1
|
Hair EC, Tulsiani S, Aseltine M, Do EK, Lien R, Zapp D, Green M, Vallone D. Vaping-Know the Truth: Evaluation of an Online Vaping Prevention Curriculum. Health Promot Pract 2024; 25:468-474. [PMID: 37545361 DOI: 10.1177/15248399231191099] [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] [Indexed: 08/08/2023]
Abstract
BACKGROUND Unacceptably high levels of e-cigarette use among youth paired with growing research about the dangers of vaping demonstrate a critical need to develop interventions that educate young people to reject e-cigarette use and promote cessation for current users. Vaping: Know the Truth (VKT) is a free digital learning experience prioritizing middle and high school students that aims to improve students' knowledge about the dangers of using e-cigarettes and provide quitting resources for those who already vape. The current study was designed to evaluate whether students receiving the curriculum increased knowledge of the dangers of vaping. METHODS The outcome measures were calculated as the change in the number of correct responses from the pre- to post-module assessments among middle and high school students who completed four modules of the VKT curriculum (N = 103,522). Linear regression was performed to determine the association between the student's pre-module assessment score and the knowledge change score after completion of the four modules. RESULTS Students' e-cigarette knowledge significantly improved by an average of 3.24 points (SD = 3.54), following implementation of the VKT curriculum. This indicates that participants answered more than 3 additional questions correctly, on average, after the intervention. CONCLUSION Findings demonstrate that the Vaping: Know the Truth curriculum is an effective resource for increasing knowledge among youth about the harms associated with e-cigarette use. Further research is needed to evaluate whether the intervention is associated with behavioral outcomes over time.
Collapse
Affiliation(s)
- Elizabeth C Hair
- Truth Initiative, Washington, DC, USA
- Johns Hopkins University, Baltimore, MD, USA
- New York University, New York, NY, USA
| | | | | | - Elizabeth K Do
- Truth Initiative, Washington, DC, USA
- The George Washington University, Washington, DC, USA
| | - Rebecca Lien
- Professional Data Analysts, Minneapolis, MN, USA
| | | | | | - Donna Vallone
- Truth Initiative, Washington, DC, USA
- Johns Hopkins University, Baltimore, MD, USA
- New York University, New York, NY, USA
| |
Collapse
|
2
|
Do EK, Aarvig K, Panigrahi G, Hair EC. Past-Year Mental Illness Diagnosis and E-cigarette Use Status Among a College-Aged Sample: Findings From the National College Health Assessment (2017-2019). Am J Health Promot 2024; 38:468-477. [PMID: 38146733 DOI: 10.1177/08901171231224864] [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] [Indexed: 12/27/2023]
Abstract
PURPOSE To examine associations between past-year mental illness (MI) diagnoses and e-cigarette use status. DESIGN Data were obtained from the National College Health Assessment, a nationally recognized cross-sectional survey of university students. SETTING Participants were recruited from 2-year and 4-year public and private universities across the United States from 2017-2019. SUBJECTS The analytic sample included 277 291 university students. MEASURES Self-reported past-year MI diagnosis, binarily coded, served as the primary predictor. The outcome was e-cigarette use status (never, noncurrent, and current user). ANALYSIS Multinomial logistic regression models were used to estimate relative risk ratios (RRR) of e-cigarette use, as predicted by past-year MI diagnoses, age, race/ethnicity, sex and gender, sexual identity, geographic region, and other combustible tobacco, alcohol, and marijuana use. RESULTS Compared to those who had never received any MI diagnosis in the past year, those who did had a 16% higher relative risk (RRR = 1.16, 95% CI: 1.11, 1.20) of being a noncurrent e-cigarette user and a 33% higher relative risk (RRR = 1.33, 95% CI: 1.28, 1.38) of being a current e-cigarette user. Schizophrenia, substance use or addiction, bipolar disorder, and attention deficit and hyperactivity disorder (ADHD) diagnoses demonstrated the strongest associations with noncurrent and current e-cigarette use. CONCLUSION Results suggest the need to screen young adults for e-cigarette use and mental health indicators to facilitate early detection and timely intervention for at-risk university students.
Collapse
Affiliation(s)
- Elizabeth K Do
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | | | | | - Elizabeth C Hair
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- School of Global Public Health, New York University, New York, NY, USA
| |
Collapse
|
3
|
Fahimi M, Hair EC, Do EK, Kreslake JM, Yan X, Chan E, Barlas FM, Giles A, Osborn L. Improving the Efficiency of Inferences From Hybrid Samples for Effective Health Surveillance Surveys: Comprehensive Review of Quantitative Methods. JMIR Public Health Surveill 2024; 10:e48186. [PMID: 38451620 PMCID: PMC10958332 DOI: 10.2196/48186] [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: 04/14/2023] [Revised: 01/02/2024] [Accepted: 01/07/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Increasingly, survey researchers rely on hybrid samples to improve coverage and increase the number of respondents by combining independent samples. For instance, it is possible to combine 2 probability samples with one relying on telephone and another on mail. More commonly, however, researchers are now supplementing probability samples with those from online panels that are less costly. Setting aside ad hoc approaches that are void of rigor, traditionally, the method of composite estimation has been used to blend results from different sample surveys. This means individual point estimates from different surveys are pooled together, 1 estimate at a time. Given that for a typical study many estimates must be produced, this piecemeal approach is computationally burdensome and subject to the inferential limitations of the individual surveys that are used in this process. OBJECTIVE In this paper, we will provide a comprehensive review of the traditional method of composite estimation. Subsequently, the method of composite weighting is introduced, which is significantly more efficient, both computationally and inferentially when pooling data from multiple surveys. With the growing interest in hybrid sampling alternatives, we hope to offer an accessible methodology for improving the efficiency of inferences from such sample surveys without sacrificing rigor. METHODS Specifically, we will illustrate why the many ad hoc procedures for blending survey data from multiple surveys are void of scientific integrity and subject to misleading inferences. Moreover, we will demonstrate how the traditional approach of composite estimation fails to offer a pragmatic and scalable solution in practice. By relying on theoretical and empirical justifications, in contrast, we will show how our proposed methodology of composite weighting is both scientifically sound and inferentially and computationally superior to the old method of composite estimation. RESULTS Using data from 3 large surveys that have relied on hybrid samples composed of probability-based and supplemental sample components from online panels, we illustrate that our proposed method of composite weighting is superior to the traditional method of composite estimation in 2 distinct ways. Computationally, it is vastly less demanding and hence more accessible for practitioners. Inferentially, it produces more efficient estimates with higher levels of external validity when pooling data from multiple surveys. CONCLUSIONS The new realities of the digital age have brought about a number of resilient challenges for survey researchers, which in turn have exposed some of the inefficiencies associated with the traditional methods this community has relied upon for decades. The resilience of such challenges suggests that piecemeal approaches that may have limited applicability or restricted accessibility will prove to be inadequate and transient. It is from this perspective that our proposed method of composite weighting has aimed to introduce a durable and accessible solution for hybrid sample surveys.
Collapse
Affiliation(s)
| | - Elizabeth C Hair
- Truth Initiative Schroeder Institute, Washington, DC, United States
| | - Elizabeth K Do
- Truth Initiative Schroeder Institute, Washington, DC, United States
| | | | - Xiaolu Yan
- Ipsos USA, San Francisco, CA, United States
| | - Elisa Chan
- Ipsos USA, San Francisco, CA, United States
| | | | | | | |
Collapse
|
4
|
Do EK, Diaz MC, Bertrand A, Liu S(M, Hair EC. E-Cigarette Brand Trends in the United States: An Investigation of Data From a Youth and Young Adult Sample and the E-Cigarette Retail Market (2022). Tob Use Insights 2024; 17:1179173X241237216. [PMID: 38455141 PMCID: PMC10916459 DOI: 10.1177/1179173x241237216] [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: 09/06/2023] [Accepted: 02/17/2024] [Indexed: 03/09/2024] Open
Abstract
Background Electronic cigarettes (e-cigarettes) remain the most used tobacco product among young people in the United States (US). Given the need for current data on popular e-cigarette products, the current study leverages data from a rapid surveillance survey of young people and examines whether the top e-cigarette brands identified from this source align with US market data. Methodology Data were obtained from current e-cigarette users (N = 4145) participating in the Truth Continuous Tracker Online (CTO; a cross-sectional tracking survey of 15-24 year-olds sourced from the national Dynata panel) and NielsenIQ retail scanner data, collected in 2022 and aggregated by quarter (Q1, Q2, and Q3). The top 15 e-cigarette brands were determined from respondents' endorsement in the Truth CTO and ranked total sales in NielsenIQ in nominal dollars. Results Overall, 58% of e-cigarette brands overlapped across the Truth CTO and NielsenIQ data (60% for Q1, 47% for Q2 and 67% for Q3). Pod-based (JUUL; VUSE) and disposable (Hyde; Breeze Smoke) brands appeared as top brands in both datasets. Top brands were fairly consistent within and across quarters; though, more variability was found in the Truth CTO, relative to NielsenIQ. Many top brands were disposable. Conclusions Results suggest that data from rapid surveillance and retail data can be used complementarily to characterize the popular e-cigarette brands currently on the US market. Many of these popular e-cigarette brands have yet to receive marketing granted orders under the US Food and Drug Administration, suggesting the need to continue monitoring e-cigarette brands among young people.
Collapse
Affiliation(s)
- Elizabeth K. Do
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Megan C. Diaz
- Schroeder Institute, Truth Initiative, Washington, DC, USA
| | | | | | - Elizabeth C. Hair
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- School of Global Public Health, New York University, New York, NY, USA
| |
Collapse
|
5
|
Fuemmeler BF, Wheeler DC, Miller CA, Hayes RB, Do EK, Jeremy Barsell D, Fugate-Laus K, Pope MA. Advertising Exposure From Online and Offline Sources and Youth Tobacco Use: Findings From the Adolescents, Place, and Behavior Study. Nicotine Tob Res 2024; 26:353-360. [PMID: 37715625 DOI: 10.1093/ntr/ntad134] [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: 12/02/2022] [Revised: 06/06/2023] [Accepted: 07/27/2023] [Indexed: 09/17/2023]
Abstract
INTRODUCTION Tobacco use among adolescents is an ongoing public health concern. Youth tobacco use has been associated with advertising, from both online sources and retail environments. AIMS AND METHODS This study examined associations between exposure to tobacco advertisements from tobacco retail outlets (TROs), internet, and social media sources and ever tobacco use among adolescents. Data were obtained from youth, aged 11-17 years (N = 401) from Richmond, VA. Bayesian index and group index models were fitted to estimate indices of exposure to (1) social media use, (2) tobacco ads on social media, and (3) TRO store visits and their association with ever tobacco use. The most important components of the exposure indices were also determined based on the index component weights from the Bayesian index models. RESULTS In Bayesian index models of single exposures, each exposure index was significantly associated with tobacco use. In the best-fitting model, social media tobacco ads (odds ratio [OR] = 2.2; 95% credible interval [CI]: 1.2, 4.5) and TRO store visits (OR = 1.6; 95% CI: 1.1, 2.3) were significantly associated with ever tobacco use, as was older age (OR = 1.4; 95% CI: 1.2, 1.8). Index component weights revealed Snapchat ad frequency as the most important platform in the social media index and convenience stores as the most important type of store in the TRO index. CONCLUSIONS Exposure to pro-tobacco advertisements on social media and visits to TROs are associated with adolescent ever tobacco use. Results provide support for policies that would restrict the promotion of tobacco products at TROs and on social media. Tobacco regulations and interventions targeting convenience stores and Snapchat may be warranted to reduce youth tobacco use. IMPLICATIONS Current evidence provide support for policies that would restrict the promotion of tobacco products at TROs and on social media. Findings suggest that regulations and interventions that specifically target advertisements in convenience stores and on Snapchat may be currently warranted to reduce youth tobacco use.
Collapse
Affiliation(s)
- Bernard F Fuemmeler
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, USA
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
| | - David C Wheeler
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, USA
| | - Carrie A Miller
- College of Journalism and Communication, University of Florida, Gainesville, FL, USA
- STEM Translational Communication Center, University of Florida, Gainesville, FL, USA
- University of Florida Health Cancer Center, Gainesville, FL, USA
| | - Rashelle B Hayes
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Elizabeth K Do
- Schroeder Institute, Truth Initiative, Washington, DC, USA
| | - D Jeremy Barsell
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, USA
| | - Kendall Fugate-Laus
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | | |
Collapse
|
6
|
Hair EC, Do EK, Liu SM, Tulsiani S, Vallone DM, Pierce JP. Patterns of Daily Cigarette and E-cigarette Use among United States Youth and Young Adults: Insights from the Truth Longitudinal Cohort between 2018 and 2019. Prev Med Rep 2023; 36:102416. [PMID: 37753384 PMCID: PMC10518703 DOI: 10.1016/j.pmedr.2023.102416] [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] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/28/2023] Open
Abstract
Purpose Temporal patterns of daily tobacco product use among ever users from the Truth Longitudinal Cohort (TLC) between 2018 and 2019 were explored. Methods The sample (N = 5274) includes individuals (15-36 years), residing in the United States, who had ever used any tobacco product at Wave 7 (February - May 2018) and provided tobacco use information at Wave 9 (September - December 2019). Results There was a nonsignificant 1.1 percentage point increase in daily tobacco use (on at least 25 of the past 30 days), from 14.6% (95% CI: 12.8, 16.6) to 15.7% (95% CI: 13.8, 17.7). Tobacco product use remained stable over time, as 65.3% (95% CI: 56.4, 73.3) of daily cigarette smokers, 57.0% (95% CI: 43.6, 69.4) of daily e-cigarette vapers, and 8.5% (95% CI: 2.0, 29.3) of daily dual users stayed with their primary tobacco product. There was also some evidence of switching, as 7.5% (95% CI: 3.7, 14.8) of daily cigarette smokers became daily e-cigarette vapers and 2.3% (95% CI: 0.7, 6.8) of daily e-cigarette vapers became daily cigarette smokers. Discussion Although most daily tobacco users were likely to continue using their primary product, some daily users transitioned to daily use of other products - suggesting that policies and public education focused on reducing overall nicotine use are essential for addressing the nicotine epidemic among young people.
Collapse
Affiliation(s)
- Elizabeth C. Hair
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- School of Global Public Health, New York University, New York, NY, USA
| | - Elizabeth K. Do
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | | | | | - Donna M. Vallone
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- School of Global Public Health, New York University, New York, NY, USA
| | - John P. Pierce
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego Cancer, La Jolla, CA, USA
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| |
Collapse
|
7
|
Do EK, Tulsiani S, Edwards G, Cha S, Amato MS, Hair EC. Treatment-seeking young people enrolled in a United States vaping cessation intervention trial report high frequency of use and nicotine dependence. Prev Med Rep 2023; 36:102533. [PMID: 38116264 PMCID: PMC10728452 DOI: 10.1016/j.pmedr.2023.102533] [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: 09/22/2023] [Revised: 11/29/2023] [Accepted: 12/01/2023] [Indexed: 12/21/2023] Open
Abstract
Objective This study examines characteristics of participants enrolled in a vaping cessation intervention trial and study generalizability of the treatment-seeking sample to the broader population of young people interested in quitting vaping to evaluate dissemination of an evidence-based treatment program. Methods Data was obtained from 697 treatment-seeking participants (aged 13-24 years) from a vaping cessation intervention trial conducted between February and March 2023 with This is Quitting and 665 participants who expressed intent to quit vaping in the Truth Longitudinal Cohort, a nationally representative longitudinal study of United States youth and young adults (aged 15-24 years), collected October 2022 to February 2023. Comparisons were made using two-sample Pearson Chi-square tests and t-tests. Results Treatment-seeking young people were younger, less racially diverse, more diverse in sexual orientation, and reported higher psychological distress, frequency of e-cigarette use, and nicotine dependence, relative to the nationally representative sample of young people expressing intentions to quit vaping. Conclusions Participants enrolled in treatment reported higher levels of dependence and use frequency than the broader population, suggesting that many young e-cigarette users with lower dependence who want to quit might not be reached by current treatment dissemination efforts. The implication of these findings is that communications for vaping cessation programs may need to be adjusted to have broader appeal among young people.
Collapse
Affiliation(s)
| | | | | | - Sarah Cha
- Innovations, Truth Initiative, Washington, DC, USA
| | | | | |
Collapse
|
8
|
Do EK, O'Connor K, Diaz MC, Schillo BA, Kreslake JM, Hair EC. Relative increases in direct-to-consumer menthol ads following 2020 FDA guidance on flavoured e-cigarettes. Tob Control 2023; 32:779-781. [PMID: 35184047 DOI: 10.1136/tobaccocontrol-2021-057069] [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: 09/20/2021] [Accepted: 02/07/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To examine potential changes in email and direct mail advertisements for flavoured e-cigarettes following the 2020 Food and Drug Administration (FDA) flavour guidance. METHODS Digital copies of e-cigarette advertisements were obtained from Mintel Comperemedia (November 2019-May 2020) and coded for the presence of flavours. Χ2 tests were used to determine changes in the prevalence of email and direct mail advertisements for e-cigarettes with menthol, non-menthol and no flavours. RESULTS Following FDA guidance, the relative proportion of menthol-flavoured e-cigarette advertisements sent via email significantly increased from 22.5% to 52.2%. No changes were found for e-cigarette advertisements mentioning no flavours, nor non-menthol-flavoured e-cigarettes, sent via email or direct mail. CONCLUSIONS The 2020 FDA flavour guidance was followed by an increased proportion of direct-to-consumer email advertisements of menthol-flavoured e-cigarette products.
Collapse
Affiliation(s)
- Elizabeth K Do
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Epidemiology, The George Washington University Milken Institute of Public Health, Washington, DC, USA
| | - Katie O'Connor
- Schroeder Institute, Truth Initiative, Washington, DC, USA
| | - Megan C Diaz
- Schroeder Institute, Truth Initiative, Washington, DC, USA
| | | | - Jennifer M Kreslake
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Elizabeth C Hair
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
9
|
Do EK, Hair EC, Donovan EM, Nelson CD, McKay T, Vallone DM, Schillo BA. Youth E-Cigarette Initiation After the Food and Drug Administration's Missed Deadline. Am J Prev Med 2023; 65:886-891. [PMID: 37141951 DOI: 10.1016/j.amepre.2023.04.015] [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: 02/08/2023] [Revised: 04/27/2023] [Accepted: 04/28/2023] [Indexed: 05/06/2023]
Abstract
INTRODUCTION The U.S. Food and Drug Administration was ordered to evaluate electronic nicotine delivery system (ENDS) products by September 9, 2021, but missed the court-ordered deadline. This study provides an estimate of electronic cigarette (E-cigarette) use initiation among youth and young adults after the U.S. Food and Drug Administration's missed deadline. METHODS Data were obtained from the Truth Longitudinal Cohort, a probability-based longitudinal sample of youth and young adults aged between 15 and 24 years (N=1,393). Respondents were surveyed at baseline (July-October 2021) and at follow-up (January-June 2022). Individuals who had not previously used any E-cigarette products were included in analyses conducted in 2022. RESULTS Results indicate that 6.9% of youth and young adults had initiated E-cigarette use, suggesting that about 900,000 youth aged 15-17 years and 320,000 young adults aged 18-20 years initiated E-cigarette use after the U.S. Food and Drug Administration's missed court-ordered deadline. CONCLUSIONS Over a million youth and young adults initiated E-cigarette use after the U.S. Food and Drug Administration's missed court-ordered deadline. The U.S. Food and Drug Administration needs to continue evaluating premarket tobacco product applications, enforce decisions on premarket tobacco product applications, and remove E-cigarettes that are deemed harmful to public health to effectively address the E-cigarette epidemic among young people.
Collapse
Affiliation(s)
- Elizabeth K Do
- Truth Initiative Schroeder Institute, Washington, District of Columbia; Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia.
| | - Elizabeth C Hair
- Truth Initiative Schroeder Institute, Washington, District of Columbia; Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland; School of Global Public Health, New York University, New York, New York
| | - Emily M Donovan
- Truth Initiative Schroeder Institute, Washington, District of Columbia
| | - Carlin D Nelson
- Truth Initiative Schroeder Institute, Washington, District of Columbia
| | - Tatum McKay
- Truth Initiative Schroeder Institute, Washington, District of Columbia
| | - Donna M Vallone
- Truth Initiative Schroeder Institute, Washington, District of Columbia; Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland; School of Global Public Health, New York University, New York, New York
| | - Barbara A Schillo
- Truth Initiative Schroeder Institute, Washington, District of Columbia
| |
Collapse
|
10
|
Do EK, Aarvig K, Muller-Tabanera H, Mills S, Sumibcay JR, Koh HK, Vallone DM, Hair EC. E-cigarette use behaviors of Asian American, Native Hawaiian, and Pacific Islander youth in the contiguous United States: Insights from the Monitoring the Future Study (2018-2019). Prev Med Rep 2023; 35:102376. [PMID: 37662868 PMCID: PMC10472302 DOI: 10.1016/j.pmedr.2023.102376] [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] [Received: 01/26/2023] [Revised: 08/02/2023] [Accepted: 08/19/2023] [Indexed: 09/05/2023] Open
Abstract
This study examines e-cigarette use behaviors of Asian American, Native Hawaiian, and Pacific Islander (AANHPI) youth, in relation to other racial/ethnic groups in the United States. Data were obtained from the 2018 and 2019 Monitoring the Future surveys, which include a random, probability-based sample of youth in 8th, 10th, and 12th grades surveyed annually across the contiguous United States. Respondents provided information on race/ethnicity and e-cigarette use (n = 42,980). Measures of e-cigarette use included current (1 + of past 30 days) and regular use (10 + of past 30 days). Chi-square tests were used to determine differences in e-cigarette use by race/ethnicity. Associations between race/ethnicity, other sociodemographic factors, and e-cigarette use were explored using logistic regression analyses. Approximately 5.1% (n = 2,410) of the sample identified as AANHPI. A greater proportion of Native Hawaiian and Pacific Islanders reported current e-cigarette use (NHPI, 28.0%), relative to Asian American (AA, 10.3%), Black (9.5%), Hispanic or Latino (15.0%), American Indian or Alaskan Native (AIAN, 16.5%), multiracial (22.3%), and non-Hispanic White (25.2%) youth. Regular e-cigarette use was highest among non-Hispanic White (12.3%), followed by multiracial (10.7%), AIAN (7.8%), Hispanic or Latino (5.0%), AA (4.3%), and Black (3.0%) youth. Associations between race/ethnicity and e-cigarette use remained significant, after controlling for other sociodemographic factors. Continued monitoring of e-cigarette use is needed among AANHPI, a historically underrepresented population in tobacco research. Special attention should be paid to NHPI, who reported the highest rates of e-cigarette use.
Collapse
Affiliation(s)
- Elizabeth K. Do
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | | | | | - Sarah Mills
- Schroeder Institute, Truth Initiative, Washington, DC, USA
| | | | - Howard K. Koh
- T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Donna M. Vallone
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Department of Health, Behavior and Society, Bloomberg School of Public Health, John Hopkins University, Baltimore, MD, USA
- School of Global Public Health, New York University, New York, NY, USA
| | - Elizabeth C. Hair
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Department of Health, Behavior and Society, Bloomberg School of Public Health, John Hopkins University, Baltimore, MD, USA
- School of Global Public Health, New York University, New York, NY, USA
| |
Collapse
|
11
|
Do EK, Aarvig K, Donovan EM, Barrington-Trimis JL, Vallone DM, Hair EC. E-cigarette Device Type, Source, and Use Behaviors of Youth and Young Adults: Findings from the Truth Longitudinal Cohort (2020-2021). Subst Use Misuse 2023; 58:796-803. [PMID: 36924188 PMCID: PMC10361006 DOI: 10.1080/10826084.2023.2188555] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Background: E-cigarette device types vary in the amount of nicotine delivered to users. Given that youth and young adults are using pod-based and disposable e-cigarettes with high nicotine concentrations, it is important to determine how e-cigarette use behaviors associated with nicotine dependence may differ across e-cigarette device type. Methods: Baseline information was collected from September 2020 to March 2021 and follow-up information was collected from July to October 2021 from the Truth Longitudinal Cohort. The final analytic sample included respondents (aged 15-24) who reported current use of e-cigarettes at either baseline or follow-up and provided information on the 4-item E-cigarette Dependence Scale (EDS). Differences in endorsement of items from the EDS by e-cigarette device type (pod-based, disposable, or tank) were assessed using chi-square tests. Results: Participants (N = 308) were evenly split on age (15-20, 21+) and gender. Most 15-20-year-olds used disposable e-cigarettes, while those 21+ years primarily used tank devices. Although EDS score did not differ by e-cigarette device type, positive endorsement of two items from the EDS significantly differed by e-cigarette device type. More tank users endorsed reaching for a device without thinking about it (tank: 92.6%; pod-based: 79.0%; disposables: 79.9%, p = 0.04) and vaping more before going into a situation where vaping is not allowed (tank: 92.9%; pod-based: 71.0%; disposables: 73.0%, p < 0.01). Conclusions: Findings have the potential to inform policy implementation by providing evidence for specific targets for regulatory action that can help to reduce the burdens of e-cigarette use among youth and young adults, as results suggest that tank device users are more likely to endorse use behaviors associated with nicotine dependence.
Collapse
Affiliation(s)
- Elizabeth K Do
- Schroeder Institute, Truth Initiative, Washington, DC, USA.,Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | | | | | - Jessica L Barrington-Trimis
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Donna M Vallone
- Schroeder Institute, Truth Initiative, Washington, DC, USA.,Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.,School of Global Public Health, New York University, New York, New York, USA
| | - Elizabeth C Hair
- Schroeder Institute, Truth Initiative, Washington, DC, USA.,Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.,School of Global Public Health, New York University, New York, New York, USA
| |
Collapse
|
12
|
Soule EK, Mayne S, Snipes W, Do EK, Theall T, Höchsmann C, Talih S, Martin CK, Eissenberg T, Fuemmeler BF. Electronic Cigarette Nicotine Flux, Nicotine Yield, and Particulate Matter Emissions: Impact of Device and Liquid Heterogeneity. Nicotine Tob Res 2023; 25:412-420. [PMID: 35965260 PMCID: PMC9910146 DOI: 10.1093/ntr/ntac196] [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: 10/26/2021] [Revised: 07/29/2022] [Accepted: 08/10/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Electronic cigarettes (ECIGs) heat a nicotine-containing liquid to produce an inhalable aerosol. ECIG power (wattage) and liquid nicotine concentration are two factors that predict nicotine emission rate ("flux"). These factors can vary greatly across devices and users. AIMS AND METHODS The purpose of this study was to examine ECIG device and liquid heterogeneity in "real world" settings and the association with predicted nicotine flux, nicotine yield, and total particulate matter (TPM) emissions. Past 30-day ECIG users (n = 84; mean age = 23.8 years [SD = 9.6]) reported device and liquid characteristics. Device power was measured via multimeter, device display screens, or obtained via labeling. Liquid nicotine concentration was obtained via labeling or through chemical analysis. Predicted nicotine flux, nicotine yield, and TPM associated with 10 4-second puffs were calculated for participants' primary devices. RESULTS Participants' primary devices were box mods (42.9%), disposable vapes (20.2%), and pod mods (36.9%). Most participants (65.5%) reported not knowing their primary device wattage. Rebuildable/box mods had the greatest power range (11.1-120.0 W); pod mod power also varied considerably (4.1-21.7 W). Unlike device wattage, most participants (95.2%) reported knowing their liquid nicotine concentration, which ranged from 3.0 to 86.9 mg/ml (M = 36.0, SD = 29.3). Predicted nicotine flux varied greatly across products (range =12.0-160.1 μg/s, M = 85.6 μg/s, SD = 34.3). Box mods had the greatest variability in wattage and predicted nicotine flux, nicotine yield, and TPM yield. CONCLUSIONS ECIG device and liquid heterogeneity influence nicotine and other toxicant emissions. Better measurement of ECIG device and liquid characteristics is needed to understand nicotine and toxicant emissions and to inform regulatory policy. IMPLICATIONS ECIG device and liquid heterogeneity cause great variability in nicotine flux and toxicants emitted. These data demonstrate the need to examine device and liquid characteristics to develop empirically informed, health-promoting regulatory policies. Policies may include setting product standards such that ECIG products cannot (1) have nicotine fluxes much greater than that of a cigarette to decrease the risk of dependence, (2) have nicotine fluxes that are very low and thus would have minimal appeal to cigarette smokers and may serve as starter products for youth or nontobacco users, and (3) emit large amounts of particulate matter and other toxicants.
Collapse
Affiliation(s)
- Eric K Soule
- Department of Health Education and Promotion, East Carolina University, Greenville, NC, USA
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
| | - Shannon Mayne
- Department of Health Education and Promotion, East Carolina University, Greenville, NC, USA
| | - William Snipes
- Department of Health Education and Promotion, East Carolina University, Greenville, NC, USA
| | - Elizabeth K Do
- Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
- Schroeder Institute, Truth Initiative, Washington, DC, USA
| | - Travis Theall
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Christoph Höchsmann
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Soha Talih
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
- Mechanical Engineering Department, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Corby K Martin
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Thomas Eissenberg
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
| | - Bernard F Fuemmeler
- Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
| |
Collapse
|
13
|
Do EK, Aarvig K, Donovan EM, Schillo BA, Vallone DM, Hair EC. Underage Youth Continue to Obtain E-Cigarettes from Retail Sources in 2022: Evidence from the Truth Continuous Tracking Survey. Int J Environ Res Public Health 2023; 20:1399. [PMID: 36674152 PMCID: PMC9859475 DOI: 10.3390/ijerph20021399] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/05/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
(1) Background: This study aims to describe the primary sources of e-cigarettes among young people and to explore how these sources may differ by individual-level characteristics. (2) Methods: Data were obtained from a cross-sectional, continuous tracking survey of participants. The analytic sample includes current e-cigarette users (aged 15-20 years) surveyed from January to August 2022 (N = 1296). Respondents provided information on e-cigarette source of acquisition, device type, and flavors used, as well as sociodemographic and residential characteristics. Chi-square tests were used to determine differences in source of acquisition by age, gender, race/ethnicity, United States (US) census region, urban-rural classification, flavors used, and device type. (3) Results: Although most current e-cigarette users obtained their devices through a social source (56.9%), a considerable proportion obtained e-cigarettes from a retail source (43.1%). The primary retail sources of e-cigarette acquisition were vape shops (22.0%) and gas station/convenience stores (15.9%). Source of e-cigarette acquisition differed by age, gender, US census region, flavors used, and device type, such that a lower proportion of those who were younger, female, residing in the West, and used vape pens had reported obtaining e-cigarettes via retail sources. (4) Conclusions: Results indicate that a significant proportion of youth report obtaining e-cigarettes from retail sources, despite the federal, state, and local policies that prohibit the sale of any tobacco products to those under the age of 21. Comprehensive retail regulations to help restrict tobacco product access are needed to reduce e-cigarette use among young people.
Collapse
Affiliation(s)
- Elizabeth K. Do
- Schroeder Institute, Truth Initiative, Washington, DC 20001, USA
- Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
| | - Kathleen Aarvig
- Schroeder Institute, Truth Initiative, Washington, DC 20001, USA
| | - Emily M. Donovan
- Schroeder Institute, Truth Initiative, Washington, DC 20001, USA
| | | | - Donna M. Vallone
- Schroeder Institute, Truth Initiative, Washington, DC 20001, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- School of Global Public Health, New York University, New York, NY 10003, USA
| | - Elizabeth C. Hair
- Schroeder Institute, Truth Initiative, Washington, DC 20001, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- School of Global Public Health, New York University, New York, NY 10003, USA
| |
Collapse
|
14
|
Cooke ME, Clifford JS, Do EK, Gilman JM, Maes HH, Peterson RE, Prom-Wormley EC, Evins AE, Schuster RM. Polygenic score for cigarette smoking is associated with ever electronic-cigarette use in a college-aged sample. Addiction 2022; 117:1071-1078. [PMID: 34636095 PMCID: PMC9875558 DOI: 10.1111/add.15716] [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: 03/03/2021] [Accepted: 09/23/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND AIMS Electronic cigarette use has escalated rapidly in recent years, particularly among youth. Little is known about the genetic influences on e-cigarette use. This study aimed to determine whether genetic risk for regular use of combustible cigarettes or for number of cigarettes smoked per day confers risk for ever e-cigarette use or frequency of e-cigarette use. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS We used data from 9541 young adults from the Spit for Science longitudinal cohort study (2011-2019). Polygenic scores (PGS) of regular combustible cigarette use (PGS-RCU) and cigarettes per day (PGS-CPD) were constructed using summary statistics from the two largest available genome-wide association study (GWAS) meta-analysis of European ancestry and East Asian ancestry of combustible cigarette use and used to test whether the PGS of RCU or CPD predicted lifetime e-cigarette use and frequency of past 30-day e-cigarette use in a diverse sample of young adults of African (AFR), Admixed American (AMR), East Asian (EAS), European (EUR), and South Asian (SAS) ancestry. FINDINGS The PGS-RCU was associated with lifetime e-cigarette use in the EUR sample (OR = 1.27, 95% CI = 1.19-1.36, P = 7.53 × 10-12 ), but not in the other subsamples (ps > 0.12). This association remained significant after excluding regular combustible cigarette smokers (OR = 1.21, 95% CI = 1.12-1.31, P = 3.36 × 10-6 ). There was no statistically significant association between PGS-CPD and lifetime e-cigarette use and neither the PGS-RCU nor the PGS-CPD were associated with frequency of e-cigarette use in the past 30 days in any of the subsamples. CONCLUSIONS Genetic factors associated with regular combustible cigarette use appear to be associated with ever e-cigarette use in young adults. We did not find evidence for shared genetic factors influencing heaviness of use of combustible cigarettes and current e-cigarette use frequency.
Collapse
Affiliation(s)
- Megan E. Cooke
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, 101 Merrimac St., Boston MA 02114, USA
| | - James S. Clifford
- Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, Richmond VA, USA
| | - Elizabeth K. Do
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond VA, USA
| | - Jodi M. Gilman
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, 101 Merrimac St., Boston MA 02114, USA
| | | | - Hermine H. Maes
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, School of Medicine, Virginia Commonwealth University Richmond VA, USA,Department of Human and Molecular Genetics, Virginia Commonwealth University Richmond VA, USA,Massey Cancer Center, Virginia Commonwealth University, Richmond VA, USA
| | - Roseann E. Peterson
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, School of Medicine, Virginia Commonwealth University Richmond VA, USA
| | - Elizabeth C. Prom-Wormley
- Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, Richmond VA, USA,Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, School of Medicine, Virginia Commonwealth University Richmond VA, USA,Department of Human and Molecular Genetics, Virginia Commonwealth University Richmond VA, USA
| | - A. Eden Evins
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, 101 Merrimac St., Boston MA 02114, USA
| | - Randi M. Schuster
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, 101 Merrimac St., Boston MA 02114, USA
| |
Collapse
|
15
|
Do EK, O'Connor K, Kreslake JM, Friedrichsen SC, Vallone DM, Hair EC. Influence of Flavors and Nicotine Concentration on Nicotine Dependence in Adolescent and Young Adult E-Cigarette Users. Subst Use Misuse 2022; 57:632-639. [PMID: 35138226 DOI: 10.1080/10826084.2022.2034876] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Objective: The objective of this study is to examine the relationships between e-cigarette flavors, nicotine concentration, and their interaction on measures of nicotine dependence.Methods: Survey data are drawn from a cross-sectional convenience sample of past 30-day e-cigarette users aged 15 to 24 years (N = 2037) collected between October 2020 and November 2020. Participants were asked to provide information about the e-cigarette products they used most regularly. Only those with available information on flavors (fruit, mint, menthol/ice, and tobacco), nicotine concentration (0-2.9%, 3-4.9%, and 5% or greater), and time to first vape after waking (within 30 minutes, greater than 30 minutes) were included in analyses (N = 1430). Generalized linear regression models were used with log link and binary distribution to assess the relationship between flavors, nicotine concentration, and nicotine dependence. Effect modification by nicotine concentration was assessed using an interaction term for flavors by nicotine concentration. Models were adjusted for age, race/ethnicity, gender, and financial situation.Findings: Fruit, mint, and menthol flavor user groups had a very similar dose-response relationship between nicotine concentration and prevalence of vaping within 30 minutes. These groups showed that the prevalence of vaping within 30 minutes gradually increased as nicotine concentration increased. Meanwhile, tobacco flavor user groups demonstrated a decrease in prevalence of vaping within 30 minutes, as nicotine concentration increased.Conclusion: Results highlight the need for understanding how e-cigarette product characteristics like flavors and nicotine concentration can facilitate nicotine dependence to e-cigarettes. Findings suggest that comprehensive e-cigarette product regulation of all flavors and reducing nicotine concentration will help to reduce the risk for nicotine dependence among young people.
Collapse
Affiliation(s)
- Elizabeth K Do
- Schroeder Institute at Truth Initiative, Washington, DC, USA
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
- Department of Epidemiology, George Washington University Milken Institute of Public Health, Washington, DC, USA
| | - Katie O'Connor
- Schroeder Institute at Truth Initiative, Washington, DC, USA
| | - Jennifer M Kreslake
- Schroeder Institute at Truth Initiative, Washington, DC, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Donna M Vallone
- Schroeder Institute at Truth Initiative, Washington, DC, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- College of Global Public Health, New York University, New York, New York, USA
| | - Elizabeth C Hair
- Schroeder Institute at Truth Initiative, Washington, DC, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- College of Global Public Health, New York University, New York, New York, USA
| |
Collapse
|
16
|
Do EK, O’Connor K, Perks SN, Soule EK, Eissenberg T, Amato MS, Graham AL, Martin CK, Höchsmann C, Fuemmeler BF. E-cigarette device and liquid characteristics and E-cigarette dependence: A pilot study of pod-based and disposable E-cigarette users. Addict Behav 2022; 124:107117. [PMID: 34555560 PMCID: PMC8511126 DOI: 10.1016/j.addbeh.2021.107117] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 04/27/2021] [Revised: 09/02/2021] [Accepted: 09/08/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND E-cigarette device and liquid characteristics, such as electrical power output and liquid nicotine concentration, determine the rate at which nicotine is emitted from the e-cigarette (i.e., nicotine flux), and thus are likely to influence user nicotine dependence. We hypothesize that nicotine flux would be associated with the E-cigarette Dependence Scale (EDS) among pod-based and disposable e-cigarette products. METHODS Data were obtained from online panel participants between 18 and 65 years of age, who had indicated that they were either former or current e-cigarette users and resided within the United States (N = 1036). To be included in these analyses, participants had to provide information regarding device type (pod-based or disposable), power (watts), and nicotine concentration (mg/mL), from which we could determine nicotine flux (µg/s) (N = 666). To assess the relationship between nicotine flux and EDS, a series of multivariable linear regressions were conducted. Each model was separated by device type and adjusted for by age and past 30-day e-cigarette use. RESULTS Greater nicotine flux was associated with higher EDS scores among pod-based e-cigarette users (beta = 0.19, SE = 0.09, p-value = 0.043), but not users of disposable e-cigarettes. Neither power nor nicotine concentration were associated with EDS scores among users of either e-cigarette device type. CONCLUSION Results support the hypothesis that nicotine flux is positively associated with nicotine dependence in a sample of current users of pod-based and disposable e-cigarettes.
Collapse
Affiliation(s)
- Elizabeth K. Do
- Schroeder Institute at Truth Initiative, Washington, DC, USA,Department of Health Behavior and Policy, Virginia Commonwealth University,Department of Epidemiology, Milken Institute of Public Health, The George Washington University, Washington, DC, USA
| | - Katie O’Connor
- Schroeder Institute at Truth Initiative, Washington, DC, USA
| | | | - Eric K. Soule
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Grenville, NC, USA,Center for the Study of Tobacco Products, Psychology Department (Health Program), Virginia Commonwealth University, Richmond, VA, USA
| | - Thomas Eissenberg
- Center for the Study of Tobacco Products, Psychology Department (Health Program), Virginia Commonwealth University, Richmond, VA, USA
| | - Michael S. Amato
- Truth Initiative Innovations Department, Washington, DC, USA,Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Amanda L. Graham
- Truth Initiative Innovations Department, Washington, DC, USA,Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Corby K. Martin
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Christoph Höchsmann
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Bernard F. Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University,Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
| |
Collapse
|
17
|
Do EK, Tulsiani S, Vallone DM, Hair EC. Transitions in Frequent to Daily Tobacco and Nicotine Use among Youth and Young Adults. Subst Use Misuse 2022; 57:1681-1687. [PMID: 35938747 DOI: 10.1080/10826084.2022.2107674] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Objective: To examine use and frequency patterns across e-cigarettes, cigarettes, and little cigars, cigarillos, and cigars (LCCs) over time. Methods: Data were obtained from the Truth Longitudinal Cohort (TLC), a nationally representative longitudinal cohort of youth and young adults. Latent class analysis was conducted to classify participants (n = 5274) into subgroups based upon frequency of use of cigarettes, e-cigarettes, and little cigars, cigarillos, and cigars (LCCs) in the past 30 days. Latent transition analysis was used to estimate the probability of use pattern transitions across 23 months (February 2018 to December 2019), adjusted for the effects of gender, race/ethnicity, financial situation, sensation seeking, parent education, and household smoking. Findings: Findings reveal four groups of tobacco product users: (1) frequent to daily cigarette users (9%), (2) frequent to daily cigarette and LCC users (3%), (3) frequent to daily e-cigarette users (10%), and (4) former or noncurrent tobacco users (78%). Although most respondents (69-94%) retained their initial user patterns during the observation period, results also indicate shifts between user groups. Notably, 14% of frequent to daily cigarette and LCC users transitioned to frequent to daily cigarette use, while 6% of frequent to daily cigarette and LCC users, 9% of frequent to daily cigarette users, and 4% of former or noncurrent tobacco users transitioned to frequent to daily e-cigarette use. Conclusion: Although most frequent to daily tobacco users stay with their primary product, there are transitions between frequent to daily cigarette, e-cigarette, and LCC use. Transition patterns may influence risk for nicotine addiction among youth and young adults. Thus, policies focused on preventing and reducing all tobacco use are needed to curb the risk of nicotine addiction among youth and young adults.
Collapse
Affiliation(s)
- Elizabeth K Do
- Schroeder Institute, Truth Initiative, Washington, DC, USA.,Department of Epidemiology, George Washington University Milken Institute of Public Health, Washington, DC, USA
| | | | - Donna M Vallone
- Schroeder Institute, Truth Initiative, Washington, DC, USA.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,College of Global Public Health, New York University, New York, NY, USA
| | - Elizabeth C Hair
- Schroeder Institute, Truth Initiative, Washington, DC, USA.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,College of Global Public Health, New York University, New York, NY, USA
| |
Collapse
|
18
|
Do EK, Ksinan AJ, Kim SJ, Del Fabbro EG, Fuemmeler BF. Cannabis use among cancer survivors in the United States: Analysis of a nationally representative sample. Cancer 2021; 127:4040-4049. [PMID: 34387864 PMCID: PMC8600683 DOI: 10.1002/cncr.33794] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 02/19/2021] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Research on cannabis use among those with a history of cancer is limited. METHODS Prevalence of past-year cannabis use among individuals with and without a cancer history and predictors of use within these 2 groups were determined using data from the Population Assessment of Tobacco and Health study, a nationally representative, longitudinal survey conducted in the United States (waves 1-4; 2013-2018). Discrete time survival analyses were used to estimate baseline (wave 1) predictors (physical health status, mental health status, pain, and demographic variables) on past-year engagement with cannabis within individuals who reported a cancer diagnosis at wave 1 (n = 1022) and individuals who reported never having cancer at any wave (n = 19,702). RESULTS At the most recent survey, 8% of cancer survivors reported past-year cannabis use, compared with 15% of those without a cancer history. Across 4 time points, an estimated 3.8% of cancer survivors engaged with cannabis, as compared to 6.5% of those without a cancer history. Across both groups, older age and having health insurance were associated with lower likelihood of engaging in cannabis use, whereas greater levels of pain were associated with higher likelihood of engaging in cannabis use. Among those without a cancer history, being female, White, and having better mental health status were associated with lower likelihood of engaging in cannabis use. CONCLUSIONS Although cannabis use prevalence is lower among cancer survivors, the reasons for use are not markedly different from those without a cancer history. Continued monitoring of use, reasons for use, and harms or benefits is warranted. LAY SUMMARY Results from this study, which uses data from the Population Assessment of Tobacco and Health Study, indicate that cannabis use is generally increasing across cancer survivors and those without a history of cancer. Cancer survivors are using cannabis at slightly lower rates than those without a history of cancer. Factors related to pain seem to be more prevalent in cancer populations relative to the general population, and could be contributing to cannabis use within cancer survivor populations.
Collapse
Affiliation(s)
- Elizabeth K. Do
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, Virginia, USA
- Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Albert J. Ksinan
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Sunny Jung Kim
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, Virginia, USA
- Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Egidio G. Del Fabbro
- Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Bernard F. Fuemmeler
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, Virginia, USA
- Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA
| |
Collapse
|
19
|
Lisdahl KM, Tapert S, Sher KJ, Gonzalez R, Nixon SJ, Ewing SWF, Conway KP, Wallace A, Sullivan R, Hatcher K, Kaiver C, Thompson W, Reuter C, Bartsch H, Wade NE, Jacobus J, Albaugh MD, Allgaier N, Anokhin AP, Bagot K, Baker FC, Banich MT, Barch DM, Baskin-Sommers A, Breslin FJ, Brown SA, Calhoun V, Casey BJ, Chaarani B, Chang L, Clark DB, Cloak C, Constable RT, Cottler LB, Dagher RK, Dapretto M, Dick A, Do EK, Dosenbach NUF, Dowling GJ, Fair DA, Florsheim P, Foxe JJ, Freedman EG, Friedman NP, Garavan HP, Gee DG, Glantz MD, Glaser P, Gonzalez MR, Gray KM, Grant S, Haist F, Hawes S, Heeringa SG, Hermosillo R, Herting MM, Hettema JM, Hewitt JK, Heyser C, Hoffman EA, Howlett KD, Huber RS, Huestis MA, Hyde LW, Iacono WG, Isaiah A, Ivanova MY, James RS, Jernigan TL, Karcher NR, Kuperman JM, Laird AR, Larson CL, LeBlanc KH, Lopez MF, Luciana M, Luna B, Maes HH, Marshall AT, Mason MJ, McGlade E, Morris AS, Mulford C, Nagel BJ, Neigh G, Palmer CE, Paulus MP, Pecheva D, Prouty D, Potter A, Puttler LI, Rajapakse N, Ross JM, Sanchez M, Schirda C, Schulenberg J, Sheth C, Shilling PD, Sowell ER, Speer N, Squeglia L, Sripada C, Steinberg J, Sutherland MT, Tomko R, Uban K, Vrieze S, Weiss SRB, Wing D, Yurgelun-Todd DA, Zucker RA, Heitzeg MM. Substance use patterns in 9-10 year olds: Baseline findings from the adolescent brain cognitive development (ABCD) study. Drug Alcohol Depend 2021; 227:108946. [PMID: 34392051 PMCID: PMC8833837 DOI: 10.1016/j.drugalcdep.2021.108946] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 01/15/2021] [Revised: 06/03/2021] [Accepted: 06/05/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND The Adolescent Brain Cognitive Development ™ Study (ABCD Study®) is an open-science, multi-site, prospective, longitudinal study following over 11,800 9- and 10-year-old youth into early adulthood. The ABCD Study aims to prospectively examine the impact of substance use (SU) on neurocognitive and health outcomes. Although SU initiation typically occurs during teen years, relatively little is known about patterns of SU in children younger than 12. METHODS This study aims to report the detailed ABCD Study® SU patterns at baseline (n = 11,875) in order to inform the greater scientific community about cohort's early SU. Along with a detailed description of SU, we ran mixed effects regression models to examine the association between early caffeine and alcohol sipping with demographic factors, externalizing symptoms and parental history of alcohol and substance use disorders (AUD/SUD). PRIMARY RESULTS At baseline, the majority of youth had used caffeine (67.6 %) and 22.5 % reported sipping alcohol (22.5 %). There was little to no reported use of other drug categories (0.2 % full alcohol drink, 0.7 % used nicotine, <0.1 % used any other drug of abuse). Analyses revealed that total caffeine use and early alcohol sipping were associated with demographic variables (p's<.05), externalizing symptoms (caffeine p = 0002; sipping p = .0003), and parental history of AUD (sipping p = .03). CONCLUSIONS ABCD Study participants aged 9-10 years old reported caffeine use and alcohol sipping experimentation, but very rare other SU. Variables linked with early childhood alcohol sipping and caffeine use should be examined as contributing factors in future longitudinal analyses examining escalating trajectories of SU in the ABCD Study cohort.
Collapse
Affiliation(s)
- Krista M Lisdahl
- University of Wisconsin, Milwaukee, WI, United States; Medical College of Wisconsin, Milwaukee, WI, United States.
| | - Susan Tapert
- University of California, San Diego, CA, United States
| | | | - Raul Gonzalez
- Florida International University, Miami, FL, United States
| | - Sara Jo Nixon
- University of Florida, Gainesville, FL, United States
| | | | - Kevin P Conway
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - Alex Wallace
- University of Wisconsin, Milwaukee, WI, United States
| | - Ryan Sullivan
- University of Wisconsin, Milwaukee, WI, United States
| | - Kelah Hatcher
- University of Wisconsin, Milwaukee, WI, United States
| | | | - Wes Thompson
- University of California, San Diego, CA, United States
| | - Chase Reuter
- University of California, San Diego, CA, United States
| | - Hauke Bartsch
- University of California, San Diego, CA, United States
| | | | | | - M D Albaugh
- University of Vermont, Burlington, VT, United States
| | - N Allgaier
- University of Vermont, Burlington, VT, United States
| | - A P Anokhin
- Washington University, St. Louis, MO, United States
| | - K Bagot
- University of California, San Diego, CA, United States; Icahn School of Medicine at Mount Sinai, United States
| | - F C Baker
- SRI International, Menlo Park, CA, United States
| | - M T Banich
- University of Colorado Boulder, CO, United States
| | - D M Barch
- Washington University, St. Louis, MO, United States
| | | | - F J Breslin
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - S A Brown
- University of California, San Diego, CA, United States
| | - V Calhoun
- Georgia State University, Atlanta, GA, United States
| | - B J Casey
- Yale University, New Haven, CT, United States
| | - B Chaarani
- University of Vermont, Burlington, VT, United States
| | - L Chang
- University of Maryland School of Medicine, Baltimore, MD, United States
| | - D B Clark
- University of Pittsburgh, Pittsburgh, PA, United States
| | - C Cloak
- University of Maryland School of Medicine, Baltimore, MD, United States
| | | | - L B Cottler
- University of Florida, Gainesville, FL, United States
| | - R K Dagher
- National Institute of Minority Health and Health Disparities, Bethesda, MD, United States
| | - M Dapretto
- University of California, Los Angeles, CA, United States
| | - A Dick
- Florida International University, Miami, FL, United States
| | - E K Do
- Virginia Commonwealth University, Richmond, VA, United States
| | | | - G J Dowling
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - D A Fair
- University of Minnesota, Minneapolis, MN, United States
| | - P Florsheim
- University of Wisconsin, Milwaukee, WI, United States
| | - J J Foxe
- University of Rochester, Rochester, NY, United States
| | - E G Freedman
- University of Rochester, Rochester, NY, United States
| | - N P Friedman
- University of Colorado Boulder, CO, United States
| | - H P Garavan
- University of Vermont, Burlington, VT, United States
| | - D G Gee
- Yale University, New Haven, CT, United States
| | - M D Glantz
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - P Glaser
- Washington University, St. Louis, MO, United States
| | - M R Gonzalez
- Children’s Hospital Los Angeles, Los Angeles, CA, United States
| | - K M Gray
- Medical University of South Carolina, Charleston, SC, United States
| | - S Grant
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - F Haist
- University of California, San Diego, CA, United States
| | - S Hawes
- Florida International University, Miami, FL, United States
| | - S G Heeringa
- University of Michigan, Ann Arbor, MI, United States
| | - R Hermosillo
- Oregon Health & Science University, Portland, OR, United States
| | - M M Herting
- University of Southern California, Los Angeles, CA, United States
| | - J M Hettema
- Virginia Commonwealth University, Richmond, VA, United States
| | - J K Hewitt
- University of Colorado Boulder, CO, United States
| | - C Heyser
- University of California, San Diego, CA, United States
| | - E A Hoffman
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - K D Howlett
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - R S Huber
- University of Utah, Salt Lake City, UT, United States
| | - M A Huestis
- University of California, San Diego, CA, United States; Thomas Jefferson University, Philadelphia, PA, United States
| | - L W Hyde
- University of Michigan, Ann Arbor, MI, United States
| | - W G Iacono
- University of Minnesota, Minneapolis, MN, United States
| | - A Isaiah
- University of Maryland School of Medicine, Baltimore, MD, United States
| | - M Y Ivanova
- University of Vermont, Burlington, VT, United States
| | - R S James
- American Psychistric Association, United States
| | - T L Jernigan
- University of California, San Diego, CA, United States
| | - N R Karcher
- Washington University, St. Louis, MO, United States
| | - J M Kuperman
- University of California, San Diego, CA, United States
| | - A R Laird
- Florida International University, Miami, FL, United States
| | - C L Larson
- University of Wisconsin, Milwaukee, WI, United States
| | - K H LeBlanc
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - M F Lopez
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - M Luciana
- University of Minnesota, Minneapolis, MN, United States
| | - B Luna
- University of Pittsburgh, Pittsburgh, PA, United States
| | - H H Maes
- Virginia Commonwealth University, Richmond, VA, United States
| | - A T Marshall
- Children’s Hospital Los Angeles, Los Angeles, CA, United States
| | - M J Mason
- University of Tennessee, Knoxville, TN, United States
| | - E McGlade
- University of Utah, Salt Lake City, UT, United States
| | - A S Morris
- Laureate Institute for Brain Research, Tulsa, OK, United States; Oklahoma State University, Stillwater, OK, United States
| | - C Mulford
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - B J Nagel
- Oregon Health & Science University, Portland, OR, United States
| | - G Neigh
- Virginia Commonwealth University, Richmond, VA, United States
| | - C E Palmer
- University of California, San Diego, CA, United States
| | - M P Paulus
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - D Pecheva
- University of California, San Diego, CA, United States
| | - D Prouty
- SRI International, Menlo Park, CA, United States
| | - A Potter
- University of Vermont, Burlington, VT, United States
| | - L I Puttler
- University of Michigan, Ann Arbor, MI, United States
| | - N Rajapakse
- National Institute of Minority Health and Health Disparities, Bethesda, MD, United States
| | - J M Ross
- University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - M Sanchez
- Florida International University, Miami, FL, United States
| | - C Schirda
- University of Pittsburgh, Pittsburgh, PA, United States
| | - J Schulenberg
- University of Michigan, Ann Arbor, MI, United States
| | - C Sheth
- University of Utah, Salt Lake City, UT, United States
| | - P D Shilling
- University of California, San Diego, CA, United States
| | - E R Sowell
- Children’s Hospital Los Angeles, Los Angeles, CA, United States
| | - N Speer
- University of Colorado Boulder, CO, United States
| | - L Squeglia
- Medical University of South Carolina, Charleston, SC, United States
| | - C Sripada
- University of Michigan, Ann Arbor, MI, United States
| | - J Steinberg
- Virginia Commonwealth University, Richmond, VA, United States
| | - M T Sutherland
- Florida International University, Miami, FL, United States
| | - R Tomko
- Medical University of South Carolina, Charleston, SC, United States
| | - K Uban
- University of California, Irvine, CA, United States
| | - S Vrieze
- University of Minnesota, Minneapolis, MN, United States
| | - S R B Weiss
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - D Wing
- University of California, San Diego, CA, United States
| | | | - R A Zucker
- University of Michigan, Ann Arbor, MI, United States
| | | | | |
Collapse
|
20
|
Chaarani B, Hahn S, Allgaier N, Adise S, Owens MM, Juliano AC, Yuan DK, Loso H, Ivanciu A, Albaugh MD, Dumas J, Mackey S, Laurent J, Ivanova M, Hagler DJ, Cornejo MD, Hatton S, Agrawal A, Aguinaldo L, Ahonen L, Aklin W, Anokhin AP, Arroyo J, Avenevoli S, Babcock D, Bagot K, Baker FC, Banich MT, Barch DM, Bartsch H, Baskin-Sommers A, Bjork JM, Blachman-Demner D, Bloch M, Bogdan R, Bookheimer SY, Breslin F, Brown S, Calabro FJ, Calhoun V, Casey BJ, Chang L, Clark DB, Cloak C, Constable RT, Constable K, Corley R, Cottler LB, Coxe S, Dagher RK, Dale AM, Dapretto M, Delcarmen-Wiggins R, Dick AS, Do EK, Dosenbach NUF, Dowling GJ, Edwards S, Ernst TM, Fair DA, Fan CC, Feczko E, Feldstein-Ewing SW, Florsheim P, Foxe JJ, Freedman EG, Friedman NP, Friedman-Hill S, Fuemmeler BF, Galvan A, Gee DG, Giedd J, Glantz M, Glaser P, Godino J, Gonzalez M, Gonzalez R, Grant S, Gray KM, Haist F, Harms MP, Hawes S, Heath AC, Heeringa S, Heitzeg MM, Hermosillo R, Herting MM, Hettema JM, Hewitt JK, Heyser C, Hoffman E, Howlett K, Huber RS, Huestis MA, Hyde LW, Iacono WG, Infante MA, Irfanoglu O, Isaiah A, Iyengar S, Jacobus J, James R, Jean-Francois B, Jernigan T, Karcher NR, Kaufman A, Kelley B, Kit B, Ksinan A, Kuperman J, Laird AR, Larson C, LeBlanc K, Lessov-Schlagger C, Lever N, Lewis DA, Lisdahl K, Little AR, Lopez M, Luciana M, Luna B, Madden PA, Maes HH, Makowski C, Marshall AT, Mason MJ, Matochik J, McCandliss BD, McGlade E, Montoya I, Morgan G, Morris A, Mulford C, Murray P, Nagel BJ, Neale MC, Neigh G, Nencka A, Noronha A, Nixon SJ, Palmer CE, Pariyadath V, Paulus MP, Pelham WE, Pfefferbaum D, Pierpaoli C, Prescot A, Prouty D, Puttler LI, Rajapaske N, Rapuano KM, Reeves G, Renshaw PF, Riedel MC, Rojas P, de la Rosa M, Rosenberg MD, Ross MJ, Sanchez M, Schirda C, Schloesser D, Schulenberg J, Sher KJ, Sheth C, Shilling PD, Simmons WK, Sowell ER, Speer N, Spittel M, Squeglia LM, Sripada C, Steinberg J, Striley C, Sutherland MT, Tanabe J, Tapert SF, Thompson W, Tomko RL, Uban KA, Vrieze S, Wade NE, Watts R, Weiss S, Wiens BA, Williams OD, Wilbur A, Wing D, Wolff-Hughes D, Yang R, Yurgelun-Todd DA, Zucker RA, Potter A, Garavan HP. Baseline brain function in the preadolescents of the ABCD Study. Nat Neurosci 2021; 24:1176-1186. [PMID: 34099922 PMCID: PMC8947197 DOI: 10.1038/s41593-021-00867-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [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: 12/31/2019] [Accepted: 04/30/2021] [Indexed: 02/05/2023]
Abstract
The Adolescent Brain Cognitive Development (ABCD) Study® is a 10-year longitudinal study of children recruited at ages 9 and 10. A battery of neuroimaging tasks are administered biennially to track neurodevelopment and identify individual differences in brain function. This study reports activation patterns from functional MRI (fMRI) tasks completed at baseline, which were designed to measure cognitive impulse control with a stop signal task (SST; N = 5,547), reward anticipation and receipt with a monetary incentive delay (MID) task (N = 6,657) and working memory and emotion reactivity with an emotional N-back (EN-back) task (N = 6,009). Further, we report the spatial reproducibility of activation patterns by assessing between-group vertex/voxelwise correlations of blood oxygen level-dependent (BOLD) activation. Analyses reveal robust brain activations that are consistent with the published literature, vary across fMRI tasks/contrasts and slightly correlate with individual behavioral performance on the tasks. These results establish the preadolescent brain function baseline, guide interpretation of cross-sectional analyses and will enable the investigation of longitudinal changes during adolescent development.
Collapse
Affiliation(s)
- B Chaarani
- Department of Psychiatry, University of Vermont, Burlington, VT, USA.
| | - S Hahn
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - N Allgaier
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - S Adise
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - M M Owens
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - A C Juliano
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - D K Yuan
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - H Loso
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - A Ivanciu
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - M D Albaugh
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - J Dumas
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - S Mackey
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - J Laurent
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - M Ivanova
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - D J Hagler
- University of California, San Diego, La Jolla, CA, USA
| | - M D Cornejo
- Institute of Physics UC, Pontificia Universidad Catolica de Chile, Pontificia, Chile
| | - S Hatton
- University of California, San Diego, La Jolla, CA, USA
| | - A Agrawal
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - L Aguinaldo
- University of California, San Diego, La Jolla, CA, USA
| | - L Ahonen
- University of Pittsburgh, Pittsburgh, PA, USA
| | - W Aklin
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - A P Anokhin
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - J Arroyo
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - S Avenevoli
- National Institute of Mental Health, Bethesda, MD, USA
| | - D Babcock
- National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - K Bagot
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - F C Baker
- SRI International, Menlo Park, CA, USA
| | - M T Banich
- University of Colorado, Boulder, CO, USA
| | - D M Barch
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - H Bartsch
- Haukeland University Hospital, Bergen, Norway
| | | | - J M Bjork
- Virginia Commonwealth University, Richmond, VA, USA
| | - D Blachman-Demner
- NIH Office of Behavioral and Social Sciences Research, Bethesda, MD, USA
| | - M Bloch
- National Cancer Institute, Bethesda, MD, USA
| | - R Bogdan
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | | | - F Breslin
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - S Brown
- University of California, San Diego, La Jolla, CA, USA
| | - F J Calabro
- University of Pittsburgh, Pittsburgh, PA, USA
| | - V Calhoun
- University of Colorado, Boulder, CO, USA
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science, Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
| | | | - L Chang
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - D B Clark
- University of Pittsburgh, Pittsburgh, PA, USA
| | - C Cloak
- University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - K Constable
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - R Corley
- University of Colorado, Boulder, CO, USA
| | | | - S Coxe
- Florida International University, Miami, FL, USA
| | - R K Dagher
- National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | - A M Dale
- University of California, San Diego, La Jolla, CA, USA
| | - M Dapretto
- University of California, Los Angeles, CA, USA
| | | | - A S Dick
- Florida International University, Miami, FL, USA
| | - E K Do
- Virginia Commonwealth University, Richmond, VA, USA
| | - N U F Dosenbach
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - G J Dowling
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - S Edwards
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - T M Ernst
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - D A Fair
- Oregon Health & Science University, Portland, OR, USA
| | - C C Fan
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - E Feczko
- Oregon Health & Science University, Portland, OR, USA
| | | | | | - J J Foxe
- University of Rochester, Rochester, NY, USA
| | | | | | | | | | - A Galvan
- University of California, Los Angeles, CA, USA
| | - D G Gee
- Yale University, New Haven, CT, USA
| | - J Giedd
- University of California, San Diego, La Jolla, CA, USA
| | - M Glantz
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - P Glaser
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - J Godino
- University of California, San Diego, La Jolla, CA, USA
| | - M Gonzalez
- Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - R Gonzalez
- Florida International University, Miami, FL, USA
| | - S Grant
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - K M Gray
- Medical University of South Carolina, Charleston, SC, USA
| | - F Haist
- University of California, San Diego, La Jolla, CA, USA
| | - M P Harms
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - S Hawes
- Florida International University, Miami, FL, USA
| | - A C Heath
- University of California, San Diego, La Jolla, CA, USA
| | - S Heeringa
- University of Michigan, Ann Arbor, MI, USA
| | | | - R Hermosillo
- Oregon Health & Science University, Portland, OR, USA
| | - M M Herting
- University of Southern California, Los Angeles, CA, USA
| | - J M Hettema
- Virginia Commonwealth University, Richmond, VA, USA
| | - J K Hewitt
- University of Colorado, Boulder, CO, USA
| | - C Heyser
- University of California, San Diego, La Jolla, CA, USA
| | - E Hoffman
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - K Howlett
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - R S Huber
- University of Utah, Salt Lake City, UT, USA
| | - M A Huestis
- Thomas Jefferson University, Philadelphia, PA, USA
| | - L W Hyde
- University of Michigan, Ann Arbor, MI, USA
| | - W G Iacono
- University of Minnesota, Minneapolis, MN, USA
| | - M A Infante
- University of California, San Diego, La Jolla, CA, USA
| | - O Irfanoglu
- National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA
| | - A Isaiah
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - S Iyengar
- National Endowment for the Arts, Washington DC, USA
| | - J Jacobus
- University of California, San Diego, La Jolla, CA, USA
| | - R James
- Virginia Commonwealth University, Richmond, VA, USA
| | - B Jean-Francois
- National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | - T Jernigan
- University of California, San Diego, La Jolla, CA, USA
| | - N R Karcher
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - A Kaufman
- National Cancer Institute, Bethesda, MD, USA
| | - B Kelley
- National Institute of Justice, Washington DC, USA
| | - B Kit
- National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - A Ksinan
- Virginia Commonwealth University, Richmond, VA, USA
| | - J Kuperman
- University of California, San Diego, La Jolla, CA, USA
| | - A R Laird
- Florida International University, Miami, FL, USA
| | - C Larson
- University of Wisconsin, Milwaukee, WI, USA
| | - K LeBlanc
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - C Lessov-Schlagger
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - N Lever
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - D A Lewis
- University of Pittsburgh, Pittsburgh, PA, USA
| | - K Lisdahl
- University of Wisconsin, Milwaukee, WI, USA
| | - A R Little
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - M Lopez
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - M Luciana
- University of Minnesota, Minneapolis, MN, USA
| | - B Luna
- University of Pittsburgh, Pittsburgh, PA, USA
| | - P A Madden
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - H H Maes
- Virginia Commonwealth University, Richmond, VA, USA
| | - C Makowski
- University of California, San Diego, La Jolla, CA, USA
| | - A T Marshall
- Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - M J Mason
- University of Tennessee, Knoxville, TN, USA
| | - J Matochik
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | | | - E McGlade
- University of Utah, Salt Lake City, UT, USA
| | - I Montoya
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - G Morgan
- National Cancer Institute, Bethesda, MD, USA
| | - A Morris
- Oklahoma State University, Stillwater, OK, USA
| | - C Mulford
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - P Murray
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - B J Nagel
- Oregon Health & Science University, Portland, OR, USA
| | - M C Neale
- Virginia Commonwealth University, Richmond, VA, USA
| | - G Neigh
- Virginia Commonwealth University, Richmond, VA, USA
| | - A Nencka
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - A Noronha
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - S J Nixon
- University of Florida, Gainesville, FL, USA
| | - C E Palmer
- University of California, San Diego, La Jolla, CA, USA
| | - V Pariyadath
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - M P Paulus
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - W E Pelham
- Florida International University, Miami, FL, USA
| | | | - C Pierpaoli
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | - A Prescot
- University of Utah, Salt Lake City, UT, USA
| | - D Prouty
- SRI International, Menlo Park, CA, USA
| | | | - N Rajapaske
- National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | | | - G Reeves
- University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - M C Riedel
- Florida International University, Miami, FL, USA
| | - P Rojas
- Florida International University, Miami, FL, USA
| | - M de la Rosa
- Florida International University, Miami, FL, USA
| | | | - M J Ross
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - M Sanchez
- Florida International University, Miami, FL, USA
| | - C Schirda
- University of Pittsburgh, Pittsburgh, PA, USA
| | - D Schloesser
- NIH Office of Behavioral and Social Sciences Research, Bethesda, MD, USA
| | | | - K J Sher
- University of Missouri, Columbia, MO, USA
| | - C Sheth
- University of Utah, Salt Lake City, UT, USA
| | - P D Shilling
- University of California, San Diego, La Jolla, CA, USA
| | - W K Simmons
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - E R Sowell
- Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - N Speer
- University of Colorado, Boulder, CO, USA
| | - M Spittel
- NIH Office of Behavioral and Social Sciences Research, Bethesda, MD, USA
| | - L M Squeglia
- Medical University of South Carolina, Charleston, SC, USA
| | - C Sripada
- University of Michigan, Ann Arbor, MI, USA
| | - J Steinberg
- Virginia Commonwealth University, Richmond, VA, USA
| | - C Striley
- University of Florida, Gainesville, FL, USA
| | | | - J Tanabe
- University of Colorado, Boulder, CO, USA
| | - S F Tapert
- University of California, San Diego, La Jolla, CA, USA
| | - W Thompson
- University of California, San Diego, La Jolla, CA, USA
| | - R L Tomko
- Medical University of South Carolina, Charleston, SC, USA
| | - K A Uban
- University of California, Irvine, CA, USA
| | - S Vrieze
- University of Minnesota, Minneapolis, MN, USA
| | - N E Wade
- University of California, San Diego, La Jolla, CA, USA
| | - R Watts
- Yale University, New Haven, CT, USA
| | - S Weiss
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - B A Wiens
- University of Florida, Gainesville, FL, USA
| | - O D Williams
- Florida International University, Miami, FL, USA
| | - A Wilbur
- SRI International, Menlo Park, CA, USA
| | - D Wing
- University of California, San Diego, La Jolla, CA, USA
| | - D Wolff-Hughes
- NIH Office of Behavioral and Social Sciences Research, Bethesda, MD, USA
| | - R Yang
- University of California, San Diego, La Jolla, CA, USA
| | | | - R A Zucker
- University of Michigan, Ann Arbor, MI, USA
| | - A Potter
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - H P Garavan
- Department of Psychiatry, University of Vermont, Burlington, VT, USA.
| |
Collapse
|
21
|
Glasgow TE, Miller CA, Barsell DJ, Do EK, Fuemmeler BF. Assessing how a tobacco-free campus leads to attitude change and support among students, faculty, and staff. Tob Prev Cessat 2021; 7:53. [PMID: 34307968 PMCID: PMC8283972 DOI: 10.18332/tpc/138224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/21/2021] [Accepted: 05/26/2021] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Universities are increasingly considering tobacco-free campus policies to help promote a healthy learning and working environment. We assessed attitudes of students, faculty, and staff, before and after the implementation of a tobacco-free campus policy at a large, urban university. We also examined individual factors associated with these attitudes. METHODS An independent panel design method was used to assess students, faculty and staff about their tobacco product use, attitudes towards tobacco policies, and support for cigarette and e-cigarette bans 3 months before and 7 months after a university-wide policy change to ban tobacco and e-cigarettes on campus. Survey participants before the policy change included 636 students and 1356 faculty/ staff. Survey participants after the policy change included 1000 students and 574 faculty/staff. We conducted separate multiple linear and logistic regression models for students and faculty/staff. RESULTS Attitudes towards tobacco-free campus policies did not improve for students, but did for faculty/staff. Support for bans of cigarettes and e-cigarettes on campus increased following the policy change among both students and faculty/staff. Students were more willing to ask their friends to stop vaping post-policy, but did not differ in their willingness to ask friends to stop smoking. Among the individual factors considered, gender and use of cigarettes and e-cigarettes were predictive of attitudes among both students and faculty/staff. Women were more likely to support and have more positive attitudes towards bans, while current tobacco product users were less likely to support tobacco product bans and have less positive attitudes towards tobacco policies. CONCLUSIONS Attitudes towards tobacco-free campus policies changed pre- to postpolicy among faculty/staff, but not among students. However, both students and faculty/staff were more supportive of tobacco product bans following the policy change. Individual factors associated with support and attitudes were identified.
Collapse
Affiliation(s)
- Trevin E Glasgow
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, United States.,Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, United States
| | - Carrie A Miller
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, United States
| | - D Jeremy Barsell
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, United States
| | - Elizabeth K Do
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, United States.,Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, United States
| | - Bernard F Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, United States
| |
Collapse
|
22
|
Wheeler DC, Do EK, Hayes RB, Hughes C, Fuemmeler BF. Evaluation of neighborhood deprivation and store characteristics in relation to tobacco retail outlet sales violations. PLoS One 2021; 16:e0254443. [PMID: 34270555 PMCID: PMC8284798 DOI: 10.1371/journal.pone.0254443] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 06/27/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Regulations of the sale of tobacco products to minors have been effective at reducing adolescent tobacco use overall. However, these efforts may not be uniformly enforced in all areas, creating uneven protection against adolescent smoking. Knowledge regarding factors associated with tobacco retail outlet (TRO) violations could help inform better enforcement strategies. METHODS In this study, we used Bayesian index regression models to determine if tobacco sales to minors violations across Virginia (2012-2021) were related to store characteristics and neighborhood deprivation and identify geographic areas at significantly elevated risk for violations after adjusting for these factors. RESULTS Results show that there were multiple factors associated with a higher likelihood of tobacco sales violations. Store type was an important factor, as grocery stores and pharmacies had significantly lowered likelihood of violations compared with convenience stores. Being located near another TRO was significantly associated with increased risk of sales to a minor. Neighborhood deprivation was also positively associated with TRO sales violations. Further, there were statistically higher likelihood of sales violations occurring in specific areas (e.g., southwest and southeast) of the state that were not explained by neighborhood deprivation and store attributes. CONCLUSIONS Together, results highlight the need to better understand where and why TRO sales violations are occurring in order to improve efforts aimed at monitoring and remediating TRO sales violations.
Collapse
Affiliation(s)
- David C. Wheeler
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Elizabeth K. Do
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Rashelle B. Hayes
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Colleen Hughes
- Virginia Department of Behavioral Health and Developmental Services, Richmond, VA, United States of America
| | - Bernard F. Fuemmeler
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, VA, United States of America
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, United States of America
| |
Collapse
|
23
|
Wheeler DC, Miller CA, Do EK, Ksinan AJ, Trogdon JG, Chukmaitov A, Fuemmeler BF. Identifying Area-Level Disparities in Human Papillomavirus Vaccination Coverage Using Geospatial Analysis. Cancer Epidemiol Biomarkers Prev 2021; 30:1689-1696. [PMID: 34172461 DOI: 10.1158/1055-9965.epi-21-0331] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/13/2021] [Accepted: 06/14/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) is the most common sexually transmitted infection within the United States (US). Despite clinical agreement on the effectiveness and widespread availability of the prophylactic HPV vaccine, vaccination coverage in the US is suboptimal and varies by geographic region and area-level variables. The goals of this article were to model the variation in vaccination rates among boys and girls within ZIP Codes in Virginia, determine whether neighborhood sociodemographic variables explain variation in HPV vaccination, and identify areas with significantly depressed vaccination coverage. METHODS We used Bayesian hierarchical spatial regression models with statewide immunization registry data to consider the correlation in vaccination among boys and girls, as well as the spatial correlation in vaccination for each sex. RESULTS The results showed low vaccination coverage in our birth cohort (28.9% in girls and 23.8% in boys) relative to the national level (56.8% and 51.8%, respectively). Several area-level variables were significantly and positively associated with vaccination coverage, including population density, percentage of Hispanic population, and average number of vehicles. In addition, there were several areas of significantly lowered vaccination coverage, including predominantly rural ones, and overall large geographic disparities in HPV vaccination. CONCLUSIONS Determining the geospatial patterning and area-level factors associated with HPV vaccination within a prescribed geographic area helps to inform future planning efforts. IMPACT The results of this study will help inform future planning efforts for geographically targeted interventions and policies, as well as drive new research to implement clinical and community strategies to increase HPV vaccination.
Collapse
Affiliation(s)
- David C Wheeler
- Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia. .,Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia
| | - Carrie A Miller
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia
| | - Elizabeth K Do
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia.,Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Albert J Ksinan
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia
| | - Justin G Trogdon
- Department of Health Policy and Management, Gillings School of Global Public Health, Chapel Hill, North Carolina.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Askar Chukmaitov
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia
| | - Bernard F Fuemmeler
- Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia.,Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia
| |
Collapse
|
24
|
Ksinan AJ, Sheng Y, Do EK, Schechter JC, Zhang J(J, Maguire RL, Hoyo C, Murphy SK, Kollins SH, Rubin B, Fuemmeler BF. Identifying the Best Questions for Rapid Screening of Secondhand Smoke Exposure Among Children. Nicotine Tob Res 2021; 23:1217-1223. [PMID: 33249470 PMCID: PMC8186417 DOI: 10.1093/ntr/ntaa254] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 07/20/2020] [Accepted: 11/28/2020] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Many children suffer from secondhand smoke exposure (SHSe), which leads to a variety of negative health consequences. However, there is no consensus on how clinicians can best query parents for possible SHSe among children. We employed a data-driven approach to create an efficient screening tool for clinicians to quickly and correctly identify children at risk for SHSe. METHODS Survey data from mothers and biospecimens from children were ascertained from the Neurodevelopment and Improving Children's Health following Environmental Tobacco Smoke Exposure (NICHES) study. Included were mothers and their children whose saliva were assayed for cotinine (n = 351 pairs, mean child age = 5.6 years). Elastic net regression predicting SHSe, as indicated from cotinine concentration, was conducted on available smoking-related questions and cross-validated with 2015-2016 National Health and Nutrition Examination Survey (NHANES) data to select the most predictive items of SHSe among children (n = 1670, mean child age = 8.4 years). RESULTS Answering positively to at least one of the two final items ("During the past 30 days, did you smoke cigarettes at all?" and "Has anyone, including yourself, smoked tobacco in your home in the past 7 days?") showed area under the curve = .82, and good specificity (.88) and sensitivity (.74). These results were validated with similar items in the nationally representative NHANES sample, area under the curve = .82, specificity = .78, and sensitivity = .77. CONCLUSIONS Our data-driven approach identified and validated two items that may be useful as a screening tool for a speedy and accurate assessment of SHSe among children. IMPLICATIONS The current study used a rigorous data-driven approach to identify questions that could reliably predict SHSe among children. Using saliva cotinine concentration levels as a gold standard for determining SHSe, our analysis employing elastic net regression identified two questions that served as good classifier for distinguishing children who might be at risk for SHSe. The two items that we validated in the current study can be readily used by clinicians, such as pediatricians, as part of screening procedures to quickly identify whether children might be at risk for SHSe.
Collapse
Affiliation(s)
- Albert J Ksinan
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA
| | | | - Elizabeth K Do
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA
| | - Julia C Schechter
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | | | - Rachel L Maguire
- Department of Biological Sciences, North Carolina State University, Raleigh, NC
| | - Cathrine Hoyo
- Department of Biological Sciences, North Carolina State University, Raleigh, NC
| | - Susan K Murphy
- Obstetrics and Gynecology, Duke University Medical Center, Durham, NC
| | - Scott H Kollins
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - Bruce Rubin
- Department of Pediatrics, Virginia Commonwealth University, Richmond, VA
| | - Bernard F Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA
| |
Collapse
|
25
|
Fallavollita WL, Do EK, Schechter JC, Kollins SH, Zheng J(J, Qin J, Maguire RL, Hoyo C, Murphy SK, Fuemmeler BF. Smoke-Free Home Rules and Association with Child Secondhand Smoke Exposure among Mother-Child Dyad Relationships. Int J Environ Res Public Health 2021; 18:5256. [PMID: 34069235 PMCID: PMC8157188 DOI: 10.3390/ijerph18105256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/05/2021] [Accepted: 05/09/2021] [Indexed: 01/22/2023]
Abstract
Smoke-free home rules restrict smoking in the home, but biomarkers of secondhand smoke exposure are needed to help understand the association between smoke-free homes and child secondhand smoke exposure. Participants (n = 346) were majority Black/African American mother-child dyads from a longitudinal study in North Carolina. Mothers completed questionnaires on household smoking behaviors and rules, and child saliva samples were assayed for secondhand smoke exposure. Regression models used smoke-free home rules to predict child risk for secondhand smoke exposure. Children in households with smoke-free home rules had less salivary cotinine and risk for secondhand smoke exposure. After controlling for smokers in the household, home smoking rules were not a significant predictor of secondhand smoke exposure. Compared to children in households with no smokers, children in households with at least one smoker but a non-smoking mother (OR 5.35, 95% CI: 2.22, 13.17) and households with at least one smoker including a smoking mother (OR 13.73, 95% CI: 6.06, 33.28) had greater risk for secondhand smoke exposure. Results suggest smoke-free home rules are not sufficient to fully protect children from secondhand smoke exposure, especially in homes with smokers. Future research should focus on how household members who smoke can facilitate the prevention of child secondhand smoke exposure.
Collapse
Affiliation(s)
- Westley L. Fallavollita
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, VA 23284, USA; (W.L.F.); (E.K.D.)
| | - Elizabeth K. Do
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, VA 23284, USA; (W.L.F.); (E.K.D.)
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Julia C. Schechter
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27701, USA; (J.C.S.); (S.H.K.)
| | - Scott H. Kollins
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27701, USA; (J.C.S.); (S.H.K.)
| | - Junfeng (Jim) Zheng
- Nicholas School of the Environment and Global Health Institute, Duke University, Durham, NC 27708, USA;
| | - Jian Qin
- School of Public Health, Guangxi Medical University, Nanning 530021, China;
| | - Rachel L. Maguire
- Department of Biological Sciences, North Carolina State University, Raleigh, NC 27695, USA; (R.L.M.); (C.H.)
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710, USA;
| | - Cathrine Hoyo
- Department of Biological Sciences, North Carolina State University, Raleigh, NC 27695, USA; (R.L.M.); (C.H.)
| | - Susan K. Murphy
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710, USA;
| | - Bernard F. Fuemmeler
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, VA 23284, USA; (W.L.F.); (E.K.D.)
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA 23284, USA
| |
Collapse
|
26
|
Fuemmeler BF, Dozmorov MG, Do EK, Zhang J(J, Grenier C, Huang Z, Maguire RL, Kollins SH, Hoyo C, Murphy SK. DNA Methylation in Babies Born to Nonsmoking Mothers Exposed to Secondhand Smoke during Pregnancy: An Epigenome-Wide Association Study. Environ Health Perspect 2021; 129:57010. [PMID: 34009014 PMCID: PMC8132610 DOI: 10.1289/ehp8099] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 02/09/2021] [Accepted: 04/19/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Maternal smoking during pregnancy is related to altered DNA methylation in infant umbilical cord blood. The extent to which low levels of smoke exposure among nonsmoking pregnant women relates to offspring DNA methylation is unknown. OBJECTIVE This study sought to evaluate relationships between maternal prenatal plasma cotinine levels and DNA methylation in umbilical cord blood in newborns using the Infinium HumanMethylation 450K BeadChip. METHODS Participants from the Newborn Epigenetics Study cohort who reported not smoking during pregnancy had verified low levels of cotinine from maternal prenatal plasma (0 ng / mL to < 4 ng / mL ), and offspring epigenetic data from umbilical cord blood were included in this study (n = 79 ). Multivariable linear regression models were fit to the data, controlling for cell proportions, age, race, education, and parity. Estimates represent changes in response to any 1 -ng / mL unit increase in exposure. RESULTS Multivariable linear regression models yielded 29,049 CpGs that were differentially methylated in relation to increases in cotinine at a 5% false discovery rate. Top CpGs were within or near genes involved in neuronal functioning (PRKG1, DLGAP2, BSG), carcinogenesis (FHIT, HSPC157) and inflammation (AGER). Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses suggest cotinine was related to methylation of gene pathways controlling neuronal signaling, metabolic regulation, cell signaling and regulation, and cancer. Further, enhancers associated with transcription start sites were enriched in altered CpGs. Using an independent sample from the same study population (n = 115 ), bisulfite pyrosequencing was performed with infant cord blood DNA for two genes within our top 20 hits (AGER and PRKG1). Results from pyrosequencing replicated epigenome results for PRKG1 (cg17079497, estimate = - 1.09 , standard error ( SE ) = 0.45 , p = 0.018 ) but not for AGER (cg09199225; estimate = - 0.16 , SE = 0.21 , p = 0.44 ). DISCUSSION Secondhand smoke exposure among nonsmoking women may alter DNA methylation in regions involved in development, carcinogenesis, and neuronal functioning. These novel findings suggest that even low levels of smoke exposure during pregnancy may be sufficient to alter DNA methylation in distinct sites of mixed umbilical cord blood leukocytes in pathways that are known to be altered in cord blood from pregnant active smokers. https://doi.org/10.1289/EHP8099.
Collapse
Affiliation(s)
- Bernard F. Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia, USA
- Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Mikhail G. Dozmorov
- Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Pathology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Elizabeth K. Do
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia, USA
- Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Junfeng (Jim) Zhang
- Nicholas School of the Environment and Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Carole Grenier
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina, USA
| | - Zhiqing Huang
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina, USA
| | - Rachel L. Maguire
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina, USA
- Department of Biological Sciences, Center for Human Health and the Environment North Carolina State University, Raleigh, North Carolina, USA
| | - Scott H. Kollins
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
| | - Cathrine Hoyo
- Department of Biological Sciences, Center for Human Health and the Environment North Carolina State University, Raleigh, North Carolina, USA
| | - Susan K. Murphy
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina, USA
| |
Collapse
|
27
|
Do EK, Bradley KC, Fugate-Laus K, Kaur K, Halquist MS, Ray L, Pope MA, Hayes RB, Wheeler DC, Fuemmeler BF. An examination of social and environmental determinants of secondhand smoke exposure among non-smoking adolescents. Tob Prev Cessat 2021; 7:20. [PMID: 33728387 PMCID: PMC7954078 DOI: 10.18332/tpc/131875] [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] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 12/20/2020] [Accepted: 12/22/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Adolescents are at increased risk of secondhand smoke exposure (SHS) due to the limited control that they have over social and physical environments. Yet, knowledge regarding determinants of SHS among non-smoking adolescents is limited. This study identifies social and environmental factors associated with SHS among non-smoking adolescents. METHODS To be included, parents and adolescents (aged 11–17 years) of the Adolescents, Place, and Behavior Study had to have completed surveys between March 2019 and May 2020. Adolescents had to have not reported smoking within the past 30 days and provided a saliva sample assayed for cotinine (≤3 ng/mL). A series of stepwise linear regression models were fit to the data to identify social and environmental determinants of SHS, using log-transformed salivary cotinine. RESULTS Of the 105 adolescent and parent dyads included, 90.3% were African American, 26.9% of parents reported smoking, 33.3% resided in multi-unit housing, and 67.7% lived in homes where smoking was not permitted. Significant associations were found between parent tobacco use (β=2.56, SE=0.98, p=0.0082) and residing in multi-unit housing (β=1.72, SE=0.86, p=0.0460) with increased log-transformed cotinine levels among non-smoking adolescents. Adolescent age, gender, and race/ ethnicity, parental education, peer tobacco use, the number of adults and children in the home, average number of days of self-reported SHS within public spaces outside of the home, and home smoking policies were not significantly associated with cotinine. CONCLUSIONS Results emphasize the importance of reducing secondhand smoke exposure by reducing parental smoking and altering exposures within social and home environments. Parental tobacco use and residential setting should be considered when developing interventions to reduce secondhand smoke exposure among non-smoking adolescents.
Collapse
Affiliation(s)
- Elizabeth K Do
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, United States.,Massey Cancer Center, Virginia Commonwealth University, Richmond, United States
| | - Kennedy C Bradley
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, United States
| | - Kendall Fugate-Laus
- Department of Psychology, Virginia Commonwealth University, Richmond, United States
| | - Kiranpreet Kaur
- School of Medicine, Virginia Commonwealth University, Richmond, United States
| | - Matthew S Halquist
- School of Pharmacy, Virginia Commonwealth University, Richmond, United States
| | - Laure Ray
- School of Pharmacy, Virginia Commonwealth University, Richmond, United States
| | | | - Rashelle B Hayes
- Department of Psychiatry, Virginia Commonwealth University, Richmond, United States
| | - David C Wheeler
- Department of Biostatistics, Virginia Commonwealth University, Richmond, United States
| | - Bernard F Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, United States.,Massey Cancer Center, Virginia Commonwealth University, Richmond, United States
| |
Collapse
|
28
|
Do EK, Bowen GA, Ksinan AJ, Adams EL, Fuemmeler BF. Sleep, Food Insecurity, and Weight Status: Findings from the Family Life, Activity, Sun, Health, and Eating Study. Child Obes 2021; 17:125-135. [PMID: 33493402 PMCID: PMC7984656 DOI: 10.1089/chi.2020.0259] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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] [Indexed: 11/13/2022]
Abstract
Background: Shorter sleep duration and lower sleep quality have been previously associated with greater obesity risk among adult samples. Food insecurity has also been found to impact sleep patterns and obesity. Yet few studies have explored associations between sleep, food insecurity, and obesity in adolescent populations, who may have more irregular sleep patterns. Thus, the objectives of this study were to determine associations between measures of sleep, food insecurity, and weight status. Methods: Data were obtained from the Family Life, Activity, Sun, Health, and Eating (FLASHE) Study, an online cross-sectional study of parent and adolescent (12-17-year old) dyads. Participants were drawn from a Consumer Opinion Panel representative of the general population of the United States with respect to sex, education, income, age, household size, and region. First, multinomial logistic regression analyses were conducted to determine associations between sleep measures (adolescent-reported average nighttime sleep duration, having a regular bedtime, and having difficulty staying asleep), food insecurity (a validated two-item parent-reported measure), and weight status (being underweight, of healthy weight, overweight, and obese). Weight status was based upon adolescent BMI z-scores using Centers for Disease Control and Prevention growth charts using information from parent report of adolescent height and weight and adolescent-reported age and sex among adolescents (N = 1544). Conditional process models were also fitted to the data to determine whether food insecurity moderates the associations between sleep measures and weight status, and to determine whether the association between food insecurity and weight status is mediated by average sleep duration. Results: Compared to those with food security, a greater percentage of those with food insecurity reported having difficulties staying asleep and a longer average sleep duration. Multinomial logistic regression models demonstrated that having a regular bedtime was associated with lower odds of having obesity, having difficulties staying asleep was associated with greater odds of being underweight, and having food insecurity was associated with greater odds of being overweight. Conditional process models demonstrated that food insecurity did not moderate associations between sleep measures and weight status and that average nighttime sleep duration did not mediate the association between food insecurity and weight status. Conclusions: This is one of the first studies to examine associations between sleep, food insecurity, and weight status among adolescents. Results provide additional support for the need to uncover mechanisms for how sleep and food insecurity affect pediatric obesity using longitudinal data.
Collapse
Affiliation(s)
- Elizabeth K. Do
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
| | - Gabrielle A. Bowen
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA.,Department of Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Albert J. Ksinan
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
| | - Elizabeth L. Adams
- Department of Pediatrics, Virginia Commonwealth University, Richmond, VA, USA
| | - Bernard F. Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA.,Department of Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA.,Address correspondence to: Bernard F. Fuemmeler, PhD, MPH, Department of Health Behavior and Policy, Virginia Commonwealth University, Box 980430, Richmond, VA 23298, USA
| |
Collapse
|
29
|
Do EK, Rossi B, Miller CA, Ksinan AJ, Wheeler DC, Chukmaitov A, Cyrus JW, Fuemmeler BF. Area-Level Variation and Human Papillomavirus Vaccination among Adolescents and Young Adults in the United States: A Systematic Review. Cancer Epidemiol Biomarkers Prev 2021; 30:13-21. [PMID: 33008874 PMCID: PMC8108385 DOI: 10.1158/1055-9965.epi-20-0617] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 04/24/2020] [Revised: 07/31/2020] [Accepted: 09/25/2020] [Indexed: 11/16/2022] Open
Abstract
Understanding how human papillomavirus (HPV) vaccination coverage varies by geography can help to identify areas of need for prevention and control efforts. A systematic review of the literature was conducted using a combination of keywords (HPV vaccination, geography, neighborhoods, and sociodemographic factors) on Medline and Embase databases. Studies had to provide information on HPV vaccination by area-level variables, be conducted in the United States, and be published in English (analyzing data from January 2006 to February 2020). Conference abstracts and opinion pieces were excluded. Of 733 records identified, 25 were included for systematic review. Across studies, the average initiation rate was 40.5% (range, 6.3%-78.0%). The average rate of completion was 23.4% (range, 1.7%-55.2%). Geographic regions and area-level factors were associated with HPV vaccination, including zip code tabulation area-level poverty, urbanicity/rurality, racial/ethnic composition, and health service region characteristics. Only three studies utilized geospatial approaches. None accounted for geospatial-temporal associations. Individual-level and area-level factors and their interactions are important for characterizing HPV vaccination. Results demonstrate the need to move beyond existing multilevel methods and toward the adoption of geospatial approaches that allow for the mapping and detection of geographic areas with low HPV vaccination coverage.
Collapse
Affiliation(s)
- Elizabeth K Do
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia
- Virginia Commonwealth University Massey Cancer Center, Richmond, Virginia
| | - Brianna Rossi
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia
| | - Carrie A Miller
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia
- Virginia Commonwealth University Massey Cancer Center, Richmond, Virginia
| | - Albert J Ksinan
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia
| | - David C Wheeler
- Virginia Commonwealth University Massey Cancer Center, Richmond, Virginia
- Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia
| | - Askar Chukmaitov
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia
| | - John W Cyrus
- Tompkins-McCaw Library, Research and Education, Virginia Commonwealth University, Richmond, Virginia
| | - Bernard F Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia.
- Virginia Commonwealth University Massey Cancer Center, Richmond, Virginia
| |
Collapse
|
30
|
Do EK, Nicksic NE, Clifford JS, Hayes A, Fuemmeler BF. Perceived harms of and exposure to tobacco use and current tobacco use among reproductive-aged women from the PATH study. Women Health 2020; 60:1040-1051. [PMID: 32654622 PMCID: PMC7484224 DOI: 10.1080/03630242.2020.1789261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 11/05/2019] [Revised: 06/15/2020] [Accepted: 06/19/2020] [Indexed: 10/23/2022]
Abstract
Data for this study were obtained from reproductive-aged women (aged 18-44 years, at wave 1) from waves 1 (2013-2014) and 2 (2014-2015) of the Population Assessment of Tobacco and Health Study (n = 13,241). Bivariate and multinomial regression analyses were performed associating past 30-day use of cigarettes only, e-cigarettes only, and dual use with perceptions of harm, exposure to tobacco product use, and sociodemographic variables. Cross-sectional and longitudinal analyses were conducted. Of all reproductive-aged women included in the analyses, 75.5 percent reported no tobacco use, 16.9 percent reported cigarette use only, 1.5 percent reported e-cigarette use only, and 6.1 percent reported dual use within the past 30 days. Perceived harm, tobacco exposure, pregnancy status, age, race/ethnicity, income, education, and sexual orientation were associated with the past 30-day use, cross-sectionally at wave 1. Similar associations were found for longitudinal analyses using wave 2 data, except for income and education, which were no longer associated. The results of this study contribute to knowledge regarding the prevalence and correlates of tobacco use across exclusive cigarette, exclusive e-cigarette, and dual use among reproductive-aged women.
Collapse
Affiliation(s)
- Elizabeth K. Do
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, VA, USA
- VCU Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Nicole E. Nicksic
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, VA, USA
| | - James S. Clifford
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Bernard F. Fuemmeler
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, VA, USA
- VCU Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
| |
Collapse
|
31
|
Abstract
We utilized a mixed methods approach to assess student attitudes towards tobacco use and campus tobacco policies. Interviews (N = 21), focus groups (N = 2 groups, 4-5 participants each), and an online survey (N = 636) were conducted among a sample of students attending a 4-year, urban, public university in the Mid-Atlantic region of the United States. In interviews and focus groups, students expressed skepticism about a tobacco-free campus policy due to perceived violations of personal rights and challenges with enforcement. Of the sample surveyed, 9.2% and 20.6% had used cigarettes or e-cigarettes within the past 30 days. The majority of students agreed that colleges have a responsibility to adopt tobacco-free policies that reduce the risk of tobacco addiction (62.4%) and ensure smoke-free air to breathe (81.5%). However, more than half (56.3%) also indicated that a policy allowing for designated smoking areas for cigarettes was best for campus, which runs counter to a comprehensive tobacco-free policy. Academic year, gender, and race/ethnicity were significant factors associated with support for tobacco-free policies. Current smokers and vapers were less likely to support tobacco-free policies that reduce the risk of tobacco addiction (OR = 0.3, 95% CI 0.1, 0.7 for smokers; OR = 0.3, 95% CI 0.1, 0.6 for vapers), but not policies that ensure smoke-free air to breathe. E-cigarettes pose a unique obstacle to tobacco-free policies, as students perceived e-cigarettes to be less harmful than cigarettes. To implement a tobacco-free campus policy, students suggested educational campaigns that focus on the potential health benefits of a tobacco-free campus.
Collapse
Affiliation(s)
- Elizabeth K Do
- Department of Health Behavior & Policy, Virginia Commonwealth University, Box 980430, Richmond, VA, 23298-0430, USA.
- Cancer Prevention and Control, VCU Massey Cancer Center, Richmond, VA, USA.
| | - Westley L Fallavollita
- Department of Health Behavior & Policy, Virginia Commonwealth University, Box 980430, Richmond, VA, 23298-0430, USA
| | - Brianna Bonat
- Division of Epidemiology, Department of Family Health and Population Sciences, Virginia Commonwealth University, Richmond, VA, USA
| | - Kendall Fugate-Laus
- Department of Health Behavior & Policy, Virginia Commonwealth University, Box 980430, Richmond, VA, 23298-0430, USA
| | - Brianna C Rossi
- Division of Epidemiology, Department of Family Health and Population Sciences, Virginia Commonwealth University, Richmond, VA, USA
| | - Bernard F Fuemmeler
- Department of Health Behavior & Policy, Virginia Commonwealth University, Box 980430, Richmond, VA, 23298-0430, USA
- Cancer Prevention and Control, VCU Massey Cancer Center, Richmond, VA, USA
| |
Collapse
|
32
|
York TP, Latendresse SJ, Jackson-Cook C, Lapato DM, Moyer S, Wolen AR, Roberson-Nay R, Do EK, Murphy SK, Hoyo C, Fuemmeler BF, Strauss JF. Replicated umbilical cord blood DNA methylation loci associated with gestational age at birth. Epigenetics 2020; 15:1243-1258. [PMID: 32448018 DOI: 10.1080/15592294.2020.1767277] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 01/07/2023] Open
Abstract
DNA methylation is highly sensitive to in utero perturbations and has an established role in both embryonic development and regulation of gene expression. The foetal genetic component has been previously shown to contribute significantly to the timing of birth, yet little is known about the identity and behaviour of individual genes. The aim of this study was to test the extent genome-wide DNA methylation levels in umbilical cord blood were associated with gestational age at birth (GA). Findings were validated in an independent sample and evidence for the regulation of gene expression was evaluated for cis gene relationships in specimens with multi-omic data. Genome-wide DNA methylation, measured by the Illumina Infinium Human Methylation 450 K BeadChip, was associated with GA for 2,372 CpG probes (5% FDR) in both the Pregnancy, Race, Environment, Genes (PREG) and Newborn Epigenetic Study (NEST) cohorts. Significant probes mapped to 1,640 characterized genes and an association with nearby gene expression measures obtained by the Affymetrix HG-133A microarray was found for 11 genes. Differentially methylated positions were enriched for actively transcribed and enhancer chromatin states, were predominately located outside of CpG islands, and mapped to genes enriched for inflammation and innate immunity ontologies. In both PREG and NEST, the first principal component derived from these probes explained approximately one-half (58.1% and 47.8%, respectively) of the variation in GA. Gene pathways identified are consistent with the hypothesis of pathogen detection and response by the immune system to elicit premature labour as a consequence of unscheduled inflammation.
Collapse
Affiliation(s)
- Timothy P York
- Department of Human and Molecular Genetics, Virginia Commonwealth University , Richmond, VA, USA.,Department of Obstetrics and Gynecology, Virginia Commonwealth University , Richmond, VA, USA
| | - Shawn J Latendresse
- Department of Psychology and Neuroscience, Baylor University , Waco, TX, USA
| | - Colleen Jackson-Cook
- Department of Human and Molecular Genetics, Virginia Commonwealth University , Richmond, VA, USA.,Department of Obstetrics and Gynecology, Virginia Commonwealth University , Richmond, VA, USA.,Department of Pathology, Virginia Commonwealth University , Richmond, VA, USA
| | - Dana M Lapato
- Department of Human and Molecular Genetics, Virginia Commonwealth University , Richmond, VA, USA
| | - Sara Moyer
- Department of Human and Molecular Genetics, Virginia Commonwealth University , Richmond, VA, USA
| | - Aaron R Wolen
- Transplant Research Institute, Department of Surgery, University of Tennessee Health Science Center , Memphis, TN, USA
| | - Roxann Roberson-Nay
- Department of Psychiatry, Virginia Commonwealth University , Richmond, VA, USA
| | - Elizabeth K Do
- Department of Health Behavior and Policy, Virginia Commonwealth University , Richmond, VA, USA
| | - Susan K Murphy
- Department of Obstetrics and Gynecology, Duke University , Durham, North Carolina, USA
| | - Catherine Hoyo
- Epidemiology and Environmental Epigenomics Laboratory, Center for Human Health and the Environment, North Carolina State University , Raleigh, NC, USA
| | - Bernard F Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University , Richmond, VA, USA
| | - Jerome F Strauss
- Department of Human and Molecular Genetics, Virginia Commonwealth University , Richmond, VA, USA.,Department of Obstetrics and Gynecology, Virginia Commonwealth University , Richmond, VA, USA
| |
Collapse
|
33
|
Fuemmeler BF, Holzwarth E, Sheng Y, Do EK, Miller CA, Blatt J, Rosoff PM, Østbye T. Mila Blooms: A Mobile Phone Application and Behavioral Intervention for Promoting Physical Activity and a Healthy Diet Among Adolescent Survivors of Childhood Cancer. Games Health J 2020; 9:279-289. [PMID: 32391734 DOI: 10.1089/g4h.2019.0060] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 01/30/2023] Open
Abstract
Objectives: Smartphone applications ("apps") can be used to promote health behavior change and expand the reach of behavioral interventions. To date, only a few existing apps have been developed for health promotion among adolescent survivors of childhood cancer. To address this gap, we developed an app-based intervention, using game design characteristics, theory-based behavioral strategies, and assistance from a health coach to motivate health behavior change for adolescent survivors of childhood cancer. This article describes the development and initial feasibility evaluation of the intervention. Methods: Using a theoretical framework and an extensive formative process, we developed an app-based game ("Mila Blooms") that promotes healthy eating and physical activity among adolescent survivors of childhood cancer. A single-arm 8-week intervention, using this app-based game, with assistance from a health coach, was conducted among a sample of pediatric cancer survivors (n = 15) to evaluate its initial feasibility for promoting health behavior change. Results: Results from the feasibility evaluation were encouraging. The majority of enrolled participants were retained throughout the 8-week intervention (93.8%). Participant satisfaction feedback indicated positive experiences, related to ease of use and enjoyment of the app. Although there was little evidence for behavior change attributable to the app in this first stage of development, there was a solid demonstration of the viability and appeal of the game features, and there were no adverse side effects. Conclusions: Results provide insights into how gamification can be used to promote health behaviors through an app-based intervention. Mila Blooms holds promise for promoting health behavior change. Lessons learned from our experiences could be useful for the future development and implementation of app-based adolescent health interventions.
Collapse
Affiliation(s)
- Bernard F Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia
| | | | - Yaou Sheng
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia
| | - Elizabeth K Do
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia
| | - Carrie A Miller
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia
| | - Julie Blatt
- Department of Pediatric Hematology Oncology Program, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina
| | - Philip M Rosoff
- Department of Pediatrics and Medicine, Duke University, Durham, North Carolina
| | - Truls Østbye
- Department of Family Medicine and Community Health, Duke University, Durham, North Carolina
| |
Collapse
|
34
|
Do EK, Fugate-Laus K, Fallavollita W, Conklin S, Hayes RB, Wheeler DC, Fuemmeler BF. Determinants of Youth-Reported Past 30-Day Tobacco Use. J Community Health 2020; 45:954-964. [PMID: 32246411 DOI: 10.1007/s10900-020-00813-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/24/2022]
Abstract
The objective of this study was to utilize cross-sectional surveys to identify factors associated with past 30-day tobacco use among a sample youth and to determine whether regional differences exist. Data were obtained from the Virginia Youth Survey (2015 and 2017). Multinomial logistic regression models were used to examine associations between measures of past 30-day tobacco use and region, sex, grade, race/ethnicity, tobacco advertisement exposure, and presence of tobacco-free policies in the home and personal vehicles. These correlates were selected based upon existing literature on youth tobacco use. Past 30-day cigarette use, combustible tobacco use, non-combustible tobacco use, and dual product use were associated with region, sex, grade, and race/ethnicity. Specifically, youth residing in the Southwestern region of the state, males, and non-Hispanic White students and youth of other race/ethnicity were more likely to report past 30-day tobacco use. Additionally, higher levels of exposure to tobacco advertisements was also associated with past 30-day tobacco use. Future research needs to investigate the mechanisms by which youth tobacco use may differ by region, to help guide and target future policy and programming related to tobacco prevention and control at the local level.
Collapse
Affiliation(s)
- Elizabeth K Do
- Department of Health Behavior & Policy, Virginia Commonwealth University, Box 980430, Richmond, VA, 23298, USA.
| | - Kendall Fugate-Laus
- Department of Health Behavior & Policy, Virginia Commonwealth University, Box 980430, Richmond, VA, 23298, USA
| | - Westley Fallavollita
- Department of Health Behavior & Policy, Virginia Commonwealth University, Box 980430, Richmond, VA, 23298, USA
| | - Sarah Conklin
- Virginia Department of Health, 109 Governor Street, Richmond, VA, 23219, USA
| | - Rashelle B Hayes
- Department of Psychiatry, Virginia Commonwealth University, Box 980710, Richmond, VA, 23298, USA
| | - David C Wheeler
- Department of Biostatistics, Virginia Commonwealth University, Box 980032, Richmond, VA, 23298, USA
| | - Bernard F Fuemmeler
- Department of Health Behavior & Policy, Virginia Commonwealth University, Box 980430, Richmond, VA, 23298, USA
| |
Collapse
|
35
|
Schechter J, Do EK, Zhang J(J, Hoyo C, Murphy SK, Kollins SH, Fuemmeler B. Effect of Prenatal Smoke Exposure on Birth Weight: The Moderating Role of Maternal Depressive Symptoms. Nicotine Tob Res 2020; 22:40-47. [PMID: 30590728 PMCID: PMC7297019 DOI: 10.1093/ntr/nty267] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 05/04/2018] [Accepted: 12/19/2018] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Both prenatal smoke exposure and depression have been linked to lower birth weight, a risk factor for morbidity and mortality. Few studies have looked at the interaction between these risk factors and none have used a biomarker to objectively measure prenatal smoke exposure. The current study sought to examine independent and interactive effects of cotinine and depression on birth weight. The effect of race was also explored. METHOD Data were drawn from a prospective study of pregnant women (N = 568) in the southeastern United States. Maternal demographic, health information, depressive symptoms, and birth data were collected via self-report and medical record abstraction. Prenatal blood samples were assayed for cotinine. RESULTS Controlling for covariates, multiple regression analyses indicated that both cotinine and depressive symptoms independently predicted lower birth weight and a significant interaction was also observed. Upon probing the interaction, a negative association between cotinine levels and birth weight was found in the context of higher depression but not lower depression scores. Similarly, logistic regression analyses revealed a significant interaction between cotinine and depression, such that cotinine predicted having a baby less than 2500 g among women who fell above the indicated cutoff score. African American women had the highest levels of cotinine and lowest weight babies; however, race was not a significant moderator. CONCLUSIONS Results suggest prenatal smoke exposure has a greater negative effect on birth weight for women endorsing co-occurring depressive symptoms. Findings can inform targeted interventions and assist medical providers with identifying women at increased risk for poor perinatal outcomes. IMPLICATIONS Despite the common occurrence of smoking during pregnancy and prenatal depression, the interaction between these risk factors on birth weight has rarely been examined. Further, the extant results have been mixed, likely due in part to difficulties in measurement. The current study was the first to use prenatal cotinine to assess bias-free, continuous levels of prenatal smoke exposure. Results indicate that prenatal cotinine was a significant predictor of birth weight only in the context of maternal depressive symptoms. These findings have important implications for mitigating negative perinatal outcomes for pregnant women and their children.
Collapse
Affiliation(s)
- Julia Schechter
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - Elizabeth K Do
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA
| | - Junfeng (Jim) Zhang
- Nicholas School of the Environment and Duke Global Health Institute, Duke University, Durham, NC
| | - Cathrine Hoyo
- Department of Biological Sciences, North Carolina State University, Raleigh, NC
| | - Susan K Murphy
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC
| | - Scott H Kollins
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - Bernard Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA
| |
Collapse
|
36
|
Nicksic NE, Do EK, Barnes AJ. Cannabis legalization, tobacco prevention policies, and Cannabis use in E-cigarettes among youth. Drug Alcohol Depend 2020; 206:107730. [PMID: 31759233 PMCID: PMC6980691 DOI: 10.1016/j.drugalcdep.2019.107730] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [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: 06/25/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND E-cigarettes are the most popular tobacco product among youth. As more states adopt cannabis legalization policies, youth cannabis use in e-cigarettes is a mounting concern. METHODS Data were from the 2016 and 2017 National Youth Tobacco Survey, a nationally-representative repeated cross-sectional survey administered to US middle and high school students. Ever use groups were categorized into e-cigarette ever users, cannabis in e-cigarette ever users, other tobacco ever users, and never users. Weighted multinomial logistic regression compared ever use groups, while controlling for state-level cannabis legalization and tobacco prevention polices, tobacco perceptions and exposures, and sociodemographic variables. Weighted prevalence of ever and current, or past 30 day, tobacco product use was determined by ever use groups. RESULTS Compared to e-cigarette ever users, cannabis in e-cigarette ever users increased (Adjusted Relative Risk Ratio (ARRR) = 1.65; p < 0.01) from 2016 to 2017. Medical-only and medical and recreational cannabis laws, and no e-cigarette minimum legal sales age (MLSA) and increased e-cigarette MLSA at 19 or 21 were positively associated with cannabis in e-cigarette ever users (ARRR = 1.34-1.85; p < 0.01, each). Ever and current use of all individual tobacco products was highest among cannabis in e-cigarette ever users compared to e-cigarette and other tobacco ever users. CONCLUSIONS Cannabis use in e-cigarettes has increased among youth, and these trends will likely continue as e-cigarettes continue to gain popularity and cannabis legalization policies proliferate. Targeted tobacco and cannabis prevention strategies are needed for youth, especially in states that have implemented cannabis 'medical and recreational laws.
Collapse
Affiliation(s)
- Nicole E Nicksic
- Department of Health Behavior and Policy, Virginia Commonwealth University, One Capitol Square, 830 East Main St, Richmond, VA 23219, USA.
| | | | | |
Collapse
|
37
|
Affiliation(s)
- Andrew W Bergen
- Oregon Research Institute, Eugene, OR.,BioRealm, LLC, Walnut, CA
| | - Elizabeth K Do
- Health Behavior Policy, Virginia Commonwealth University, Richmond, VA.,VCU Massey Cancer Center, Virginia Commonwealth University, Richmond, VA
| | - Li-Shiun Chen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO.,Siteman Cancer Center, St. Louis, MO
| | - Sean P David
- Department of Family Medicine, The University of Chicago.,NorthShore University Health System, IL
| |
Collapse
|
38
|
Do EK, Haberstick BC, Williams RB, Lessem JM, Smolen A, Siegler IC, Fuemmeler BF. The role of genetic and environmental influences on the association between childhood ADHD symptoms and BMI. Int J Obes (Lond) 2019; 43:33-42. [PMID: 30349010 PMCID: PMC7065598 DOI: 10.1038/s41366-018-0236-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 11/13/2017] [Revised: 08/02/2018] [Accepted: 08/29/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND/OBJECTIVES Although childhood attention deficit hyperactivity disorder (ADHD) has been previously associated with concurrent and later obesity in adulthood, the etiology of this association remains unclear. The objective of this study is to determine the shared genetic effects of ADHD symptoms and BMI in a large sample of sibling pairs, consider how these shared effects may vary over time, and examine potential sex differences. SUBJECT/METHODS Sibling pair data were obtained from the National Longitudinal Study of Adolescent to Adult Health (Add Health); childhood ADHD symptoms were reported retrospectively during young adulthood, while three prospective measurements of BMI were available from young adulthood to later adulthood. Cholesky decomposition models were fit to this data using Mx and maximum-likelihood estimation. The twin and sibling sample for these analyses included: 221 monozygotic (MZ) pairs (92 male-male, 139 female-female), 228 dizygotic (DZ) pairs (123 male-male, 105 female-female), 471 full-sibling (FS) pairs (289 male-male, 182 female-female), 106 male-female DZ twin pairs, and 234 male-female FS pairs. RESULTS The magnitude of the association between childhood ADHD symptoms and BMI changed over time and by sex. The etiological relationship between childhood ADHD symptoms and the three prospective measurements of BMI differed for males and females, such that unique or non-shared environmental influences contributed to the relationship within males and genetic factors contributed to the relationship within females. Specifically, among females, genetic influences on childhood ADHD symptoms were partially shared with those effecting BMI and increased from adolescence to later adulthood (genetic correlation = 0.20 (95% CI: 0.07-0.36) in adolescence and 0.24 (95% CI: 0.10, 0.41) in adulthood). CONCLUSION Genetic influences on ADHD symptoms in childhood are partially shared with those effecting obesity. However, future research is needed to determine why this association is limited to females.
Collapse
Affiliation(s)
- Elizabeth K Do
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
| | - Brett C Haberstick
- Institute for Behavioral Genetics, University of Colorado at Boulder, Boulder, CO, USA
| | - Redford B Williams
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Jeffrey M Lessem
- Institute for Behavioral Genetics, University of Colorado at Boulder, Boulder, CO, USA
| | - Andrew Smolen
- Institute for Behavioral Genetics, University of Colorado at Boulder, Boulder, CO, USA
| | - Ilene C Siegler
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Bernard F Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA.
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA.
| |
Collapse
|
39
|
Do EK, Prom-Wormley EC, Fuemmeler BF, Dick DM, Kendler KS, Maes HH. Associations Between Initial Subjective Experiences with Tobacco and Self-Reported Recent Use in Young Adulthood. Subst Use Misuse 2018; 53:2291-2298. [PMID: 29843549 PMCID: PMC6143142 DOI: 10.1080/10826084.2018.1473435] [Citation(s) in RCA: 3] [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] [Indexed: 10/14/2022]
Abstract
BACKGROUND Youth tobacco use behaviors are predictive of patterns in adulthood and effect long-term health outcomes. Yet, few studies have examined the effect of initial subjective experiences (ISEs) during first tobacco use, which has been found to be an indicator of individuals. sensitivity to nicotine and vulnerability to dependence. OBJECTIVE The present study aimed to determine the prevalence of ISEs across a variety of tobacco products, evaluate the factor structure of ISEs by first tobacco product used, and examine the relationship between ISEs and recent (30-day) use of tobacco products across time, using a university sample. METHODS Exploratory factor analyses were conducted to identify latent factors present with respect to items measuring ISEs with tobacco, separately by tobacco product (e.g. cigarettes, cigars, hookah, e-cigarettes). Factor scores for positive and negative ISEs were calculated. Multiple logistic regression analyses were conducted to examine associations between ISEs and recent use of each tobacco product, adjusted for age at first use, sex, race/ethnicity, and cohort. RESULTS ISEs differ by the first tobacco product used. Associations between factor scores for positive and negative ISEs and recent use were found across a variety of tobacco products. Overall, positive ISEs were more strongly associated with recent use, relative to negative ISEs. CONCLUSIONS Further research is needed to identify genetic and biological pathways and social contexts influencing initial subjective experiences with tobacco use, in efforts to delay the initiation for tobacco use and reduce risk for continued use among young adults.
Collapse
Affiliation(s)
- Elizabeth K Do
- a Department of Health Behavior & Policy , Virginia Commonwealth University , Richmond , Virginia , USA
| | - Elizabeth C Prom-Wormley
- b Division of Epidemiology, Department of Family Medicine & Population Health , Virginia Commonwealth University , Richmond , Virginia , USA
| | - Bernard F Fuemmeler
- a Department of Health Behavior & Policy , Virginia Commonwealth University , Richmond , Virginia , USA.,c Massey Cancer Center , Virginia Commonwealth University , Richmond , Virginia , USA
| | - Danielle M Dick
- d Departments of Psychology, Human & Molecular Genetics, College Behavioral and Emotional Health Institute , Virginia Commonwealth University , Richmond , Virginia , USA
| | - Kenneth S Kendler
- e Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics , Virginia Commonwealth University , Richmond , Virginia , USA
| | - Hermine H Maes
- c Massey Cancer Center , Virginia Commonwealth University , Richmond , Virginia , USA.,e Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics , Virginia Commonwealth University , Richmond , Virginia , USA.,f Department of Human & Molecular Genetics , Virginia Commonwealth University , Richmond , Virginia , USA
| |
Collapse
|
40
|
Do EK, Green TL, Prom-Wormley EC, Fuemmeler BF. Social determinants of smoke exposure during pregnancy: Findings from waves 1 & 2 of the Population Assessment of Tobacco and Health (PATH) Study. Prev Med Rep 2018; 12:312-320. [PMID: 30406010 PMCID: PMC6218644 DOI: 10.1016/j.pmedr.2018.10.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 08/25/2018] [Accepted: 10/25/2018] [Indexed: 11/02/2022] Open
Abstract
Maternal smoking during pregnancy (MSDP) and secondhand smoke (SHS) exposure are associated with a myriad of negative health effects for both mother and child. However, less is known regarding social determinants for SHS exposure, which may differ from those of maternal smoking during pregnancy (MSDP). To identify social determinants for SHS exposure only, MSDP only, and MSDP and SHS exposure, data were obtained from all pregnant women (18-54 years; N = 726) in waves 1 and 2 of the Population Assessment of Tobacco and Health Study (2014-2015). Multiple logistic regressions were conducted using SAS 9.4. Smoke exposure during pregnancy was common; 23.0% reported SHS exposure only, 6.1% reported MSDP only, and 11.8% reported both SHS exposure and MSDP. Results demonstrate that relationships between smoke exposure during pregnancy and social determinants vary by type of exposure. Women at risk for any smoke exposure during pregnancy include those who are unmarried and allow the use of combustible tobacco products within the home. Those who are at higher risk for SHS exposure include those who are younger in age, and those who are earlier in their pregnancy. Those who are at higher risk for maternal smoking include those with fair/poor mental health status and those who believe that others' view tobacco use more positively. These results suggest the need for implementing more comprehensive policies that promote smoke-free environments. Implementing these strategies have the potential to improve maternal and fetal health outcomes associated with tobacco smoke exposure.
Collapse
Affiliation(s)
- Elizabeth K. Do
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Tiffany L. Green
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Elizabeth C. Prom-Wormley
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Bernard F. Fuemmeler
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, VA, United States of America
| |
Collapse
|
41
|
Hawn SE, Sheerin CM, Webb BT, Peterson RE, Do EK, Dick D, Kendler KS, Bacanu SA, Amstadter AB. Replication of the Interaction of PRKG1 and Trauma Exposure on Alcohol Misuse in an Independent African American Sample. J Trauma Stress 2018; 31:927-932. [PMID: 30376604 PMCID: PMC6295354 DOI: 10.1002/jts.22339] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 03/05/2018] [Revised: 07/31/2018] [Accepted: 08/06/2018] [Indexed: 12/11/2022]
Abstract
In the present study, we sought to replicate recent findings of Polimanti et al. (2017), who conducted a genome-wide gene-by-environment interaction study (GEWIS) and identified a gene-by-trauma interaction that predicts alcohol misuse among African Americans. Consistent with the findings published by Polimanti and colleagues, results of the current study demonstrated an interaction effect, b = 0.41, of trauma exposure and rs1729578 in the intron of PRKG1 on alcohol misuse in a subsample of ancestral African Americans. The minor allele (rs1729578*C) was positively associated with increased alcohol use disorder symptoms in trauma-exposed subjects and negatively associated in non-trauma-exposed subjects. This effect, however, was only significant for one out of three alcohol outcome measures we investigated, suggesting the interaction may be most salient when predicting higher severity of alcohol misuse. Additionally, the effect did not remain significant after we accounted for testing the effect on three different outcome variables. Also in line with the original study, the gene-by-environment effect was not demonstrated among the ancestral European subsample. The findings suggest this gene variant may increase an individual's susceptibility to environmental influences, both adverse and supportive.
Collapse
Affiliation(s)
- Sage E. Hawn
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA,Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Christina M. Sheerin
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Bradley T. Webb
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA,Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Roseann E. Peterson
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA,Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Elizabeth K. Do
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Danielle Dick
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA,College Behavioral and Emotional Health Institute, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA,Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Silviu-Alin Bacanu
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Ananda B. Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA,Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA,Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
| |
Collapse
|
42
|
Dozmorov MG, Bilbo SD, Kollins SH, Zucker N, Do EK, Schechter JC, Zhang J(J, Murphy SK, Hoyo C, Fuemmeler BF. Associations between maternal cytokine levels during gestation and measures of child cognitive abilities and executive functioning. Brain Behav Immun 2018; 70:390-397. [PMID: 29588230 PMCID: PMC6471612 DOI: 10.1016/j.bbi.2018.03.029] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [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: 08/02/2017] [Revised: 03/14/2018] [Accepted: 03/23/2018] [Indexed: 12/12/2022] Open
Abstract
Preclinical studies demonstrate that environmentally-induced alterations in inflammatory cytokines generated by the maternal and fetal immune system can significantly impact fetal brain development. Yet, the relationship between maternal cytokines during gestation and later cognitive ability and executive function remains understudied. Children (n = 246) were born of mothers enrolled in the Newborn Epigenetic Study - a prospective pre-birth cohort in the Southeastern US. We characterized seven cytokines [IL-1β, IL-4,IL-6, IL-12p70, IL-17A, tumor necrosis factor-α (TNFα), and interferon-γ (IFNγ)] and one chemokine (IL-8) from maternal plasma collected during pregnancy. We assessed children's cognitive abilities and executive functioning at a mean age of 4.5 (SD = 1.1) years. Children's DAS-II and NIH toolbox scores were regressed on cytokines and the chemokine, controlling for maternal age, race, education, body mass index, IQ, parity, smoking status, delivery type, gestational weeks, and child birth weight and sex. Higher IL-12p70 (βIL-12p70 = 4.26, p = 0.023) and IL-17A (βIL-17A = 3.70, p = 0.042) levels were related to higher DAS-II GCA score, whereas higher IL-1β (βIL-1B = -6.07, p = 0.003) was related to lower GCA score. Higher IL-12p70 was related to higher performance on NIH toolbox measures of executive functions related to inhibitory control and attention (βIL-12p70 = 5.20, p = 0.046) and cognitive flexibility (βIL-12p70 = 5.10, p = 0.047). Results suggest that dysregulation in gestational immune activity are associated with child cognitive ability and executive functioning.
Collapse
Affiliation(s)
- Mikhail G. Dozmorov
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Staci D. Bilbo
- Lurie Center for Autism, MassGeneral Hospital for Children, Harvard Medical School, Boston, MA 02129, USA
| | - Scott H. Kollins
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27708, USA
| | - Nancy Zucker
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27708, USA
| | - Elizabeth K. Do
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Julia C. Schechter
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27708, USA
| | - Junfeng (Jim) Zhang
- The Nicholas School of the Environment and Duke Global Health Institute, Duke University, Durham, NC 27708, USA
| | - Susan K. Murphy
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27708, USA
| | - Cathrine Hoyo
- Department of Biological Sciences, North Carolina State University, Raleigh, NC 27695, USA
| | - Bernard F. Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA 23298, USA,Corresponding author at: Virginia Commonwealth University, Department of Health Behavior and Policy, P.O. Box 980149, 830 E Main St., Richmond, VA 23219, USA., (B.F. Fuemmeler)
| |
Collapse
|
43
|
Abstract
INTRODUCTION There has been rapid growth in research exploring gene-environment interaction (G×E) contributing to smoking behaviors. Yet, no systematic review exists to date. METHODS This article aims to review evidence on the contribution of G×E to the risk of smoking. Through a search of electronic databases (ie, Google Scholar, PubMed, ScienceDirect, and Elsevier) up until May 2014, 16 studies of G×E focused on smoking behaviors were identified. These studies were compared in terms of: research design and sample studied, measure of smoking behavior and environments used, genes explored, and G×E in relation to these factors. RESULTS Thirteen of 16 studies (81.2%) found at least one significant G×E association. Wide variation in analytic methods was found across studies, especially with respect to the phenotypes of interest, environmental measures used, and tests conducted to estimate G×E. Heterogeneity across studies made it difficult to compare findings and evaluate the strength of evidence for G×E. CONCLUSIONS G×E research on smoking contains studies that are methodologically different, making it difficult to assess the current state of the evidence. To decrease heterogeneity, we offer recommendations related to: (1) choice of measurement for environmental variables, (2) testing and reporting of main and interaction effects, (3) treatment of covariates, (4) reporting gene-environment correlation, and (5) conducting sensitivity analyses and checking for scaling artifacts. Continued study is needed to identify mechanisms by which genes and environmental factors combine to influence smoking behaviors. IMPLICATIONS No comprehensive review of G×E studies of smoking behavior has previously been published. The present article seeks to fill this gap by providing a comprehensive review of: how G×E has been defined, how twin and molecular genetic methodologies have been used to test for G×E, and which genes and environmental factors are associated with smoking behaviors. Variations in methodological approaches make it difficult to interpret and summarize findings, so recommendations for future research are provided as a means to more easily compare and replicate findings across studies.
Collapse
Affiliation(s)
- Elizabeth K Do
- Department of Psychiatry and School of Medicine, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
- Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, VA
| | - Hermine H Maes
- Department of Psychiatry and School of Medicine, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA
| |
Collapse
|
44
|
Do EK, Latendresse SJ, Edwards AC, Kendler KS, Dick DM, York TP. Associations Between Gestational Age at Birth and Alcohol Use in the Avon Longitudinal Study of Parents and Children. Alcohol Clin Exp Res 2016; 40:1328-38. [PMID: 27155784 DOI: 10.1111/acer.13080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 11/30/2015] [Accepted: 03/28/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND The relationship between gestational age at birth (GA) and alcohol use measures in early adulthood was examined in a large U.K. community-based birth cohort (Avon Longitudinal Study of Parents and Children). METHODS A series of linear and logistic regression models were used to test for main effects of a continuous measure of GA on a range of alcohol use measures, and moderation of these associations by sex. In addition, mediation analyses assessed the extent to which significant associations between GA and alcohol use operated indirectly, through influences of the parental environment and/or childhood measures of emotional and behavioral health (EBH). RESULTS Earlier GA significantly predicted never drinking by age 18, but was not associated with other measures of alcohol use behavior among young adult drinkers (i.e., Self-Rating of the Effects of Alcohol, Alcohol Use Disorders Identification Test, or DSM-IV-TR Criteria for Alcohol Dependence). The association between earlier GA and never drinking by age 18 was moderated by sex, such that females born early were less likely to have ever had a drink by age 18. In the full sample, childhood measures of EBH were found to mediate the association between earlier GA and never drinking by age 18. This association was not mediated by parenting factors. CONCLUSIONS Earlier GA is associated with never drinking alcohol in early adulthood, in females. Emotional and behavioral difficulties experienced in early childhood may mediate the relationship between earlier GA and never drinking by age 18.
Collapse
Affiliation(s)
- Elizabeth K Do
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, Virginia
| | | | - Alexis C Edwards
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia
| | - Kenneth S Kendler
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia
| | - Danielle M Dick
- Departments of Psychology, African American Studies, and Human and Molecular Genetics, Virginia Commonwealth University, Richmond, Virginia
| | - Timothy P York
- Department of Human and Molecular Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia
| |
Collapse
|
45
|
Abstract
Previous studies have not examined whether documentation status has an effect on healthcare utilization among US Hispanic immigrants with diabetes. A secondary analysis was conducted using data from the Pew Hispanic Center and Robert Johnson Wood Foundation's 2007 Hispanic Healthcare Survey. Hispanic immigrants diagnosed with diabetes were included in analyses. The association between documentation status and healthcare utilization was assessed using logistic regressions. Of N = 577 Hispanic immigrants with diabetes, 80 % were documented immigrants and 81% reported having visited a healthcare provider in the last 6 months. Adjusting for confounders, those who were undocumented faced higher odds of having seen a healthcare provider more than 6 months ago or never when compared to those who were documented (OR = 1.79; 95% CI 1.01, 3.14). Unique opportunities in addressing healthcare disparities can be found in focusing on the Hispanic immigrant population living with diabetes.
Collapse
Affiliation(s)
- Elizabeth K Do
- Department of Social and Behavioral Health, Virginia Commonwealth University, P.O. Box 980149, Richmond, VA, 23298-0149, USA,
| | | |
Collapse
|
46
|
Do EK, Cohen SA, Brown MJ. Socioeconomic and demographic factors modify the association between informal caregiving and health in the Sandwich Generation. BMC Public Health 2014; 14:362. [PMID: 24735495 PMCID: PMC3990012 DOI: 10.1186/1471-2458-14-362] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 03/26/2014] [Indexed: 11/30/2022] Open
Abstract
Background Nearly 50 million Americans provide informal care to an older relative or friend. Many are members of the “sandwich generation”, providing care for elderly parents and children simultaneously. Although evidence suggests that the negative health consequences of caregiving are more severe for sandwiched caregivers, little is known about how these associations vary by sociodemographic factors. Methods We abstracted data from the Behavioral Risk Factor Surveillance System to determine how the association between caregiving and health varies by sociodemographic factors, using ordinal logistic regression with interaction terms and stratification by number of children, income, and race/ethnicity. Results The association between informal caregiving and health varied by membership in the “sandwich generation,” income, and race/ethnicity. This association was significant among subjects with one (OR = 1.13, 95% CI [1.04, 1.24]) and two or more children (OR = 1.17, 95% CI = 1.09, 1.26]), but not in those without children (OR = 1.01, 95% CI [0.97, 1.05]). Associations were strongest in those earning $50,000-$75,000 annually, but these income-dependent associations varied by race/ethnicity. In Whites with two or more children, the strongest associations between caregiving and health occurred in lower income individuals. These trends were not observed for Whites without children. Conclusions Our findings suggest that the added burden of caregiving for both children and elderly relatives may be impacted by income and race/ethnicity. These differences should be considered when developing culturally appropriate interventions to improve caregiver health and maintain this vital component of the US health care system.
Collapse
Affiliation(s)
| | - Steven A Cohen
- Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, 830 East Main Street- 8th Floor, Richmond, Virginia 23298, USA.
| | | |
Collapse
|
47
|
Vanderwielen LM, Vanderbilt AA, Dumke EK, Do EK, Isringhausen KT, Wright MS, Enurah AS, Mayer SD, Bradner M. Improving public health through student-led interprofessional extracurricular education and collaboration: a conceptual framework. J Multidiscip Healthc 2014; 7:105-10. [PMID: 24550677 PMCID: PMC3926462 DOI: 10.2147/jmdh.s52019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [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] [Indexed: 12/25/2022] Open
Abstract
In the US, health care professionals are trained predominantly in uniprofessional settings independent of interprofessional education and collaboration. Yet, these professionals are tasked to work collaboratively as part of an interprofessional team in the practice environment to provide comprehensive care to complex patient populations. Although many advantages of interprofessional education have been cited in the literature, interprofessional education and collaboration present unique barriers that have challenged educators and practitioners for years. In spite of these impediments, one student-led organization has successfully implemented interprofessional education and cross-disciplinary collaboration. The purpose of this paper is to provide a conceptual framework for successful implementation of interprofessional education and collaboration for other student organizations, as well as for faculty and administrators. Each member of the interprofessional team brings discipline-specific expertise, allowing for a diverse team to attend to the multidimensional health needs of individual patients. The interprofessional team must organize around a common goal and work collaboratively to optimize patient outcomes. Successful interdisciplinary endeavors must address issues related to role clarity and skills regarding teamwork, communication, and conflict resolution. This conceptual framework can serve as a guide for student and health care organizations, in addition to academic institutions to produce health care professionals equipped with interdisciplinary teamwork skills to meet the changing health care demands of the 21st century.
Collapse
Affiliation(s)
- Lynn M Vanderwielen
- School of Allied Health Professions, Department of Health Administration, Virginia Commonwealth University, Richmond, VA, USA
| | - Allison A Vanderbilt
- Center of Health Disparities, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Erika K Dumke
- Division for Health Sciences Diversity, Virginia Commonwealth University, Richmond, VA, USA
| | - Elizabeth K Do
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Kim T Isringhausen
- Department of Oral Health Promotion and Community Outreach, School of Dentistry, Virginia Commonwealth University, Richmond, VA, USA
| | - Marcie S Wright
- Center of Health Disparities, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Sallie D Mayer
- Department of Pharmacotherapy and Outcomes Science, School of Pharmacy, Virginia Commonwealth University, Richmond, VA, USA
| | - Melissa Bradner
- Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| |
Collapse
|
48
|
Abstract
BACKGROUND Bipolar disorder is associated with substance use and misuse. However, to date few studies have examined the relationship between hypomania and substance misuse and dependence in the general population. METHODS Data come from the National Institute of Mental Health Collaborative Psychiatric Epidemiology Surveys (CPES), a set of multi-stage area probability samples of US adults (N=10,404). Multivariable linear and logistic regression was used to assess the relationship between DSM-IV hypomania and nicotine, alcohol, cannabis, cocaine, and prescription drug use. Models were adjusted for age, gender, education, and marital status. Stratified analyses and interaction terms were used to determine whether the relationship between hypomania and substance misuse varied by race/ethnicity. RESULTS The 12-month prevalence of hypomania was 0.5%. Hypomania was more common among African Americans (0.9%) relative to non-Hispanic Whites (0.5%) or other race/ethnicities (0.7%). Individuals with hypomania were 3.6 (95% CI: 1.5, 8.5) and 2.9 (95% CI: 1.3, 6.8) times more likely to also meet criteria for alcohol abuse/dependence and drug abuse/dependence relative to individuals without. The relationship between hypomania and substance use outcomes did not vary by race/ethnicity. LIMITATIONS The primary limitation of this study is its cross-sectional design, which precludes any inference about the causal nature of comorbid hypomania-substance use. CONCLUSIONS Hypomania is associated with increased likelihood of substance use and dependence/abuse across a broad range of substances. These associations were consistent across racial/ethnic groups. Findings indicate that even sub-syndromal conditions, such as hypomania, are significantly related to substance use and misuse in the community.
Collapse
Affiliation(s)
- Elizabeth K. Do
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, P.O. Box 980126, Richmond, VA, USA,Corresponding author. Tel.: +1 804 828 8157
| | - Briana Mezuk
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, P.O. Box 980126, Richmond, VA, USA,Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, P.O. Box 980212, Richmond, VA, USA
| |
Collapse
|