schulte
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Colin R Ring
- Department of Psychology, Loma Linda University School of Behavioral Health, Loma Linda, CA, USA
| | - Junhan Cho
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA
| | - Jessica L Barrington-Trimis
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA
| | - Raina D Pang
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA
| | - Nancy C Jao
- Department of Psychology, Rosalind Franklin University of Medicine and Science, Chicago, IL, USA
| | - Suzanne M Colby
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA; Department of Psychiatry & Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Rachel N Cassidy
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA
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Dai HD, Subica A, Mattingly DT, Harlow A, Leventhal AM. Association of Race-Ethnicity Intersection with Disparities in Cigarette Smoking in US Adults. Nicotine Tob Res 2024:ntae041. [PMID: 38401167 DOI: 10.1093/ntr/ntae041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Indexed: 02/26/2024]
Abstract
BACKGROUND Detailed estimates of disparities in cigarette smoking across single- and multi-race groups and their intersections with ethnicity are lacking. This study estimates the prevalence of self-reported current smoking among intersecting adult race-ethnicity groups in the United States. METHODS The analysis uses 2018-2019 data from the Tobacco Use Supplement - Current Population Supplement (TUS-CPS; n=137,471). Self-reported Hispanic origin and race were recoded into 19 mutually-exclusive race by ethnicity intersecting groups. Weighted race-ethnicity group smoking prevalence were compared to the overall population prevalence and one another. RESULTS Compared to the US population current smoking prevalence (11.4% [95% CI=11.2%-11.6%]), smoking was particularly higher in non-Hispanic American Indian/Alaska Native (AI/AN) groups (20.7% [95% CI=17.8%-24.0%]) and non-Hispanic multiracial AI/AN/White (24.4% [95% CI = 20.3%-29.1%]) and AI/AN/Black (22.4% [95% CI = 14.4%-33.2%]) groups. Non-Hispanic single-race Asian (5.0% [95% CI = 4.4%-5.6%]) and Hispanic single-race White (7.2% [95% CI = 6.7%-7.7%]) smoking prevalence undercut the overall US population prevalence. In pairwise comparisons, smoking prevalence was higher in various non-Hispanic single- and multi-race AI/AN groups than non-AI/AN groups and was lower in various Hispanic groups than non-Hispanic groups. CONCLUSION Smoking prevalence disparities are not monolithic across complex diversity of race and ethnicity in the US. Accurate identification of priority populations in need of targeted tobacco control efforts may benefit by acknowledging multinomial heterogeneity across intersecting racial and ethnic identities. IMPLICATION Understanding racial and ethnic disparities in cigarette smoking can inform national strategies for reducing health inequities. This study examines cigarette smoking disparities among 19 adult intersecting race-ethnicity groups in the United States using the 2018-2019 TUS-CPS data. Results show higher smoking rates in some non-Hispanic American Indian/Alaska Native and Black groups, while lower rates are seen in Asian and Hispanic individuals. These findings emphasize the need for disaggregated data to tackle smoking disparities and guide targeted prevention efforts.
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Affiliation(s)
- Hongying Daisy Dai
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Andrew Subica
- School of Medicine, University of California, Riverside, CA, USA
| | - Delvon T Mattingly
- Center for Health Equity Transformation, College of Medicine, University of Kentucky, Lexington, KY, USA
- Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Alyssa Harlow
- USC Institute for Addiction Science, University of Southern California, Los Angeles, CA USA
- Department of Population and Public Health Sciences, University of Southern California, Keck School of Medicine, Los Angeles, CA USA
- USC Tobacco Center of Regulatory Science, University of Southern California, Los Angeles, CA USA
| | - Adam M Leventhal
- USC Institute for Addiction Science, University of Southern California, Los Angeles, CA USA
- Department of Population and Public Health Sciences, University of Southern California, Keck School of Medicine, Los Angeles, CA USA
- USC Norris Comprehensive Cancer Center, University of Southern California, Keck School of Medicine, Los Angeles, CA USA
- USC Tobacco Center of Regulatory Science, University of Southern California, Los Angeles, CA USA
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Harlow AF, Hendricks PS, Leventhal AM, Barrington-Trimis JL. Psychedelic Microdosing among Young Adults from Southern California. J Psychoactive Drugs 2024:1-12. [PMID: 38341607 DOI: 10.1080/02791072.2024.2313684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
Despite common depictions in the media, there is little scientific evidence on microdosing psychedelic drugs. We assessed awareness, prevalence, and dosing practices of microdosing psychedelic drugs among young adults 18-22 years old from Southern California (2018-2019). We examined whether sociodemographic factors, personality traits, mental health, or other substance use behaviors were correlated with having ever microdosed. Among 2,396 participants, 293 (12%) had heard of microdosing and 74 (3%) ever microdosed. Among those who had heard of microdosing, 79% correctly defined microdosing as taking an amount of a psychedelic much lower than a standard dose, whereas 15% misperceived microdosing as a standard psychedelic dose. Psilocybin was the most common drug ever microdosed (70%), followed by lysergic acid diethylamide (LSD, 57%). Among those who ever microdosed, ~18% reported using psychoactive doses far higher than would be generally considered a microdose. White race, male/masculine gender identity, bisexual identity, past 6-month other drug use, greater attention deficit/hyperactivity disorder symptoms, mindfulness, and sensation-seeking were positively associated with having ever microdosed in multivariable models. Young adult microdosing merits further attention from scientific and public health professionals to help prevent misperceptions and potential adverse consequences as well as explore its potential therapeutic applications.
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Affiliation(s)
- Alyssa F Harlow
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA
| | - Peter S Hendricks
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama School of Medicine, Birmingham, AL, USA
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA
| | - Jessica L Barrington-Trimis
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA
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Mason TB, Tackett AP, Leventhal AM. Indirect Effects of Body Mass Index and Sweet Taste Responsiveness on E-Cigarette Dependence: The Role of E-Cigarette Motives. Subst Use Misuse 2024; 59:608-615. [PMID: 38149796 PMCID: PMC10922687 DOI: 10.1080/10826084.2023.2294962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
Background: Recent research has shown obesity to be associated with e-cigarette use and appeal, but models have yet to examine how weight status may be related to e-cigarette dependence among e-cigarette users. Objectives: To increase our understanding of pathways from body mass index (BMI) to e-cigarette dependence, the present cross-sectional observational study investigated a model in which BMI, sweet taste responsiveness, and the interaction of BMI and sweet taste responsiveness are associated with e-cigarette dependence indirectly via seven conceptually-distinct motives for e-cigarette use. Data from several e-cigarette clinical laboratory research studies were pooled and analyzed; only current e-cigarette users were included in the analyses (N=330). Structural equation modeling was used to analyze the hypothesized model. Results: BMI was positively associated with lower social/environmental goad motives and higher weight control motives, and BMI x sweet taste interaction terms found that sweet taste responsiveness strengthened the association of BMI and weight control motives. BMI was not directly or indirectly associated with e-cigarette dependence nor was there a bivariate association between BMI and e-cigarette dependence. Sweet taste responsiveness was positively associated with greater affiliative attachment motives, cognitive enhancement motives, cue exposure-associative process motives, weight control motives, and affect enhancement motives. Sweet taste responsiveness was bivariately associated with e-cigarette dependence and mediation paths show indirect relations to e-cigarette dependence via three of the seven motives. Conclusions: The findings suggest that sweet taste responsiveness, opposed to BMI, is associated with a wider range of e-cigarette use motives and indirectly relates to e-cigarette dependence via several e-cigarette use motives.
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Affiliation(s)
- Tyler B. Mason
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA
- Institute for Addiction Science, University of Southern California, Los Angeles, CA
| | - Alayna P. Tackett
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA
- Institute for Addiction Science, University of Southern California, Los Angeles, CA
| | - Adam M. Leventhal
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA
- Institute for Addiction Science, University of Southern California, Los Angeles, CA
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11
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Mattingly DT, Mezuk B, Elliott MR, Neighbors HW, Leventhal AM, Fleischer NL. Distress about social problems and tobacco and cannabis use outcomes among young adults in Los Angeles County. Prev Med 2024; 179:107850. [PMID: 38199591 PMCID: PMC10843547 DOI: 10.1016/j.ypmed.2024.107850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 01/12/2024]
Abstract
OBJECTIVE To examine associations of concern, worry, and stress about discrimination, shootings/violence, and police brutality and exclusive and dual tobacco and cannabis use among young adults. METHODS A prospective, racially/ethnically diverse cohort of young adults (n = 1960) living in Los Angeles, California completed a baseline survey in 2020 (age range: 19-23) and a follow-up survey in 2021. Exploratory factor analysis (EFA) was employed on nine variables assessing levels of concern, worry, and stress about societal discrimination, societal shootings/violence, and community police brutality at baseline. Past 30-day tobacco and cannabis use at follow-up was categorized as current exclusive tobacco, exclusive cannabis, and dual tobacco and cannabis (vs never/former) use based on eleven use variables. Multinomial logistic regressions estimated adjusted associations between each factor score (translated to standard deviation units) with exclusive and dual tobacco and cannabis use. RESULTS The EFA produced four factor scores representing concern/worry/stress (i.e., distress) about community police brutality (F1), distress about societal shootings/violence (F2), and distress about societal discrimination (F3), as well as generalized stress about police brutality, shootings/violence, and discrimination (F4). F1, F2, and F3 were associated with subsequent exclusive current cannabis use, with F1 having the strongest association (OR: 1.35, 95% CI: 1.18-1.55), while only F1 (OR: 1.51, 95% CI: 1.27-1.78) was associated with dual tobacco and cannabis use. None of the factors were associated with exclusive tobacco use. CONCLUSIONS Young adult concern, worry, and/or stress about social problems may increase risk of cannabis use with or without concurrent tobacco use 6-12 months later.
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Affiliation(s)
- Delvon T Mattingly
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY 40536, USA; Center for Health Equity Transformation, University of Kentucky College of Medicine, Lexington, KY 40536, USA.
| | - Briana Mezuk
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Michael R Elliott
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI 48104, USA
| | - Harold W Neighbors
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA 90089, USA; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90089, USA; Institute for Addiction Science, University of Southern California, Los Angeles, CA 90089, USA
| | - Nancy L Fleischer
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
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Guillot CR, Pang RD, Vilches JR, Arnold ML, Cajas JO, Alemán AM, Leventhal AM. Longitudinal associations between anxiety sensitivity and substance use in adolescents: Mediation by depressive affect. Exp Clin Psychopharmacol 2024; 32:90-103. [PMID: 37358544 PMCID: PMC10749990 DOI: 10.1037/pha0000668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Though anxiety sensitivity (AS)-fear of anxiety-related experiences-is primarily tied to anxiety vulnerability, AS has also been prospectively associated with general negative affect and depression. Furthermore, depression has been longitudinally associated with different forms of substance use, and some AS subfactors (e.g., cognitive concerns) have been associated more consistently with depression and substance use than others. However, no previous study has investigated if longitudinal associations of AS with substance use may be mediated by depression or whether aspects of AS may be prospectively associated with substance use among adolescents. Hence, the present study tested depressive affect (the negative affective aspect of depression) as a prospective mediator of AS associations with substance use and examined longitudinal AS subfactor associations with substance use and problems. High school 9th graders (N = 2,877; Mage = 14.1 years; 55.3% female) completed self-report measures at baseline and at 6 months and 1 year later. Depressive affect mediated AS associations with subsequent alcohol, cigarette, electronic cigarette, cannabis, benzodiazepine, and opioid use. Also, AS cognitive and social concerns (vs. physical concerns) were more consistently associated with later depressive affect and substance use and problems. Current findings suggest that adolescents high in anxiety sensitivity tend to prospectively experience greater depressive affect, which in turn is related to a higher likelihood of engaging in several different forms of substance use. Thus, it is possible that interventions which target AS (particularly AS cognitive concerns) may help to treat or prevent depression and substance use among adolescents. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | - Raina D Pang
- Department of Population and Public Health Sciences, University of Southern California
| | | | | | | | | | - Adam M Leventhal
- Department of Population and Public Health Sciences, University of Southern California
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13
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Harlow AF, Liu F, Young LE, Coreas SI, Rahman T, Unger JB, Leventhal AM, Barrington-Trimis JL, Krueger EA. Sexual and Gender Identity Disparities in Nicotine and Tobacco Use Susceptibility and Prevalence: Disaggregating Emerging Identities Among Adolescents From California, USA. Nicotine Tob Res 2024; 26:203-211. [PMID: 37493636 PMCID: PMC10803110 DOI: 10.1093/ntr/ntad131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/18/2023] [Accepted: 07/24/2023] [Indexed: 07/27/2023]
Abstract
INTRODUCTION Prior studies report nicotine/tobacco use disparities for sexual and gender minority (SGM) youth but have insufficiently characterized SGM identity diversity. AIMS AND METHODS Adolescents (mean age = 15.2) from 11 high schools in Southern California completed surveys in Fall 2021. Ever use of combustible (cigarettes, cigars, hookah) and noncombustible (e-cigarettes, e-hookah, heated tobacco, smokeless/snus, oral nicotine) nicotine/tobacco (among overall sample, n = 3795) and susceptibility to future initiation of cigarettes, e-cigarettes, and flavored non-tobacco oral nicotine (among n = 3331 tobacco-naïve youth) were compared across four gender (male/masculine, female/feminine, transgender male/female, non-binary) and seven sexual (heterosexual, bisexual, pansexual, queer, questioning, gay/lesbian, asexual) identities. RESULTS Non-binary (vs. cisgender male) youth had greater prevalence of ever combustible (prevalence ratio [PR] = 2.86, 95% confidence intervals (CI): 1.76 to 4.66) and non-combustible (PR = 1.94, 95% CI: 1.31 to 2.86) nicotine/tobacco use, and susceptibility to future nicotine/tobacco initiation (PR range = 2.32-2.68). Transgender (vs. cisgender male) youth had greater susceptibility to nicotine/tobacco use (PR range = 1.73-1.95), but not greater tobacco use prevalence. There was greater prevalence of non-combustible nicotine/tobacco use (PR range = 1.78-1.97) and susceptibility to nicotine/tobacco initiation (PR range = 1.36-2.18) for all sexual minority (vs. heterosexual) identities, except for asexual. Bisexual (PR = 2.03, 95% CI: 1.30 to 3.16) and queer (PR = 2.87, 95% CI: 1.31 to 6.27) youth had higher ever combustible tobacco use than heterosexual youth. Questioning (vs. heterosexual) youth were more susceptible to future tobacco initiation (PR range = 1.36-2.05) but did not differ in ever use. CONCLUSIONS Disparities in nicotine/tobacco use and susceptibility were present with similar effect sizes across most, but not all, SGM identities. Inclusive measurement of SGM identities in research and surveillance may inform more precise tobacco control efforts to reduce disparities. IMPLICATIONS Among high school students from Southern California with substantial diversity in sexual and gender identities, there was greater prevalence of tobacco use and susceptibility to future tobacco initiation for most, but not all, sexual and gender minority youth, including those with emerging sexual and gender identities such as non-binary, queer and pansexual. Additionally, findings indicate that tobacco control initiatives targeting youth who are questioning their sexual identities may be particularly important for preventing tobacco use initiation. This study reinforces the importance of measuring diversity within the LGBTQ + community for tobacco use research, and highlights how inclusive measurement can inform more precise tobacco control interventions.
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Affiliation(s)
- Alyssa F Harlow
- University of Southern California, Department of Population and Public Health Sciences, Los Angeles, CA, USA
- University of Southern California, Institute for Addiction Science, Los Angeles, CA, USA
| | - Fei Liu
- University of Southern California, Department of Population and Public Health Sciences, Los Angeles, CA, USA
| | - Lindsay E Young
- University of Southern California, Institute for Addiction Science, Los Angeles, CA, USA
- University of Southern California, Annenberg School for Communication and Journalism, Los Angeles, CA, USA
| | - Saida I Coreas
- University of Southern California, Department of Population and Public Health Sciences, Los Angeles, CA, USA
| | - Tahsin Rahman
- University of Southern California, Department of Population and Public Health Sciences, Los Angeles, CA, USA
| | - Jennifer B Unger
- University of Southern California, Department of Population and Public Health Sciences, Los Angeles, CA, USA
- University of Southern California, Institute for Addiction Science, Los Angeles, CA, USA
| | - Adam M Leventhal
- University of Southern California, Department of Population and Public Health Sciences, Los Angeles, CA, USA
- University of Southern California, Institute for Addiction Science, Los Angeles, CA, USA
| | - Jessica L Barrington-Trimis
- University of Southern California, Department of Population and Public Health Sciences, Los Angeles, CA, USA
- University of Southern California, Institute for Addiction Science, Los Angeles, CA, USA
| | - Evan A Krueger
- Tulane University, School of Social Work, New Orleans, LA, USA
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14
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Han DH, Davis JP, Davies DL, Clapp JD, Pedersen ER, Leventhal AM. Association of over the counter "hangover remedy" use with alcohol use problems and consumption patterns among young adults. Alcohol Alcohol 2024; 59:agad081. [PMID: 38016799 PMCID: PMC10794163 DOI: 10.1093/alcalc/agad081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 10/12/2023] [Accepted: 10/27/2023] [Indexed: 11/30/2023] Open
Abstract
This cross-sectional study of young adults examined associations of hangover remedy use with alcohol use problems. Results suggest that ever-use of hangover remedy products was positively associated with alcohol use problem score, drinks per typical drinking day, and alcohol use disorder symptom count. Use of hangover remedies among young adults merits further scientific and regulatory attention.
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Affiliation(s)
- Dae-Hee Han
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
- Institute for Addiction Science, University of Southern California, Los Angeles, CA, United States
| | - Jordan P Davis
- Institute for Addiction Science, University of Southern California, Los Angeles, CA, United States
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
| | - Daryl L Davies
- Institute for Addiction Science, University of Southern California, Los Angeles, CA, United States
- Titus Family Department of Clinical Pharmacy, School of Pharmacy, University of Southern California, Los Angeles, CA, United States
| | - John D Clapp
- Institute for Addiction Science, University of Southern California, Los Angeles, CA, United States
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
| | - Eric R Pedersen
- Institute for Addiction Science, University of Southern California, Los Angeles, CA, United States
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
- Institute for Addiction Science, University of Southern California, Los Angeles, CA, United States
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
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15
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Vogel EA, Tackett AP, Unger JB, Gonzalez MJ, Peraza N, Jafarzadeh NS, Page MK, Goniewicz ML, Wong M, Leventhal AM. Effects of flavour and modified risk claims on nicotine pouch perceptions and use intentions among young adults who use inhalable nicotine and tobacco products: a randomised controlled trial. Tob Control 2023:tc-2023-058382. [PMID: 38148143 DOI: 10.1136/tc-2023-058382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 12/13/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND Availability of flavours and potential modified risk tobacco product (MRTP) claims may influence young adults' (YAs') perceptions of and intentions to use nicotine pouches ('pouches'). METHODS YAs aged 21-34 years (N=47, M age=24.5, SD=3.1) with past-month nicotine/tobacco use (10.6% cigarette-only, 51.1% e-cigarette-only, 38.3% dual use) and no intention to quit were randomised to self-administer four Zyn 3 mg nicotine pouches in a 4 (flavour; within-subjects: smooth, mint, menthol, citrus) × 2 (MRTP claim on packaging; between subjects: present or absent) mixed-factorial design. After self-administering each pouch, participants reported appeal, use intentions and perceived harm compared with cigarettes and e-cigarettes. Three mixed-factorial analysis of variances (ANOVAs) examined main and interactive effects of flavour and MRTP claim on appeal, use intentions and comparative harm perceptions. RESULTS Mint (M=55.9, SD=26.4), menthol (M=49.7, SD=26.8) and citrus (M=46.6, SD=24.8) flavours were significantly more appealing than smooth (M=37.6, SD=25.4; p<0.001). MRTP claim did not significantly affect product appeal (p=0.376). Use intentions were greater for mint (M=2.6, SD=1.3) and menthol (M=2.0, SD=1.1) flavours than smooth (M=1.8, SD=1.0; p=0.002). Flavour did not affect comparative harm perceptions (p values>0.418). MRTP claims increased use intention (p=0.032) and perceptions of pouches as less harmful than cigarettes (p=0.011), but did not affect perceived harm relative to e-cigarettes (p=0.142). Flavour × MRTP claim interactions were not significant. CONCLUSIONS Flavoured (vs smooth) pouches were more appealing to YAs. MRTP claims reduced perceived harm of pouches compared with cigarettes; however, intentions to switch were low. To protect YAs' health, regulatory restrictions could target flavours and MRTP claims.
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Affiliation(s)
- Erin A Vogel
- TSET Health Promotion Research Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Alayna P Tackett
- Center for Tobacco Research, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Jennifer B Unger
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Maria J Gonzalez
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Natalia Peraza
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
| | - Nikki S Jafarzadeh
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
| | - Michelle K Page
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Melissa Wong
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
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Harlow AF, Han DH, Eckel SP, McConnell R, Leventhal AM, Barrington-Trimis JL. The interaction of e-cigarette use and mental health symptoms on risk of cigarette smoking initiation among young adults in the United States. Addiction 2023; 118:2317-2326. [PMID: 37620973 PMCID: PMC10783200 DOI: 10.1111/add.16319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 07/04/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND AND AIMS It is unknown whether young adults who vape nicotine and have poor mental health have greater risk of smoking initiation than expected based on individual risks of vaping and mental health alone. This study aimed to estimate the joint association of vaping and mental health symptoms with smoking initiation among young adults, and test for additive interaction between vaping and mental health in smoking initiation risk. DESIGN Using five waves of the Population Assessment of Tobacco and Health (wave 1, 2013-2014; wave 2, 2014-2015; wave 3, 2015-2016; wave 4, 2016-2018; wave 5, 2018-2019), we estimated risk differences (RD) for the association of time-varying and time-lagged vaping and internalizing (e.g., anxiety, depressive) and externalizing (e.g., inattention/hyperactivity) mental health symptoms with cigarette smoking initiation at follow-up, over four 1-year intervals. We calculated interaction contrasts (IC) to estimate the excess risk of smoking initiation attributable to the interaction of vaping and mental health symptoms. SETTING United States. PARTICIPANTS A total of 6908 cigarette-naïve individuals aged 18-24 years. MEASUREMENTS Exposures included current (past-30 day) vaping and internalizing and externalizing mental health symptoms (high vs moderate/low symptoms). The outcome was smoking initiation (ever cigarette use) after 1 year. FINDINGS The per-interval risk of smoking initiation was 7.6% (1039 cases/13 712 person-intervals). Compared with noncurrent vaping and moderate/low mental health symptoms, adjusted RDs for current vaping and high mental health symptoms were 17.2% (95% confidence interval [CI]: 7.2% to 27.3%) for internalizing and 18.7% (95%CI: 8.1% to 29.2%) for externalizing symptoms. The excess risk attributed to interaction of current vaping and high externalizing symptoms was IC = 11.3% (95%CI: 1.3% to 21.2%; P = 0.018), with inconclusive findings for internalizing symptoms (IC = 7.7% [95%CI: -2.2% to 17.7%; P = 0.097]). CONCLUSIONS There is possible, but inconclusive, superadditivity between vaping and mental health in risk of smoking initiation among young adults in the United States.
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Affiliation(s)
- Alyssa F. Harlow
- University of Southern California, Department of Population and Public Health Sciences, Institute for Addiction Science, Los Angeles, CA, USA
| | - Dae-Hee Han
- University of Southern California, Department of Population and Public Health Sciences, Institute for Addiction Science, Los Angeles, CA, USA
| | - Sandrah P. Eckel
- University of Southern California, Department of Population and Public Health Sciences, Institute for Addiction Science, Los Angeles, CA, USA
| | - Rob McConnell
- University of Southern California, Department of Population and Public Health Sciences, Institute for Addiction Science, Los Angeles, CA, USA
| | - Adam M. Leventhal
- University of Southern California, Department of Population and Public Health Sciences, Institute for Addiction Science, Los Angeles, CA, USA
| | - Jessica L. Barrington-Trimis
- University of Southern California, Department of Population and Public Health Sciences, Institute for Addiction Science, Los Angeles, CA, USA
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17
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Bello MS, Zhang Y, Cho J, Kirkpatrick MG, Pang RD, Oliver JA, Webb Hooper M, Barrington-Trimis JL, Ahluwalia JS, Leventhal AM. Nicotine deprivation amplifies attentional bias toward racial discrimination stimuli in African American adults who smoke cigarettes. Exp Clin Psychopharmacol 2023; 31:1023-1031. [PMID: 37535524 PMCID: PMC10837307 DOI: 10.1037/pha0000662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
High smoking prevalence and low quit smoking rates among African American adults are well-documented, but poorly understood. We tested a transdisciplinary theoretical model of psychopharmacological-social mechanisms underlying smoking among African American adults. This model proposes that nicotine's acute attention-filtering effects may enhance smoking's addictiveness in populations unduly exposed to discrimination, like African American adults, because nicotine reduces the extent to which discrimination-related stimuli capture attention, and in turn, generate distress. During nicotine deprivation, attentional biases toward discrimination may be unmasked and exacerbated, which may induce distress and perpetuate smoking. To test this model, this within-subject laboratory experiment determined whether attentional bias toward racial discrimination stimuli was amplified by nicotine deprivation in African American adults who smoked daily. Participants (N = 344) completed a computerized modified Stroop task assessing attentional interference from racial discrimination-related words during two counterbalanced sessions (nicotine sated vs. overnight nicotine deprived). The task required participants to quickly name the color of discrimination and matched neutral words. Word Type (Discrimination vs. Neutral) × Pharmacological State (Nicotine Deprived vs. Sated) effects on color naming reaction times were examined. Attentional bias toward racial discrimination-related stimuli was amplified in nicotine deprived (reaction time to discrimination minus neutral stimuli: M [95%CI] = 34.69 [29.62, 39.76] ms; d = 0.15) compared to sated (M [95%CI] = 24.88 [19.84, 29.91] ms; d = 0.11) conditions (Word Type × Pharmacological State, p < .0001). The impact of nicotine deprivation on attentional processes in the context of adverse societal conditions merit consideration in future science and intervention addressing smoking in African American adults. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Mariel S Bello
- Department of Behavioral and Social Sciences, School of Public Health, Brown University
| | - Yi Zhang
- Department of Epidemiology and Biostatistics, University of Arizona
| | - Junhan Cho
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California
| | - Matthew G Kirkpatrick
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California
| | - Raina D Pang
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California
| | - Jason A Oliver
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center
| | | | - Jessica L Barrington-Trimis
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California
| | - Jasjit S Ahluwalia
- Department of Behavioral and Social Sciences, School of Public Health, Brown University
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California
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Tackett AP, Han DH, Peraza N, Whaley RC, Mason T, Cahn R, Hong K, Pang R, Monterosso J, Page MK, Goniewicz ML, Leventhal AM. Effects of 'Ice' flavoured e-cigarettes with synthetic cooling agent WS-23 or menthol on user-reported appeal and sensory attributes. Tob Control 2023:tc-2023-058125. [PMID: 37940405 DOI: 10.1136/tc-2023-058125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 10/24/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND This clinical experiment tested the effects of exposure to e-cigarettes with WS-23 or menthol cooling additives on user appeal and sensory attributes, and, secondarily, whether WS-23 effects generalised across base characterising flavour, nicotine concentration, or nicotine/tobacco product use status. METHODS In this within-participant double-blind experiment, adult tobacco/nicotine users administered standardised puffs of 18 different e-cigarette solutions in randomised sequences using a pod-style device. Each of three base characterising e-cigarette flavour solutions ('bold tobacco', 'mango,' 'wintergreen') in both 2% and 4% concentrations of nicotine benzoate salt were manipulated by adding either: (1) Menthol (0.5%), (2) WS-23 (0.75%) or (3) No cooling agent. After each administration, participants rated 3 appeal and 5 sensory attributes (0-100 scales). RESULTS Participants (n=84; M(SD)=38.6 (13.6) years old) were either exclusive e-cigarette (25.0%), cigarette (36.9%) or dual (38.1%) users. WS-23 versus no coolant products produced higher liking, willingness to use again, smoothness, and coolness and lower disliking, bitterness, and harshness ratings (|B|difference range: 4.8 to 20.1; ps<0.005). Menthol (vs no coolant) increased willingness to use again and reduced harshness and coolness (ps<0.05). Flavours with WS-23 (vs menthol) were rated as smoother, cooler and less harsh (ps<0.05). Coolant effects did not differ by base flavour, nicotine concentration, or tobacco use status. CONCLUSIONS Adding synthetic coolant WS-23 to e-cigarettes appears to make the vaping user experience more appealing, regardless of characterising base flavour. Regulatory agencies should be aware that the manufacturing process of adding synthetic coolants may increase the attractiveness of various e-cigarette products.Cite Now.
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Affiliation(s)
- Alayna P Tackett
- Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Dae Hee Han
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
- Institute for Addiction Science, Univeresity of Southern California, Los Angeles, CA, USA
| | - Natalia Peraza
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Reid C Whaley
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Tyler Mason
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Rael Cahn
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Kurt Hong
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California, USA
- Department of Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Raina Pang
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - John Monterosso
- Institute for Addiction Science, Univeresity of Southern California, Los Angeles, CA, USA
- Department of Psychology, University of Southern California, Los Angeles, California, USA
| | - Michelle K Page
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Maciej Lukasz Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
- Institute for Addiction Science, Univeresity of Southern California, Los Angeles, CA, USA
- Department of Psychology, University of Southern California, Los Angeles, California, USA
- USC Norris Comprehensive Cancer Center, Los Angeles, CA, USA
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Leventhal AM, Tackett AP, Whitted L, Jordt SE, Jabba SV. Ice flavours and non-menthol synthetic cooling agents in e-cigarette products: a review. Tob Control 2023; 32:769-777. [PMID: 35483721 PMCID: PMC9613790 DOI: 10.1136/tobaccocontrol-2021-057073] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 04/19/2022] [Indexed: 01/21/2023]
Abstract
E-cigarettes with cooling flavours have diversified in ways that complicate tobacco control with the emergence of: (1) Ice-hybrid flavours (eg, 'Raspberry Ice') that combine cooling and fruity/sweet properties; and (2) Products containing non-menthol synthetic cooling agents (eg, Wilkinson Sword (WS), WS-3, WS-23 (termed 'koolada')). This paper reviews the background, chemistry, toxicology, marketing, user perceptions, use prevalence and policy implications of e-cigarette products with ice-hybrid flavours or non-menthol coolants. Scientific literature search supplemented with industry-generated and user-generated information found: (a) The tobacco industry has developed products containing synthetic coolants since 1974, (b) WS-3 and WS-23 are detected in mass-manufactured e-cigarettes (eg, PuffBar); (c) While safe for limited oral ingestion, inhalational toxicology and health effects from daily synthetic coolant exposure are unknown and merit scientific inquiry and attention from regulatory agencies; (d) Ice-hybrid flavours are marketed with themes incorporating fruitiness and/or coolness (eg, snow-covered raspberries); (e) WS-23/WS-3 concentrates also are sold as do-it-yourself additives, (f) Pharmacology research and user-generated and industry-generated information provide a premise to hypothesise that e-cigarette products with ice flavours or non-menthol cooling agents generate pleasant cooling sensations that mask nicotine's harshness while lacking certain aversive features of menthol-only products, (g) Adolescent and young adult use of e-cigarettes with ice-hybrid or other cooling flavours may be common and cross-sectionally associated with more frequent vaping and nicotine dependence in convenience samples. Evidence gaps in the epidemiology, toxicology, health effects and smoking cessation-promoting potential of using these products exist. E-cigarettes with ice flavours or synthetic coolants merit scientific and regulatory attention.
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Affiliation(s)
- Adam M Leventhal
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
| | - Alayna P Tackett
- Department of Preventive Medicine, Keck School of Medicine University of Southern California, Los Angeles, California, USA
| | - Lauren Whitted
- Department of Preventive Medicine, Keck School of Medicine University of Southern California, Los Angeles, California, USA
| | - Sven Eric Jordt
- Anesthesiology, Duke University School of Medicine, Durham, North Carolina, USA
- Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Sairam V Jabba
- Anesthesiology, Duke University School of Medicine, Durham, North Carolina, USA
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20
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Hacker KJ, Chen-Sankey J, Leventhal AM, Choi K. Concern for Police Brutality, Societal Discrimination, and School Shootings and Subsequent Cigarette and Cannabis Use in Los Angeles County Hispanic and Non-Hispanic White Youth: a Longitudinal Study. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01787-z. [PMID: 37725252 DOI: 10.1007/s40615-023-01787-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVE Examine if concerns for police brutality, societal discrimination, and school shootings relate to subsequent cigarette and cannabis use among Hispanic and non-Hispanic White (NHW) youth. Hispanic youth may be particularly vulnerable to such concern. METHODS Data are from the University of Southern California's Happiness and Health Survey, a prospective cohort study, which followed Hispanic (N = 1007) and NHW (N = 251) students from ten inner-city and suburban high schools in Los Angeles County, starting from 2013 until 2019. Participants reported concern, worry, and stress levels regarding police brutality, societal discrimination, and school shootings. Four categories were created to indicate levels of each concern variable over time (consistently low, decreased, increased, and consistently high). Associations with past-30-day cannabis, blunt, THC-oil, and cigarette use in 2019 were assessed. Separate models for each racial/ethnic category were used. RESULTS Among Hispanic participants, reporting consistently high concern about police brutality (vs. consistently low concern) was associated with higher odds to subsequently smoke cannabis (aOR = 1.69, 95% CI = 1.18-2.40), smoke blunts (aOR = 1.63, 95% CI = 1.11-2.39), and vape THC-oil (aOR = 1.67, 95% CI = 1.14-2.44). Hispanic participants who reported consistently high concern for societal discrimination also had higher odds (vs. consistently low concern) to subsequently smoke blunts (aOR = 1.54, 95% CI = 1.04-2.29) and vape THC-oil (aOR = 1.65, 95% CI = 1.12-2.43). Among NHW participants, increasing concern over school shootings (vs. consistently low concern) was associated with higher odds to subsequently smoke cannabis (aOR = 2.98, 95% CI = 1.08-7.70). CONCLUSIONS Concerns for police brutality, societal discrimination, and school shootings were associated with cannabis use especially among Hispanic participants. Providing Hispanic youth with healthy coping strategies may reduce cannabis use.
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Affiliation(s)
- Kiana J Hacker
- National Institute on Minority Health and Health Disparities Division of Intramural Research, 9000 Rockville Pike, Bethesda, MD, 20892, USA.
| | - Julia Chen-Sankey
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, Newark, USA
| | - Adam M Leventhal
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA
- Department of Psychology, University of Southern California, Los Angeles, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, USA
| | - Kelvin Choi
- National Institute on Minority Health and Health Disparities Division of Intramural Research, 9000 Rockville Pike, Bethesda, MD, 20892, USA
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21
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Kechter A, Wong M, Mason TB, Tackett AP, Smith CE, Leventhal AM, Dunton GF, Barrington-Trimis JL. E-cigarette weight and appetite control beliefs and e-cigarette initiation in young adults. Health Psychol 2023; 42:668-673. [PMID: 37347927 PMCID: PMC10527852 DOI: 10.1037/hea0001298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
E-cigarette use has increased among young adults, and emerging research suggests a subset of young adults report using e-cigarettes for appetite control/weight loss. The current article examined the association of e-cigarette weight control beliefs with subsequent e-cigarette initiation. Data were collected via online surveys from a prospective cohort study of young adults in Southern California (N = 1,368) at baseline (May-October 2020; M [SD]age = 21.2 [0.4]) and 6 months later (January-May 2021). Binary logistic regression models were used to evaluate the association of e-cigarette weight control beliefs (i.e., perceptions that e-cigarettes help people lose weight and satisfy hunger and desire to eat unhealthy foods) with new onset e-cigarette use at follow-up. All models were adjusted for sociodemographic characteristics. Among individuals who had never used e-cigarettes at baseline, those who agreed (vs. disagreed) that e-cigarettes help people lose weight had more than three times the odds of initiating e-cigarette use by follow-up (OR [95% CI]: 3.24 [1.52, 6.62]). Similarly, those who agreed (vs. disagreed) that vaping certain e-cigarette flavors help satisfy hunger and desire to eat unhealthy foods had more than twice the odds of initiating e-cigarette use by follow-up (OR [95% CI]: 2.40 [1.15, 4.82]). Findings highlight that e-cigarette weight control beliefs are an important risk factor for vaping initiation. Future interventions and policies aiming to prevent vaping among young adults should address e-cigarette weight control beliefs and long-term health consequences from related use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Afton Kechter
- Department of Population and Public Health Sciences, University of Southern California
| | - Melissa Wong
- Department of Population and Public Health Sciences, University of Southern California
| | - Tyler B Mason
- Department of Population and Public Health Sciences, University of Southern California
| | - Alayna P Tackett
- Department of Population and Public Health Sciences, University of Southern California
| | - Caitlin E Smith
- Department of Psychiatry, Yale University School of Medicine
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, University of Southern California
| | - Genevieve F Dunton
- Department of Population and Public Health Sciences, University of Southern California
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22
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Biernacki K, Molokotos E, Han C, Dillon DG, Leventhal AM, Janes AC. Enhanced decision-making in nicotine dependent individuals who abstain: A computational analysis using Hierarchical Drift Diffusion Modeling. Drug Alcohol Depend 2023; 250:110890. [PMID: 37480798 PMCID: PMC10530296 DOI: 10.1016/j.drugalcdep.2023.110890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/26/2023] [Accepted: 07/04/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Variability in decision-making capacity and reward responsiveness may underlie differences in the ability to abstain from smoking. Computational modeling of choice behavior, as with the Hierarchical Drift Diffusion Model (HDDM), can help dissociate reward responsiveness from underlying components of decision-making. Here we used the HDDM to identify which decision-making or reward-related parameters, extracted from data acquired in a reward processing task, contributed to the ability of people who smoke that are not seeking treatment to abstain from cigarettes during a laboratory task. METHODS 80 adults who smoke cigarettes completed the Probabilistic Reward Task (PRT) - a signal detection task with a differential reinforcement schedule - following smoking as usual, and the Relapse Analogue Task (RAT) - a task in which participants could earn money for delaying smoking up to 50min - after a period of overnight abstinence. Two cohorts were defined by the RAT; those who waited either 0-min (n=36) or the full 50-min (n=44) before smoking. RESULTS PRT signal detection metrics indicated all subjects learned the task contingencies, with no differences in response bias or discriminability between the two groups. However, HDDM analyses indicated faster drift rates in 50-min vs. 0-min waiters. CONCLUSIONS Relative to those who did not abstain, computational modeling indicated that people who abstained from smoking for 50min showed faster evidence accumulation during reward-based decision-making. These results highlight the importance of decision-making mechanisms to smoking abstinence, and suggest that focusing on the evidence accumulation process may yield new targets for treatment.
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Affiliation(s)
- Kathryn Biernacki
- National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD21224, United States.
| | - Elena Molokotos
- Suffolk University, Boston, MA02116, United States; CBTeam, Lexington, MA02421, United States
| | - Chungmin Han
- National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD21224, United States
| | - Daniel G Dillon
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA02478, United States; Harvard Medical School, Boston, MA02115, United States
| | - Adam M Leventhal
- Institute for Addiction Science, University of Southern California, Los Angeles, CA90033, United States
| | - Amy C Janes
- National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD21224, United States
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23
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Akbari M, Seydavi M, Chasson GS, Leventhal AM, Lockwood MI. Global prevalence of smoking among individuals with obsessive-compulsive disorder and symptoms: a systematic review and meta-analysis. Health Psychol Rev 2023; 17:505-519. [PMID: 36173036 PMCID: PMC10495108 DOI: 10.1080/17437199.2022.2125037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 09/09/2022] [Indexed: 11/04/2022]
Abstract
Disease from nicotine dependency continues to be a leading cause of preventable death worldwide, and therefore research that elucidates potential correlates of tobacco use may facilitate the advancement of research, clinical practice, and policy in this area to target this public health challenge. One potential tobacco use correlate is obsessive-compulsive disorder (OCD) phenomena. The growing research evidence on the association between tobacco use and OCD phenomena is mixed, making it difficult to synthesize extant findings into meaningful conclusions. Indeed, there has never been a systematic review or meta-analysis of this area of research. To this end, a systematic review was carried out with studies between 1988 and 2021, and from this review, 71 independent estimations (n = 10,475; Females = 51.95%; mean age = 37.29, SD = 13.78) were extracted for meta-analysis. We found that about three in ten participants with OCD are likely to use tobacco, which is higher than the general population. The prevalence was the same among OCD participants at all levels (those with symptomology but no confirmed diagnosis, those surpassing a clinical cutoff for OCD but no confirmed diagnosis, and those with a confirmed OCD diagnosis). The results also indicated considerable variability across study results and a wide confidence interval associated with the tobacco use prevalence rate among those with OCD phenomena. The findings provide support for continued study of this comorbidity, perhaps with longitudinal and experimental designs to test for reciprocal associations between tobacco use and OCD phenomena in the service of targeting nicotine dependence as a substantial global public health concern.
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Affiliation(s)
- Mehdi Akbari
- Department of Clinical Psychology, Faculty of Psychology and Education, Kharazmi University, Tehran, Iran
| | - Mohammad Seydavi
- Department of Clinical Psychology, Faculty of Psychology and Education, Kharazmi University, Tehran, Iran
| | - Gregory S. Chasson
- Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA
| | - Adam M. Leventhal
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- USC Norris Cancer Center, University of Southern California, Los Angeles, CA, USA
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
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24
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Affiliation(s)
- Brian P Lee
- Division of Gastroenterology and Liver Diseases, University of Southern California Keck School of Medicine, and Institute for Addiction Science, University of Southern California, Los Angeles, California
| | - Jennifer L Dodge
- Division of Gastroenterology and Liver Diseases and Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Wendy J Mack
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Adam M Leventhal
- Institute for Addiction Science, University of Southern California, and Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Norah A Terrault
- Division of Gastroenterology and Liver Diseases, University of Southern California Keck School of Medicine, and Institute for Addiction Science, University of Southern California, Los Angeles, California
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25
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Tran DD, Davis JP, Ring C, Wang J, Fitzke RE, Leventhal AM, Pedersen ER. Associations between depression, stress, and e-cigarette use among OEF/OIF veterans. Mil Psychol 2023; 35:245-251. [PMID: 37133546 PMCID: PMC10156999 DOI: 10.1080/08995605.2022.2114278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 08/12/2022] [Indexed: 10/15/2022]
Abstract
The COVID-19 pandemic has had profound mental and behavioral health implications for the general U.S. population. However, little is known regarding outcomes for U.S. veterans, who represent a population with high rates of depression, stress, and e-cigarette use. One month prior to the pandemic-related closures (February 2020), 1230 OEF/OIF veterans (ages 18-40) completed an online baseline survey. Six months later, participants completed a follow-up survey (83% retention rate). Hierarchical negative binomial regressions were used to examine the relationship between baseline depression and past 30-day e-cigarette use at follow-up and whether baseline stress moderated this relationship. Veterans who screened positive for depression or who endorsed higher stress levels reported greater e-cigarette use at follow-up. Stress also moderated the relationship between depression and e-cigarette use, such that regardless of stress levels, a positive depression screen was associated with greater rates of later e-cigarette use. However, for those with a negative depression screen, higher stress levels were associated with greater e-cigarette use relative to lower stress levels. Veterans with pre-pandemic depression and stress may be at highest risk for e-cigarette use. Ongoing assessment and treatment for depression and promoting stress management skills for veterans in e-cigarette use prevention and intervention programs may be valuable.
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Affiliation(s)
- Denise D. Tran
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Jordan P. Davis
- Suzanne Dworak-Peck School of Social Work, USC Center for Artificial Intelligence in Society, USC Center for Mindfulness Science, University of Southern California, Los Angeles, California
- Institute for Addiction Science, University of Southern California, Los Angeles, California
| | - Colin Ring
- Suzanne Dworak-Peck School of Social Work, USC Center for Artificial Intelligence in Society, USC Center for Mindfulness Science, University of Southern California, Los Angeles, California
| | - Jennifer Wang
- Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Reagan E. Fitzke
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Adam M. Leventhal
- Institute for Addiction Science, University of Southern California, Los Angeles, California
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Eric R. Pedersen
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California
- Institute for Addiction Science, University of Southern California, Los Angeles, California
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26
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Tackett AP, Dai HD, Han DH, Vogel EA, Coreas SI, Jafarzadeh N, Gonzalez Anaya MJ, Patel D, Peraza N, Mason TB, Leventhal AM. Appeal of e-cigarette flavors: Differences between never and ever use of combustible cigarettes. Drug Alcohol Depend 2023; 246:109849. [PMID: 37028103 PMCID: PMC10161874 DOI: 10.1016/j.drugalcdep.2023.109849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 02/28/2023] [Accepted: 03/08/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND Characterizing the appeal of flavored e-cigarette solutions by tobacco product use status can inform regulations to reduce vaping in those who never smoked without discouraging adopting e-cigarettes as a quit-smoking aid. METHODS Adults aged 21+ who currently use tobacco products (N = 119) self-administered standardized puffs of eight non-tobacco flavored and two tobacco-flavored e-cigarette solutions using a pod-style device. Participants rated appeal (0-100 scale) following each administration. Mean differences in flavor appeal ratings were compared between four groups: people who never smoked/currently vape, formerly smoked/currently vape, currently smoke/currently vape, and currently smoke/do not vape (with interest in vaping). RESULTS The Global Flavor (all non-tobacco vs. tobacco)×Group interaction (p = .028) revealed higher appeal for non-tobacco vs. tobacco flavors in adults who never smoked/currently vape (B[95 %CI] = 13.6[4.1-23.1]), formerly smoked/currently vape (B[95 %CI] = 11.6[4.2-18.9]), and currently smoke/currently vape (B[95 %CI] = 9.3[2.5-11.6]), but not adults who currently smoke/never vaped (B[95 %CI] = -0.1[-5.1 to 4.9]). In flavor-specific analyses, adults who never smoked/currently vape rated strawberry (p = .022), peppermint (p = .028), and menthol (p = .028) more appealing than tobacco flavors. Among adults who formerly smoked/currently vape, strawberry (p < .001), peppermint (p = .009), and vanilla (p = .009), were more appealing than tobacco. Adults who currently smoked/currently vape rated peppermint (p = .022) and vanilla (p = .009) as more appealing than tobacco. No non-tobacco flavors were more appealing than tobacco in adults who currently smoke/never vaped. CONCLUSIONS E-cigarette sales restrictions on non-tobacco flavors, including menthol, may eliminate products preferred by adults who vape, including those who never smoked, without discouraging adults who currently smoke and never vaped from trying e-cigarettes.
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Affiliation(s)
- Alayna P Tackett
- Department of Internal Medicine, The Ohio State University, Columbus, OH, United States; Center for Tobacco Research, The Ohio State University, Columbus, OH, United States
| | - Hongying Daisy Dai
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, United States
| | - Dae-Hee Han
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA, United States; Institute for Addiction Science, University of Southern California, Los Angeles, CA, United States
| | - Erin A Vogel
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Saida I Coreas
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA, United States
| | - Nikki Jafarzadeh
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA, United States; Institute for Addiction Science, University of Southern California, Los Angeles, CA, United States
| | - Maria J Gonzalez Anaya
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA, United States
| | - Devaki Patel
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA, United States; Institute for Addiction Science, University of Southern California, Los Angeles, CA, United States
| | - Natalia Peraza
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA, United States; Institute for Addiction Science, University of Southern California, Los Angeles, CA, United States
| | - Tyler B Mason
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA, United States; Institute for Addiction Science, University of Southern California, Los Angeles, CA, United States
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA, United States; Institute for Addiction Science, University of Southern California, Los Angeles, CA, United States; Department of Psychology, University of Southern California, Los Angeles, CA, United States.
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27
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Tackett AP, Barrington-Trimis JL, Leventhal AM. 'Flavour ban approved': new marketing strategies from tobacco-free nicotine pouch maker Zyn. Tob Control 2023; 32:e134-e135. [PMID: 35459750 PMCID: PMC9587134 DOI: 10.1136/tobaccocontrol-2021-057222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Alayna P Tackett
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Jessica L Barrington-Trimis
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
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Abstract
OBJECTIVE In light of the current U.S. Food and Drug Administration (FDA) proposal to ban menthol cigarettes, this study updates trends in menthol cigarette use among adolescents age 13-18 years up to the year 2020. The study considers a potential role for the ban to reduce black/non-black disparities in menthol cigarette use, as well as a counterargument that a ban is not necessary because menthol use is already diminishing. METHODS Data are from annual, cross-sectional, nationally representative Monitoring the Future (MTF) surveys of 85 547 8th, 10th and 12th grade students surveyed between 2012 and 2020. Analyses include trends in past 30-day menthol and non-menthol cigarette smoking among the total adolescent population, as well as stratified by race/ethnicity. RESULTS Declines in adolescent menthol and non-menthol cigarette smoking continued through 2020 so that in 2018-2020 past 30-day prevalence for each was less than 1% for non-Hispanic black adolescents and less than 2.2% for non-black adolescents. For non-Hispanic black adolescents no smoking declines in mentholated or non-mentholated cigarette use from 2015-2017 to 2018-2020 were statistically significant, in part because prevalence levels approached a floor effect and had little room to fall further. Menthol levels were lower for non-Hispanic black versus all other adolescents in all study years. CONCLUSIONS Continuing declines in adolescent menthol prevalence indicate that both menthol prevalence and also black/non-black disparities in its use are steadily decreasing. However, these decreases in adolescence will take decades to reach later ages through generational replacement. Efforts to accelerate menthol decreases will require new initiatives to increase cessation among adult menthol users.
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Affiliation(s)
- Richard A Miech
- Department of Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Adam M Leventhal
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Lloyd D Johnson
- Department of Social Research, University of Michigan, Ann Arbor, Michigan, USA
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Han DH, Cho J, Harlow AF, Tackett AP, Vogel EA, Wong M, Barrington-Trimis JL, Lerman C, Unger JB, Leventhal AM. Young adults' beliefs about modern oral nicotine products: Implications for uptake in nonvapers, dual use with e-cigarettes, and use to reduce/quit vaping. Exp Clin Psychopharmacol 2023; 31:455-463. [PMID: 36048111 PMCID: PMC10026537 DOI: 10.1037/pha0000595] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Modern oral nicotine products (ONPs; nontherapeutic nicotine pouches, gums, lozenges, and gummies) may be perceived in ways that could promote uptake in nonvapers, dual use with e-cigarettes, or use to quit vaping. In this cross-sectional digital remote survey of 1,460 respondents aged 21-24 from Southern California, we examined beliefs about ONPs among past-30-day e-cigarette nonusers, users unmotivated to quit vaping, and users motivated to quit vaping. Positive beliefs about ONPs were reported by 31.8% of the overall sample and higher in past-30-day e-cigarette users (with or without quit motivation) than nonusers. Perceiving ONPs to be easy to conceal, convenient, and able to be used where vaping/smoking is not allowed were the most common types of beliefs reported. Among e-cigarette users with quit motivation (n = 142), interest in using ONPs to quit/reduce vaping (44.4%) was higher than interest in using medicinal nicotine gum/lozenges (23.4%), nicotine patch (17.6%), or prescription medications (16.6%). Interest in using ONPs to reduce/quit vaping (vs. no interest) was greater among participants who reported vaping ≥ 20 (vs. < 10) days in the past month, vaping ≥ 10 (vs. < 10) times per day, low/moderate (vs. high) quit vaping self-efficacy, and low/moderate (vs. high) desire to quit vaping. These findings suggest that: (a) appreciable subsets of the young adult population may hold positive beliefs about ONPs that could promote ONP uptake, particularly e-cigarette users and (b) some young adult e-cigarette users may be interested in using ONPs to reduce/quit vaping, particularly frequent vapers with relatively lower self-efficacy and desire to quit vaping. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Dae-Hee Han
- Institute for Addiction Science, University of Southern California
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California
| | - Junhan Cho
- Institute for Addiction Science, University of Southern California
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California
| | - Alyssa F. Harlow
- Institute for Addiction Science, University of Southern California
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California
| | - Alayna P. Tackett
- Institute for Addiction Science, University of Southern California
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California
| | - Erin A. Vogel
- Institute for Addiction Science, University of Southern California
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California
| | - Melissa Wong
- Institute for Addiction Science, University of Southern California
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California
| | - Jessica L. Barrington-Trimis
- Institute for Addiction Science, University of Southern California
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California
| | - Caryn Lerman
- Institute for Addiction Science, University of Southern California
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California
| | - Jennifer B. Unger
- Institute for Addiction Science, University of Southern California
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California
| | - Adam M. Leventhal
- Institute for Addiction Science, University of Southern California
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California
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Jafarzadeh NS, Bello MS, Wong M, Cho J, Leventhal AM. Associations between anxiety symptoms and barriers to smoking cessation among African Americans who smoke cigarettes daily. Drug Alcohol Depend 2023; 245:109808. [PMID: 36857843 PMCID: PMC10108659 DOI: 10.1016/j.drugalcdep.2023.109808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 01/25/2023] [Accepted: 01/31/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND African Americans who smoke cigarettes and experience heightened anxiety symptoms may have low quit smoking rates. Identifying which particular barriers to cessation are associated with specific types of anxiety symptoms in African Americans could inform cessation treatments for this population. This cross-sectional, correlational study examined associations of anxiety-related symptoms and distinct barriers to cessation among non-treatment-seeking African Americans who smoke cigarettes daily. METHODS African Americans who smoke (N = 536) enrolled in a clinical research study on individual differences in tobacco addiction between 2013 and 2017 completed self-report measures of anxiety-related symptoms (i.e., social anxiety, panic, and posttraumatic intrusions) and types of barriers to cessation (i.e., addiction-related, social-related, and affect-related barriers). Linear regression models tested associations of anxiety symptoms with cessation barriers with and without adjusting for age, sex, depressive symptoms, and nicotine dependence. RESULTS All anxiety-related symptoms were associated with each cessation barrier (βs = 0.240-0.396). After covariate adjustment, panic and trauma-related symptoms were not associated with cessation barriers, and the strength of association of social anxiety with external barriers was reduced but remained significant (β = 0.254). CONCLUSION Symptoms of social anxiety, but not trauma or panic-related symptoms, may play a unique, but modest, role in certain barriers to cessation in non-treatment-seeking African Americans who smoke cigarettes over. Further research is needed to uncover why African Americans who smoke and have anxiety might experience these barriers, and how future interventions can mitigate these obstacles.
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Affiliation(s)
- Nikki S Jafarzadeh
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90033, United States; Institute for Addiction Science, University of Southern California, Los Angeles, CA 90033, United States
| | - Mariel S Bello
- Center for Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, RI 02903, United States
| | - Melissa Wong
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90033, United States; Institute for Addiction Science, University of Southern California, Los Angeles, CA 90033, United States
| | - Junhan Cho
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90033, United States; Institute for Addiction Science, University of Southern California, Los Angeles, CA 90033, United States
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90033, United States; Institute for Addiction Science, University of Southern California, Los Angeles, CA 90033, United States.
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31
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Braymiller JL, Riehm KE, Meier M, Krueger EA, Unger JB, Barrington-Trimis JL, Cho J, Lanza HI, Madden DR, Kechter A, Leventhal AM. Associations of alternative cannabis product use and poly-use with subsequent illicit drug use initiation during adolescence. Psychopharmacology (Berl) 2023:10.1007/s00213-023-06330-w. [PMID: 36864260 PMCID: PMC10475141 DOI: 10.1007/s00213-023-06330-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 01/28/2023] [Indexed: 03/04/2023]
Abstract
RATIONALE Specific cannabis products may differentially increase risk of initiating non-cannabis illicit drug use during adolescence. OBJECTIVE To determine whether ever- and poly-use of smoked, vaporized, edible, concentrate, or blunt cannabis products are associated with subsequent initiation of non-cannabis illicit drug use. METHODS High school students from Los Angeles completed in-classroom surveys. The analytic sample (N = 2163; 53.9% female; 43.5% Hispanic/Latino; baseline M age = 17.1 years) included students who reported never using illicit drugs at baseline (spring, 11th grade) and provided data at follow-up (fall and spring, 12th grade). Logistic regression models assessed associations between use of smoked, vaporized, edible, concentrate, and blunt cannabis at baseline (yes/no for each product) and any non-cannabis illicit drug use initiation-including cocaine, methamphetamine, psychedelics, ecstasy, heroin, prescription opioids, or benzodiazepines-at follow-up. RESULTS Among those who never used non-cannabis illicit drugs at baseline, ever cannabis use varied by cannabis product (smoked = 25.8%, edible = 17.5%, vaporized = 8.4%, concentrates = 3.9%, and blunts = 18.2%) and patterns of use (single product use = 8.2% and poly-product use = 21.8%). After adjustment for baseline covariates, odds of illicit drug use at follow-up were largest for baseline ever users of concentrates (aOR [95% CI] = 5.74[3.16-10.43]), followed by vaporized (aOR [95% CI] = 3.11 [2.41-4.01]), edibles (aOR [95% CI] = 3.43 [2.32-5.08]), blunts (aOR [95% CI] = 2.66[1.60-4.41]), and smoked (aOR [95% CI] = 2.57 [1.64-4.02]) cannabis. Ever use of a single product (aOR [95% CI] = 2.34 [1.26-4.34]) or 2 + products (aOR [95% CI] = 3.82 [2.73-5.35]) were also associated with greater odds of illicit drug initiation. CONCLUSIONS For each of five different cannabis products, cannabis use was associated with greater odds of subsequent illicit drug use initiation, especially for cannabis concentrate and poly-product use.
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Affiliation(s)
- Jessica L Braymiller
- Department of Population and Public Health Sciences, University of Southern California, Keck School of Medicine, Los Angeles, CA, 90033, USA
| | - Kira E Riehm
- Department of Mental Health, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Madeline Meier
- Department of Psychology, Arizona State University, Tempe, AZ, 85281, USA
| | - Evan A Krueger
- Department of Population and Public Health Sciences, University of Southern California, Keck School of Medicine, Los Angeles, CA, 90033, USA
| | - Jennifer B Unger
- Department of Population and Public Health Sciences, University of Southern California, Keck School of Medicine, Los Angeles, CA, 90033, USA
| | - Jessica L Barrington-Trimis
- Department of Population and Public Health Sciences, University of Southern California, Keck School of Medicine, Los Angeles, CA, 90033, USA
- Institute for Addiction Science, University of Southern California, 2001 N Soto Street, #302-C, Los Angeles, CA, 90032, USA
- USC Norris Comprehensive Cancer Center, Los Angeles, CA, 90033, USA
| | - Junhan Cho
- Department of Population and Public Health Sciences, University of Southern California, Keck School of Medicine, Los Angeles, CA, 90033, USA
- Institute for Addiction Science, University of Southern California, 2001 N Soto Street, #302-C, Los Angeles, CA, 90032, USA
| | - H Isabella Lanza
- Department of Human Development, California State University, Long Beach, CA, 90840, USA
| | - Danielle R Madden
- Institute for Addiction Science, University of Southern California, 2001 N Soto Street, #302-C, Los Angeles, CA, 90032, USA
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, 90089, USA
| | - Afton Kechter
- Department of Population and Public Health Sciences, University of Southern California, Keck School of Medicine, Los Angeles, CA, 90033, USA
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, University of Southern California, Keck School of Medicine, Los Angeles, CA, 90033, USA.
- Institute for Addiction Science, University of Southern California, 2001 N Soto Street, #302-C, Los Angeles, CA, 90032, USA.
- USC Norris Comprehensive Cancer Center, Los Angeles, CA, 90033, USA.
- Department of Psychology, University of Southern California, Los Angeles, CA, 90033, USA.
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Harlow AF, McConnell R, Leventhal AM, Goodwin RD, Barrington-Trimis JL. Racial, Ethnic, and Education Differences in Age of Smoking Initiation Among Young Adults in the United States, 2002 to 2019. JAMA Netw Open 2023; 6:e235742. [PMID: 36995718 PMCID: PMC10064249 DOI: 10.1001/jamanetworkopen.2023.5742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Affiliation(s)
- Alyssa F Harlow
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles
- Institute for Addiction Science, University of Southern California, Los Angeles
| | - Rob McConnell
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles
- Institute for Addiction Science, University of Southern California, Los Angeles
| | - Renee D Goodwin
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York
| | - Jessica L Barrington-Trimis
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles
- Institute for Addiction Science, University of Southern California, Los Angeles
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Sidhu NK, Lechner WV, Cwalina SN, Whitted L, Smiley SL, Barrington-Trimis JL, Cho J, Wagener TL, Leventhal AM, Tackett AP. Adolescent and Young Adult Response to Hypothetical E-Liquid Flavor Restrictions. J Stud Alcohol Drugs 2023; 84:303-308. [PMID: 36971721 PMCID: PMC10171255 DOI: 10.15288/jsad.21-00466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 10/13/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Rates of e-cigarette use among adolescents and young adults (AYAs) remain high despite several federal policy changes intended to limit their availability and appeal. The current study examined how restricting flavors would affect current AYA users' intentions to discontinue vaping, as a function of their current flavor preference. METHOD In a national cross-sectional survey, AYA e-cigarette users (N = 1,414) completed measures of e-cigarette use, device type, e-liquid flavor (tobacco, menthol, cool mint, fruit ice, fruit/sweet), and intent to discontinue e-cigarette use in response to hypothetical federal product standards (i.e., tobacco and menthol or tobacco-only e-liquid). Logistic regression was used to model the association of preferred flavor with odds of discontinuing e-cigarette use (vs. continuing), for menthol and tobacco hypothetical product standards. RESULTS Overall, 38.8% of the sample reported intent to discontinue using their e-cigarette if tobacco and menthol-flavored e-liquid were the only options available, whereas 70.8% would discontinue under a tobacco-only product standard. AYAs preferring fruit/sweet flavor were most sensitive to either restricted scenario, with odds of discontinuing use ranging from adjusted odds ratio (aOR) = 2.22 to aOR = 2.38 under a tobacco and menthol product standard and aOR = 1.33 to aOR = 2.59 under a tobacco-only product standard, compared with other flavor preferences. In addition, AYAs using cooling flavors (e.g., fruit ice) reported higher odds of discontinuing use under a tobacco-only product standard, compared with menthol flavor users, indicating an important distinction between these groups. CONCLUSIONS Results indicate potential for flavor restrictions to reduce use of e-cigarettes among AYAs and suggest that a tobacco flavor product standard may result in the greatest discontinuation of use.
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Affiliation(s)
- Natasha K. Sidhu
- Department of Psychological Sciences, Kent State University, Kent, Ohio
| | | | - Sam N. Cwalina
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Lauren Whitted
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Sabrina L. Smiley
- Division of Health Promotion and Behavioral Science, San Diego State University, San Diego, California
| | | | - Junhan Cho
- Institute for Addiction Science, University of Southern California, Los Angeles, California
| | - Theodore L. Wagener
- Division of Medical Oncology, Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, Ohio
- Center for Tobacco Research, Ohio State University Comprehensive Cancer Center, Columbus, Ohio
| | - Adam M. Leventhal
- Institute for Addiction Science, University of Southern California, Los Angeles, California
| | - Alayna P. Tackett
- Institute for Addiction Science, University of Southern California, Los Angeles, California
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34
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Cho J, Sussman S, Kechter A, Vogel EA, Barrington-Trimis JL, Unger JB, Leventhal AM. Alcohol use and life stressors during the COVID-19 pandemic: a longitudinal study of young adults. Journal of Substance Use 2023. [DOI: 10.1080/14659891.2023.2183909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Affiliation(s)
- Junhan Cho
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Steve Sussman
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Afton Kechter
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Erin A. Vogel
- Department of Pediatrics, University of Oklahoma College of Medicine, Oklahoma, Oklahoma, USA
| | - Jessica L. Barrington-Trimis
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Jennifer B. Unger
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Adam M. Leventhal
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
- Department of Psychology, University of Southern California, Los Angeles, California, USA
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Lee JO, Lee WJ, Kritikos AF, Jin H, Leventhal AM, Pedersen ER, Cho J, Davis JP, Kapteyn A, Wilson JP, Pacula RL. Regular Cannabis Use During the First Year of the Pandemic: Studying Trajectories Rather Than Prevalence. Am J Prev Med 2023; 64:888-892. [PMID: 36805369 DOI: 10.1016/j.amepre.2023.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 01/19/2023] [Accepted: 01/19/2023] [Indexed: 02/21/2023]
Abstract
INTRODUCTION Cannabis use in the U.S. rose early in the COVID-19 pandemic, but it is unclear whether that rise was temporary or permanent. This study estimated the nature and sociodemographic correlates of U.S. adult subpopulations regularly using cannabis by examining weekly trajectories of use during the first year of the pandemic. METHODS Data came from the Understanding America Study, a nationally representative panel of U.S. adults (N=8,397; March 10, 2020-March 29, 2021). A growth mixture model was deployed to identify subgroups with similar regular cannabis use. Sociodemographic correlates of subgroups were examined using multinomial logistic regression. RESULTS Four cannabis-use groups were identified. Most participants did not regularly use cannabis (no regular use; 81.7%). The other groups increased regular use until April 2020 but then diverged. Some (7.1%) decreased thereafter, whereas others (3.4%) maintained their elevated use until October 26, 2020 before decreasing. The last group (7.7%) sustained their elevated use throughout. Individuals aged between 18 and 39 years, unmarried, living in poverty, without a college degree, and with longer unemployment or underemployment spells had higher odds of being in the other groups with more weekly use than in the no-regular-use group. CONCLUSIONS The analyses revealed population subgroups with prolonged regular cannabis use and a disproportionate concentration of socioeconomically vulnerable members of society in these subgroups. These findings elucidate important heterogeneity in the subpopulations using cannabis, highlighting the urgent need to tailor public health programs for subgroups that may have unique service needs.
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Affiliation(s)
- Jungeun Olivia Lee
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California; Institute for Addiction Science, University of Southern California, Los Angeles, California.
| | - Woo Jung Lee
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California
| | - Alexandra F Kritikos
- Leonard D. Schaeffer Center for Health Policy and Economics, Sol Price School of Public Policy, University of Southern California, Los Angeles, California
| | - Haomiao Jin
- School of Health Sciences, University of Surrey, Guildford, United Kingdom
| | - Adam M Leventhal
- Institute for Addiction Science, University of Southern California, Los Angeles, California; Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles, California
| | - Eric R Pedersen
- Institute for Addiction Science, University of Southern California, Los Angeles, California; Department of Psychiatry and Behavioral Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Junhan Cho
- Institute for Addiction Science, University of Southern California, Los Angeles, California; Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles, California
| | - Jordan P Davis
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California; Institute for Addiction Science, University of Southern California, Los Angeles, California
| | - Arie Kapteyn
- Dornsife Center for Economic and Social Research, University of Southern California, Los Angeles, California
| | - John P Wilson
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles, California; Dornsife Spatial Sciences Institute, University of Southern California, Los Angeles, California; Department of Civil and Environmental Engineering and Computer Science, Viterbi School of Engineering and Computing, University of Southern California, Los Angeles, California; Department of Sociology, Dana and David Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, California; School of Architecture, University of Southern California, Los Angeles, California
| | - Rosalie L Pacula
- Institute for Addiction Science, University of Southern California, Los Angeles, California; Leonard D. Schaeffer Center for Health Policy and Economics, Sol Price School of Public Policy, University of Southern California, Los Angeles, California
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36
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Dai HD, Leventhal AM. Use of Traditional Smokeless, Snus, and Dissolvable Tobacco Among U.S. Youth. Am J Prev Med 2023; 64:204-212. [PMID: 36335080 PMCID: PMC10019526 DOI: 10.1016/j.amepre.2022.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/11/2022] [Accepted: 09/13/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Snus, dissolvable, and traditional smokeless tobacco product use is often amalgamated in youth epidemiologic research despite differences across these products. Prevalence, trends, and correlates of U.S. youth use across different classes of oral tobacco products are unknown. METHODS Using 2011-2020 National Youth Tobacco Survey (N=193,933) data, the authors tested for cross-year linear and quadratic trends in the weighted prevalence of ever and current use of traditional smokeless tobacco, snus, and dissolvable tobacco. Multivariable logistic regressions estimated the demographic and tobacco use factors associated with the use of different oral tobacco products in 2020. Analyses were conducted in 2022. RESULTS During 2011-2020, there were declines in the prevalence of ever use of traditional smokeless tobacco (11.0% to 5.6%; linear trend, p<0.0001) and snus (5.2% to 2.4%; p<0.0001) but no change in ever dissolvable tobacco use (0.8%-1.2%). In 2020, an estimated 1,546,000 U.S. youth ever used traditional smokeless tobacco (7.7% high school, 3.0% middle school), 662,000 ever used snus (high school: 3.5%, middle school: 1.0%), and 326,000 ever used dissolvables (high school: 1.5%, middle school: 0.8%). In 2020, females and non-Hispanic Blacks and Hispanics had lower smokeless or snus ever use odds than males and non-Hispanic Whites, respectively, whereas sexual minorities (than heterosexuals) or those speaking a language other than English at home were more likely to report ever use of dissolvable tobacco. Flavored tobacco use was common, particularly for dissolvable current users (72.8% used any flavor). CONCLUSIONS Differences in the epidemiology of oral tobacco use across product types among U.S. youth suggest that oral tobacco products should be disaggregated in future research and policy strategies.
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Affiliation(s)
- Hongying Daisy Dai
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California.
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Anderson MK, Whitted L, Mason TB, Pang RD, Tackett AP, Leventhal AM. Characterizing different-flavored e-cigarette solutions from user-reported sensory attributes and appeal. Exp Clin Psychopharmacol 2023; 31:46-56. [PMID: 35467923 PMCID: PMC9592684 DOI: 10.1037/pha0000563] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Scientists and regulators need parsimonious methods of characterizing flavored e-cigarettes which may vary widely in both chemical flavoring constituents and marketing descriptors. This laboratory experiment characterized user-reported appeal and experience of five cross-cutting sensory attributes (sweetness, bitterness, smoothness, harshness, coolness) of 10 common e-cigarette flavors. In a within-subject double-blind single-visit protocol, current nicotine/tobacco product users (N = 119) self-administered a single puff of each e-liquid flavor via a pod-style device and rated its appeal and sensory attributes on 0-100 scales. Custom-manufactured e-liquids, nicotine concentration: M (SD) = 23.4 (0.9) mg/mL, representative of commonly marketed fruit (green apple, strawberry), dessert (dark chocolate, vanilla), mint (peppermint, spearmint), nonmint cooling (menthol, koolada), and tobacco (subtle tobacco, full-flavored tobacco) flavor descriptors were used and their constituents were independently analyzed. Results largely demonstrated that a flavor's sensory attributes concorded with its marketed flavor descriptor. Among the 10 flavors, vanilla was rated sweetest (B[difference vs. mean of 9 other flavors] = 14.44, 95% CI [10.84, 18.03]), full-flavored tobacco was most bitter, B = 8.34, 95% CI [4.73, 11.96], subtle tobacco was most harsh, B = 5.69, 95% CI [1.70, 9.68], and peppermint scored highest in both smoothness, B = 6.98, 95% CI [3.13, 10.82], and coolness, B = 29.25, 95% CI [25.50, 33.01]. Flavors with higher appeal ratings tended to be sweeter, smoother, cooler, and less bitter and harsh. Chemical analysis found numerous flavoring constituents among study products without any clear differentiation of chemicals being present in particular flavor categories, which underscores the utility of using sensory ratings to characterize different-flavored e-cigarettes over and above constituent analyses. Characterizing e-cigarette flavors by subjective sensory attributes may be useful in future research and regulatory activities. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Marissa K. Anderson
- Department of Population and Public Health Sciences, Keck School of Medicine of USC
| | - Lauren Whitted
- Department of Population and Public Health Sciences, Keck School of Medicine of USC
| | - Tyler B. Mason
- Department of Population and Public Health Sciences, Keck School of Medicine of USC
| | - Raina D. Pang
- Department of Population and Public Health Sciences, Keck School of Medicine of USC
- Institute for Addiction Science, University of Southern California
- Department of Psychology, University of Southern California
| | - Alayna P. Tackett
- Department of Population and Public Health Sciences, Keck School of Medicine of USC
- Institute for Addiction Science, University of Southern California
| | - Adam M. Leventhal
- Department of Population and Public Health Sciences, Keck School of Medicine of USC
- Institute for Addiction Science, University of Southern California
- Department of Psychology, University of Southern California
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Han DH, Wong M, Peraza N, Vogel EA, Cahn R, Mason TB, Kirkpatrick M, Tackett AP, Leventhal AM. Dose-response effects of two nicotine salt formulations on electronic cigarette appeal and sensory attributes. Tob Control 2023:tobaccocontrol-2022-057553. [PMID: 36593119 PMCID: PMC10314953 DOI: 10.1136/tc-2022-057553] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 12/16/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Various organic acids are used to create nicotine salt formulations, which may improve the appeal and sensory experience of vaping electronic cigarettes (e-cigarettes). This clinical experiment examined the effects of partially and highly protonated forms of two nicotine salt formulations (nicotine lactate and benzoate) versus free-base (no acid additive) on the appeal and sensory attributes of e-cigarettes. METHODS Current adult tobacco product users (n=116) participated in an online remote double-blind within-subject randomised experiment involving standardised self-administration of e-cigarette solutions varying in nicotine formulation (free-base, 50% nicotine lactate -1:2 lactic acid to nicotine molar ratio, 100% nicotine lactate - 1:1 ratio, 50% nicotine benzoate and 100% nicotine benzoate). Each formulation had equivalent nicotine concentrations (27.0-33.0 mg/mL) and was administered in four flavours in a pod-style device. After each administration, participants rated appeal (liking, disliking and willingness to use again) and sensory attributes (0-100 scale). RESULTS Compared with free-base nicotine, 50% and 100% nicotine lactate and benzoate yielded higher appeal, smoothness and sweetness and lower harshness and bitterness. Dose-response analyses found 100% vs 50% nicotine salt improved appeal, smoothness, bitterness and harshness for nicotine lactate and sweetness, smoothness and harshness for nicotine benzoate. Solutions with higher pH were associated with worse appeal and sensory attributes across nicotine formulations. Nicotine formulation effects did not differ by tobacco use status and flavours. CONCLUSION Restricting benzoic acid or lactic acid additives or setting minimal pHs in e-cigarettes merits consideration in regulations designed to reduce vaping among populations deterred from using e-cigarettes with aversive sensory properties. TRIAL REGISTRATION NUMBER This study was registered under ClinicalTrials.gov Identifier: NCT03742817 under the title 'Effects of e-Cigarettes on Perceptions and Behavior'.
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Affiliation(s)
- Dae-Hee Han
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
| | - Melissa Wong
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
| | - Natalia Peraza
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Erin A Vogel
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
| | - Rael Cahn
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
- Department of Psychiatry and Behavioral Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Tyler B Mason
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
| | - Matthew Kirkpatrick
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
| | - Alayna P Tackett
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
- Department of Psychology, University of Southern California, Los Angeles, California, USA
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Leventhal AM, Dai H, Barrington-Trimis JL, Sussman S. 'Ice' flavoured e-cigarette use among young adults. Tob Control 2023; 32:114-117. [PMID: 34127549 PMCID: PMC8669039 DOI: 10.1136/tobaccocontrol-2020-056416] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 04/19/2021] [Accepted: 04/27/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND 'Ice' e-cigarette flavours-marketed as a combination of fruity/sweet and cooling flavours (eg, 'blueberry ice' or 'melon ice')-recently entered the US market. The prevalence and correlates of ice flavoured e-cigarette use in young adults are unknown. METHODS This cross-sectional study of a Los Angeles, California, USA, cohort analysed data from the past 30-day e-cigarette (current) users (n=344; M (SD)=21.2 (0.4) years old) who completed web-based surveys from May-August 2020. The exposure variable was self-reported e-cigarette flavour used most often in the past month (menthol/mint, fruit/sweet or ice). Outcomes included self-reported combustible tobacco use, vaping dependence symptoms, frequency of use and device type used. RESULTS Among current e-cigarette users, 48.8% reported using ice flavours most often, 33.7% predominately used fruit/sweet and 17.4% used menthol/mint. Using primarily ice-flavour was associated with reporting more past-30-day vaping days (vs menthol/mint: b=4.4, 95% CI (1 to 7.7); vs fruit/sweet: b=3.6, 95% CI (0.8 to 6.4)) and more episodes per vaping day versus fruit/sweet users (b=2.4, 95% CI (0.5 to 4.3)). Ice-flavour users were less likely than menthol/mint users to use JUUL/cartridge-based rechargeable (OR=0.1, 95% CI (0.03 to 0.45)) and more likely than sweet/fruit users to use disposable non-cartridge (OR=3.9, 95% CI (2.1 to 7.4)) devices than refillable/rechargeable tank/pen or other devices. Ice users had greater odds of past 30-day combustible tobacco use versus menthol/mint users (OR=2.7, 95% CI (1.3 to 5.7)) and vaping dependence symptoms than versus sweet/fruit users (OR=2.6, 95% CI (1.5 to 4.4)). CONCLUSION Young adult use of ice flavoured e-cigarettes may be common and positively associated with combustible tobacco use, nicotine vaping frequency and dependence and use of disposable e-cigarette devices. Further study of the prevalence, determinants and health effects of ice flavoured e-cigarette use is warranted.
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Affiliation(s)
- Adam M. Leventhal
- department of Preventive Medicine, University of Southern California Keck School of Medicine, 2001 N Soto Street, 302-C, Los Angeles, CA 90089
| | - Hongying Dai
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198-4355
| | - Jessica L. Barrington-Trimis
- department of Preventive Medicine, University of Southern California Keck School of Medicine, 2001 N Soto Street, 302-C, Los Angeles, CA 90089
| | - Steve Sussman
- department of Preventive Medicine, University of Southern California Keck School of Medicine, 2001 N Soto Street, 302-C, Los Angeles, CA 90089
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40
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Vogel EA, Barrington-Trimis JL, Harlow AF, Wong M, Cho J, Han DH, Leventhal AM, Tackett AP. Prevalence of and disparities in adolescents' susceptibility to novel oral nicotine products marketed as "tobacco-free". Prev Med 2023; 166:107387. [PMID: 36503016 PMCID: PMC9845133 DOI: 10.1016/j.ypmed.2022.107387] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 12/03/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
Non-therapeutic, novel oral nicotine products are convenient, discreet to use, and flavored, with increasing sales in the United States. It is unclear whether these products appeal predominantly to adolescents already susceptible to inhalable nicotine products, or whether they attract adolescents who would not otherwise use nicotine. This study examined prevalence and correlates of susceptibility to inhalable and oral nicotine product use among adolescents. Ninth- and tenth-grade students from Southern California who had never used any nicotine product (N = 3129) completed an online survey in Fall 2021 assessing susceptibility to inhalable (i.e., cigarettes, e-cigarettes) and oral (e.g., pouches, gum, gummies) nicotine products. Multinomial logistic regression analyses estimated associations of demographic characteristics with odds of susceptibility to oral, inhalable, or both products. Susceptibility was highest for e-cigarettes (19.7%), followed by cigarettes (15.0%) and nicotine gum, lozenges, tablets and/or gummies (15.0%), and nicotine pouches (8.7%). Dual susceptibility to oral and inhalable products (vs. neither product type) was higher in cisgender female and non-cisgender (vs. cisgender male) adolescents (odds ratios [ORs] = 1.36-2.02; ps < 0.05). Hispanic adolescents (vs. Asian) were more susceptible to both products (OR = 1.47; p < .05). Lower-socioeconomic status (SES) and sexual minority adolescents were more susceptible to oral (ORs = 1.76-1.87; ps < 0.05) and both products (ORs = 1.32-1.88; ps < 0.05), compared to higher-SES and heterosexual adolescents. Adolescents in Southern California may be more susceptible to e-cigarettes than other nicotine/tobacco products. However, appreciable numbers may be susceptible to oral nicotine products, including some youth who might not otherwise use nicotine and youth from populations historically impacted by tobacco-related health disparities.
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Affiliation(s)
- Erin A Vogel
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, United States of America; Institute for Addiction Science, University of Southern California, United States of America; Norris Comprehensive Cancer Center, University of Southern California, United States of America.
| | - Jessica L Barrington-Trimis
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, United States of America; Institute for Addiction Science, University of Southern California, United States of America; Norris Comprehensive Cancer Center, University of Southern California, United States of America
| | - Alyssa F Harlow
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, United States of America; Institute for Addiction Science, University of Southern California, United States of America
| | - Melissa Wong
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, United States of America; Institute for Addiction Science, University of Southern California, United States of America
| | - Junhan Cho
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, United States of America; Institute for Addiction Science, University of Southern California, United States of America; Norris Comprehensive Cancer Center, University of Southern California, United States of America
| | - Dae-Hee Han
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, United States of America; Institute for Addiction Science, University of Southern California, United States of America
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, United States of America; Institute for Addiction Science, University of Southern California, United States of America
| | - Alayna P Tackett
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, United States of America; Institute for Addiction Science, University of Southern California, United States of America; Norris Comprehensive Cancer Center, University of Southern California, United States of America
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41
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Harlow AF, Stokes AC, Brooks DR, Benjamin EJ, Leventhal AM, McConnell RS, Barrington‐Trimis JL, Ross CS. Prospective association between e-cigarette use frequency patterns and cigarette smoking abstinence among adult cigarette smokers in the United States. Addiction 2022; 117:3129-3139. [PMID: 35913015 PMCID: PMC9804676 DOI: 10.1111/add.16009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 07/05/2022] [Indexed: 01/07/2023]
Abstract
AIMS To estimate the association of longitudinal patterns of e-cigarette use with cigarette smoking abstinence, after accounting for time-dependent confounding and selection bias. DESIGN Secondary analysis of longitudinal national cohort data. Using marginal structural models and four waves of the population assessment of tobacco and health (wave 1, 2013-14; wave 2, 2014-15; wave 3, 2015-16; wave 4, 2016-18), we estimated the association of vaping frequency across waves 2 and 3 with 12-month sustained cigarette smoking abstinence at wave 4, adjusting for time-dependent confounders at waves 1 and 2 and selection bias due to drop-out with inverse probability of treatment and censoring weights. SETTING United States. PARTICIPANTS/CASES A total of 5699 adults (18+ years) who smoked cigarettes and did not vape at wave 1. MEASUREMENTS The exposure was vaping frequency at waves 2 and 3 (non-use, non-daily use, daily use), representing nine possible combinations of vaping frequency across two waves. Non-use at both waves was the exposure reference group. The primary outcome was sustained 12-month cigarette smoking abstinence at wave 4. FINDINGS Among 5699 adults who smoked cigarettes at wave 1, a total of 560 (9.8%) reported smoking abstinence at wave 4. Compared with nonuse at both waves, daily vaping at both waves [risk ratio (RR) = 3.82, 95% confidence interval (CI) = 2.59-5.64] and non-use at wave 2 followed by daily vaping at wave 3 (RR = 2.50, 95% CI = 1.66-3.77) were positively associated with smoking abstinence; non-daily vaping at both waves was inversely associated with smoking abstinence (RR = 0.28, 95% CI = 0.11-0.75). Results persisted after accounting for misclassification of e-cigarette use and cigarette smoking abstinence and after restricting to participants with plans to quit smoking. CONCLUSIONS In a US cohort of adult smokers, longitudinal patterns of vaping frequency appear to predict smoking abstinence, even after accounting for several sources of systematic error. Consistent daily vaping is associated with increased chances of cigarette smoking abstinence, while consistent non-daily vaping is associated with decreased chances of smoking abstinence.
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Affiliation(s)
- Alyssa F. Harlow
- University of Southern California, Department of Population and Public Health SciencesInstitute for Addiction ScienceLos AngelesCAUSA,Department of EpidemiologyBoston University School of Public HealthBostonMAUSA
| | - Andrew C. Stokes
- Department of Global HealthBoston University School of Public HealthBostonMAUSA
| | - Daniel R. Brooks
- Department of EpidemiologyBoston University School of Public HealthBostonMAUSA
| | - Emelia J. Benjamin
- Department of EpidemiologyBoston University School of Public HealthBostonMAUSA,Department of MedicineBoston University School of Medicine and Boston Medical CenterBostonMAUSA
| | - Adam M. Leventhal
- University of Southern California, Department of Population and Public Health SciencesInstitute for Addiction ScienceLos AngelesCAUSA
| | - Rob S. McConnell
- University of Southern California, Department of Population and Public Health SciencesInstitute for Addiction ScienceLos AngelesCAUSA
| | - Jessica L. Barrington‐Trimis
- University of Southern California, Department of Population and Public Health SciencesInstitute for Addiction ScienceLos AngelesCAUSA
| | - Craig S. Ross
- Department of EpidemiologyBoston University School of Public HealthBostonMAUSA
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42
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Mason TB, Dolgon-Krutolow A, Smith KE, Leventhal AM. Body Dissatisfaction and Binge Eating: The Moderating Roles of Sweet Taste Reward Sensitivity and Dietary Restraint among Tobacco Product Users. Int J Environ Res Public Health 2022; 19:15523. [PMID: 36497598 PMCID: PMC9740665 DOI: 10.3390/ijerph192315523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/12/2022] [Accepted: 11/20/2022] [Indexed: 06/17/2023]
Abstract
Body dissatisfaction is a key predictor of binge eating, yet less is known about factors that may potentiate the association between body dissatisfaction and binge eating. This study examined self-reported dietary restraint and sweet taste reward sensitivity as candidate moderators of the association between body dissatisfaction and binge eating in adults. A convenience sample of 221 tobacco product users completed measures of eating disorder pathology and sweet taste reward sensitivity. Results revealed that elevated sweet taste reward sensitivity strengthened the positive association between higher body dissatisfaction and binge eating. However, there was no main effect, or moderation effect, of dietary restraint on binge eating. The findings of this study demonstrate the key role of sweet taste reward sensitivity in potentiating the association between body dissatisfaction and binge eating. Sweet taste reward sensitivity may serve as a key dispositional factor for uncontrolled eating.
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Affiliation(s)
- Tyler B. Mason
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA 90032, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, CA 90032, USA
| | - Anna Dolgon-Krutolow
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA 90032, USA
| | - Kathryn E. Smith
- Institute for Addiction Science, University of Southern California, Los Angeles, CA 90032, USA
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA 90032, USA
| | - Adam M. Leventhal
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA 90032, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, CA 90032, USA
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Abstract
This Viewpoint discusses a federal policy loophole that allows psychotropic cannabis products to be commercially marketed and sold across the US, even in states where recreational cannabis is not legal.
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Affiliation(s)
- Alyssa F Harlow
- Department of Population and Public Health Sciences and Institute for Addiction Science, Keck School of Medicine, University of Southern California, Los Angeles
| | - Adam M Leventhal
- Department of Population and Public Health Sciences and Institute for Addiction Science, Keck School of Medicine, University of Southern California, Los Angeles
| | - Jessica L Barrington-Trimis
- Department of Population and Public Health Sciences and Institute for Addiction Science, Keck School of Medicine, University of Southern California, Los Angeles
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44
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Dai HD, Leventhal AM, Khan AS. Trends in Urinary Biomarkers of Exposure to Nicotine and Carcinogens Among Adult e-Cigarette Vapers vs Cigarette Smokers in the US, 2013-2019. JAMA 2022; 328:1864-1866. [PMID: 36346420 PMCID: PMC9644255 DOI: 10.1001/jama.2022.14847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This study assesses temporal trends of biomarkers among adult nicotine and nonnicotine e-cigarette users and cigarette smokers.
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Affiliation(s)
| | - Adam M. Leventhal
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles
| | - Ali S. Khan
- College of Public Health, University of Nebraska Medical Center, Omaha
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Yang Z, Berhane K, Leventhal AM, Liu M, Barrington-Trimis JL, Thomas DC. Modeling the longitudinal transitions of electronic cigarettes and conventional cigarettes with time-dependent covariates among adolescents. Prev Med 2022; 164:107294. [PMID: 36216121 PMCID: PMC10002430 DOI: 10.1016/j.ypmed.2022.107294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/16/2022] [Accepted: 10/02/2022] [Indexed: 11/17/2022]
Abstract
E-cigarettes may help combustible cigarette smokers switch to a less harmful alternative, or may increase the risk of subsequent initiation of cigarettes among non-smokers. Among youth, it is not clear whether both pathways occur equally, or whether one direction is more likely than the other. We used data from a prospective cohort study of youth in Southern California followed twice annually from Fall 2013 (9th grade) to Fall 2015 (11th grade) (N = 1977). A polytomous logistic regression model was used to simultaneously estimate transition rates for initiation of and abstention from e-cigarettes and cigarettes. Use of e-cigarettes was positively associated with initiation of cigarettes (OR = 7.57; 95%CI:[5.32, 10.8]) and negatively associated with cigarette abstention (OR = 0.58; 95%CI:[0.33, 0.99]) in adjusted models; cigarette use was positively associated with e-cigarette initiation (OR = 2.54; 95%CI:[1.45, 4.47]) and negatively associated with e-cigarette abstention (OR = 0.31; 95%CI:[0.17,0.57]). Uni-directional transition from e-cigarettes only to cigarettes only occurred less frequently than expected under independence (OR = 0.33; 95% CI [0.20, 0.55]), whereas simultaneously initiating both products (OR = 9.79; 95%CI:[7.22, 13.3]) and simultaneously abstaining (OR = 2.84; 95%CI:[1.50, 5.37]) were more frequent than expected. E-cigarettes were more strongly associated with subsequent cigarette initiation than the reverse, though both models indicated that use of either product seems to encourage use of the other. Models also indicated that use of either e-cigarettes or cigarettes resulted in reduced abstention of the other product. Findings suggest that prevention efforts for that continue to focus on both e-cigarettes and cigarettes are needed.
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Affiliation(s)
- Zhi Yang
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Kiros Berhane
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Mengyu Liu
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, United States of America
| | - Jessica L Barrington-Trimis
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America.
| | - Duncan C Thomas
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
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Parnarouskis L, Leventhal AM, Ferguson SG, Gearhardt AN. Withdrawal: A key consideration in evaluating whether highly processed foods are addictive. Obes Rev 2022; 23:e13507. [PMID: 36196649 PMCID: PMC9786266 DOI: 10.1111/obr.13507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 07/04/2022] [Accepted: 09/20/2022] [Indexed: 12/30/2022]
Abstract
Researchers are currently debating whether theories of addiction explain compulsive overeating of highly processed (HP) foods (i.e., industrially created foods high in refined carbohydrates and/or fat), which contributes to obesity and diet-related disease. A subset of individuals consumes HP foods with behavioral phenotypes that mirror substance use disorders. Withdrawal, the emergence of aversive physical and psychological symptoms upon reduction or cessation of substance use, is a core component of addiction that was central to historical debates about other substances' addictive potential (e.g., nicotine and cocaine). However, no one has systematically considered evidence for whether HP foods cause withdrawal, which represents a key knowledge gap regarding the utility of addiction models for understanding compulsive overeating. Thus, we reviewed evidence for whether animals and humans exhibit withdrawal when reducing or eliminating HP food intake. Controlled experimental evidence indicates animals experience HP food withdrawal marked by neural reward changes and behaviors consistent with withdrawal from other addictive substances. In humans, preliminary evidence supports subjective withdrawal-like experiences. However, most current human research is limited to retrospective recall. Further experimental research is needed to evaluate this construct. We outline future research directions to investigate HP food withdrawal in humans and consider potential clinical implications.
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Affiliation(s)
| | - Adam M Leventhal
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
| | - Stuart G Ferguson
- Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Ashley N Gearhardt
- Department of Psychology, The University of Michigan, Ann Arbor, Michigan, USA
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Leventhal AM, Conti DV, Ray LA, Baurley JW, Bello MS, Cho J, Zhang Y, Pester MS, Lebovitz L, Budiarto A, Mahesworo B, Pardamean B. A genetic association study of tobacco withdrawal endophenotypes in African Americans. Exp Clin Psychopharmacol 2022; 30:673-681. [PMID: 34279980 PMCID: PMC8928755 DOI: 10.1037/pha0000492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Genome-wide association (GWA) genetic epidemiology research has identified several variants modestly associated with brief self-report smoking measures, predominately in European Americans. GWA research has not applied intensive laboratory-based measures of smoking endophenotypes in African Americans-a population with disproportionately low quit smoking rates and high tobacco-related disease risk. This genetic epidemiology study of non-Hispanic African Americans tested associations of 89 genetic variants identified in previous GWA research and exploratory GWAs with 24 laboratory-derived tobacco withdrawal endophenotypes. African American cigarette smokers (N = 528; ≥10 cig/day; 36.2% female) completed two counterbalanced visits following either 16-hr of tobacco deprivation or ad libitum smoking. At both visits, self-report and behavioral measures across six unique "sub-phenotype" domains within the tobacco withdrawal syndrome were assessed (Urge/Craving, Negative Affect, Low Positive Affect, Cognition, Hunger, and Motivation to Resume Smoking). Results of the candidate variant analysis found two significant small-magnitude associations. The rs11915747 alternate allele in the CAD2M gene region was associated with .09 larger deprivation-induced changes in reported impulsivity (0-4 scale). The rs2471711alternate allele in the AC097480.1/AC097480.2 gene region was associated with 0.26 lower deprivation-induced changes in confusion (0-4 scale). For both variants, associations were opposite in direction to previous research. Individual genetic variants may exert only weak influences on tobacco withdrawal in African Americans. Larger sample sizes of non-European ancestry individuals might be needed to investigate both known and novel loci that may be ancestry-specific. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Adam M. Leventhal
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California
- Department of Psychology, University of Southern California
| | - David V. Conti
- Department of Psychology, University of Southern California
| | - Lara A. Ray
- Department of Psychology, University of California, Los Angeles
| | | | | | - Junhan Cho
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Yi Zhang
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | | | - Lucas Lebovitz
- Keck School of Medicine, University of Southern California
| | - Arif Budiarto
- Bioinformatics and Data Science Research Center, Bina Nusantara University, Jakarta, Indonesia
| | - Bharuno Mahesworo
- Bioinformatics and Data Science Research Center, Bina Nusantara University, Jakarta, Indonesia
| | - Bens Pardamean
- BioRealm LLC, California
- Bioinformatics and Data Science Research Center, Bina Nusantara University, Jakarta, Indonesia
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Harlow AF, Cho J, Tackett AP, McConnell RS, Leventhal AM, Stokes AC, Barrington-Trimis JL. Motivations for E-cigarette use and associations with vaping frequency and smoking abstinence among adults who smoke cigarettes in the United States. Drug Alcohol Depend 2022; 238:109583. [PMID: 35907310 PMCID: PMC9994580 DOI: 10.1016/j.drugalcdep.2022.109583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/13/2022] [Accepted: 07/17/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION In observational studies, vaping daily is positively associated with cigarette smoking abstinence, while non-daily vaping is associated with less smoking abstinence (versus no e-cigarette use). It remains unknown whether cigarette smokers who vape daily have different motivations for using e-cigarettes than those who vape non-daily. METHODS Using latent class analysis and 10 self-reported reasons for vaping, we identified sub-groups of participants based on vaping motivations among 1544 adult (≥18 y) dual users of e-cigarettes and cigarettes at wave 4 of the Population Assessment of Tobacco and Health (2016-2018). We examined the association of motivation sub-groups with vaping frequency at wave 4, and subsequent cigarette smoking abstinence at wave 5 (2018-2019). Additional analyses examined the association of vaping frequency with smoking abstinence before and after adjustment for motivation sub-groups. RESULTS Four distinct sub-groups of e-cigarette users emerged, including 54 % of participants who were "Vaping Enthusiasts", 20 % who vaped for "Convenience and Social Acceptability", 10 % classified as "Experimenters", and 16 % who vaped for "Quitting Smoking and Harm Reduction." The Convenience and Social Acceptability sub-group were less likely than "Vaping Enthusiasts" (AOR=0.29, 95 %CI[0.20-0.42]) and "Quitting Smoking and Harm Reduction" (AOR=0.41, 95 %CI[0.24-0.71]) classes to vape daily (versus non-daily). Sub-groups were not associated with smoking abstinence after one year. Adjustment for motivation sub-groups did not attenuate a positive association of daily vaping with smoking abstinence. CONCLUSIONS Cigarette smokers who vaped for convenience and social acceptability were less frequent e-cigarette users than those with other vaping motivations. Vaping motivations were not associated with subsequent smoking abstinence.
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Affiliation(s)
- Alyssa F Harlow
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 1845 N. Soto Street, Los Angeles, CA 90032, USA.
| | - Junhan Cho
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 1845 N. Soto Street, Los Angeles, CA 90032, USA
| | - Alayna P Tackett
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 1845 N. Soto Street, Los Angeles, CA 90032, USA
| | - Rob S McConnell
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 1845 N. Soto Street, Los Angeles, CA 90032, USA
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 1845 N. Soto Street, Los Angeles, CA 90032, USA
| | - Andrew C Stokes
- Department of Global Health, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
| | - Jessica L Barrington-Trimis
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 1845 N. Soto Street, Los Angeles, CA 90032, USA
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49
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Harlow AF, Vogel EA, Tackett AP, Cho J, Han DH, Wong M, Cockburn MG, Sussman SY, Unger JB, Leventhal AM, Barrington-Trimis JL. Adolescent Use of Flavored Non-Tobacco Oral Nicotine Products. Pediatrics 2022; 150:188734. [PMID: 35934731 PMCID: PMC9994602 DOI: 10.1542/peds.2022-056586] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/01/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Flavored non-tobacco oral nicotine products (eg, nicotine pouches and nontherapeutic nicotine gum, lozenges, tablets, gummies), are increasingly marketed in the United States. Prevalence of non-tobacco oral nicotine product use among adolescents is unknown. METHODS We calculated prevalence of ever and past 6-month use of nicotine pouches, other non-tobacco oral nicotine products (ie, gum, lozenges, tablets, and/or gummies), e-cigarettes, cigarettes, hookah or waterpipe, cigars, cigarillos, and snus among high school students in Southern California between September and December 2021. Generalized linear mixed models tested associations of sociodemographic factors and tobacco-product use with use of any non-tobacco oral nicotine product. RESULTS Among the sample (n = 3516), prevalence was highest for e-cigarettes (ever: 9.6%, past 6-month: 5.5%), followed by non-tobacco oral nicotine products (ever: 3.4%, past 6-month: 1.7%), and <1% for other products. Ever users of combustible tobacco (adjusted odds ratio [aOR] = 77.6; 95% confidence interval [CI] = 39.7-152) and ever users of noncombustible tobacco (aOR = 40.4; 95% CI= 24.3-67.0) had higher odds of ever using non-tobacco oral nicotine products, compared to never users of combustible and noncombustible tobacco. Use of any non-tobacco oral nicotine product was greater for Hispanic (versus all other races/ethnicities except Asian, aOR = 2.58; 95% CI = 1.36-4.87), sexual minority (versus heterosexual, aOR=1.63; 95% CI = 1.03-2.57), gender minority (versus male, aOR = 2.83; 95% CI = 1.29-6.19), and female (versus male, aOR=1.92, 95% CI = 1.20-3.06) participants. CONCLUSIONS Non-tobacco oral nicotine products were the second most prevalent nicotine product used by adolescents. They were disproportionately used by certain racial or ethnic, sexual, or gender minority groups, and those with a history of nicotine use. Adolescent non-tobacco oral nicotine product use surveillance should be a public health priority.
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Affiliation(s)
- Alyssa F Harlow
- USC Institute for Addiction Science.,Department of Population and Public Health Sciences, Keck School of Medicine
| | - Erin A Vogel
- USC Institute for Addiction Science.,Department of Population and Public Health Sciences, Keck School of Medicine
| | - Alayna P Tackett
- USC Institute for Addiction Science.,Department of Population and Public Health Sciences, Keck School of Medicine.,USC Norris Comprehensive Cancer Center, Keck School of Medicine
| | - Junhan Cho
- USC Institute for Addiction Science.,Department of Population and Public Health Sciences, Keck School of Medicine.,USC Norris Comprehensive Cancer Center, Keck School of Medicine
| | - Dae-Hee Han
- USC Institute for Addiction Science.,Department of Population and Public Health Sciences, Keck School of Medicine
| | - Melissa Wong
- USC Institute for Addiction Science.,Department of Population and Public Health Sciences, Keck School of Medicine
| | - Myles G Cockburn
- USC Institute for Addiction Science.,Department of Population and Public Health Sciences, Keck School of Medicine.,USC Norris Comprehensive Cancer Center, Keck School of Medicine.,Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Steve Y Sussman
- USC Institute for Addiction Science.,Department of Population and Public Health Sciences, Keck School of Medicine.,USC Norris Comprehensive Cancer Center, Keck School of Medicine
| | - Jennifer B Unger
- USC Institute for Addiction Science.,Department of Population and Public Health Sciences, Keck School of Medicine.,USC Norris Comprehensive Cancer Center, Keck School of Medicine
| | - Adam M Leventhal
- USC Institute for Addiction Science.,Department of Population and Public Health Sciences, Keck School of Medicine.,USC Norris Comprehensive Cancer Center, Keck School of Medicine
| | - Jessica L Barrington-Trimis
- USC Institute for Addiction Science.,Department of Population and Public Health Sciences, Keck School of Medicine.,USC Norris Comprehensive Cancer Center, Keck School of Medicine
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50
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Steeger CM, Harlow AF, Barrington-Trimis JL, Simon P, Hill KG, Leventhal AM. Longitudinal associations between flavored tobacco use and tobacco product cessation in a national sample of adults. Prev Med 2022; 161:107143. [PMID: 35803351 PMCID: PMC9994601 DOI: 10.1016/j.ypmed.2022.107143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 05/05/2022] [Accepted: 07/02/2022] [Indexed: 11/28/2022]
Abstract
Use of flavored tobacco has been associated with lower likelihood of short-term abstinence from tobacco. It is unknown whether longer-term associations exist, particularly for a variety of products and specific flavor categories. This study used adult survey data from the Population Assessment of Tobacco and Health (PATH) Study (2013-2018). We tested associations of past 30-day tobacco product use at wave 2 using both a 2-category any flavor versus unflavored variable and 4-category specific flavor (menthol/mint, sweet, and both menthol/mint and sweet) versus unflavored variable with past 12-month cessation from the same product two years later at wave 4. Separate models were run for each product (combustible cigarettes, cigars, hookah, e-cigarettes, and smokeless), adjusting for wave 1 sociodemographic characteristics. For all five products, past 30-day use of any flavored (versus unflavored) product at wave 2 was associated with reduced likelihood of same-product cessation at wave 4. Most specific flavor categories were associated with reduced odds of same-product cessation across all products. Any flavor use was also associated with reduced likelihood of longer-term cessation (i.e., past 24-months at both waves 3 and 4) and cessation from all five tobacco products in several analyses. Exploratory moderation results indicated that the association between e-cigarette flavor use and lower likelihood of cessation was stronger for young adults (18-24) versus older adults (25+). Current use of flavored tobacco products is associated with lower likelihood of product cessation. Flavored tobacco products warrant consideration in regulatory policy to reduce the adverse public health impact of tobacco use.
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Affiliation(s)
- Christine M Steeger
- Institute of Behavioral Science, University of Colorado Boulder, 1440 15(th) St., Boulder, CO 80309, USA.
| | - Alyssa F Harlow
- School of Medicine, University of Southern California, 2250 Alcazar St., CSC 271, Los Angeles, CA 90033, USA; Institute for Addiction Science, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032, USA.
| | - Jessica L Barrington-Trimis
- School of Medicine, University of Southern California, 2250 Alcazar St., CSC 271, Los Angeles, CA 90033, USA; Institute for Addiction Science, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032, USA.
| | - Patricia Simon
- Department of Psychiatry, Yale School of Medicine, 389 Whitney Avenue, New Haven, CT 06511, USA.
| | - Karl G Hill
- Institute of Behavioral Science, University of Colorado Boulder, 1440 15(th) St., Boulder, CO 80309, USA.
| | - Adam M Leventhal
- School of Medicine, University of Southern California, 2250 Alcazar St., CSC 271, Los Angeles, CA 90033, USA; Institute for Addiction Science, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032, USA.
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