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Nam JK, Piper ME, Tong Z, Li R, Yang JJ, Jorenby DE, Buu A. Dependence motives and use contexts that predicted smoking cessation and vaping cessation: A two-year longitudinal study with 13 waves. Drug Alcohol Depend 2023; 250:110871. [PMID: 37406572 PMCID: PMC10623667 DOI: 10.1016/j.drugalcdep.2023.110871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/10/2023] [Accepted: 06/19/2023] [Indexed: 07/07/2023]
Abstract
INTRODUCTION Prior studies examining the impact of e-cigarette use, dependence, cessation motivation/goals, and environmental restriction on smoking cessation were based on cross-sectional or shorter-term longitudinal data with binary outcomes. There is also a critical knowledge gap in corresponding impact on vaping cessation. This study aims to fill in these gaps by investigating these factors' effects on speed of progression to smoking and vaping cessation. METHODS This study conducted secondary analysis of data from 13 waves of assessment of adult cigarette users in Wisconsin from October 2015 through July 2019. Cox regression was employed to examine baseline predictors' effects on speed of progression to smoking cessation (past-month abstinence) among 405 exclusive combustible cigarette users and dual users of combustible and electronic cigarettes, as well as progression to vaping cession among 178 dual users. RESULTS Dual use of e-cigarettes with cigarettes, lower primary dependence motives of smoking, higher secondary dependence motives of smoking, higher motivation to quit smoking, more ambitious future goals to quit smoking, and more restrictive environment for smoking all contributed to quicker progression to smoking cessation. Dual users with higher secondary dependence motives of smoking or with lower primary dependence motives of vaping progressed faster to vaping cessation. CONCLUSIONS The findings support that nicotine dependence is product-specific with two distinct constructs: the primary dependence motives are associated with more difficulty to quit, whereas the secondary dependence motives have the opposite effect. Dual users with strong instrumental reasons for smoking may not find e-cigarettes as an effective substitute for cigarettes.
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Affiliation(s)
- Joon Kyung Nam
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center, 7000 Fannin St.Houston, TX77030USA
| | - Megan E Piper
- Center for Tobacco Research & Intervention, University of Wisconsin, 1930 Monroe Street, Suite 200Madison, WI53711USA
| | - Zhaoxue Tong
- Department of Statistics, Pennsylvania State University, 413 Thomas Building, University Park, PA16802-2111USA
| | - Runze Li
- Department of Statistics, Pennsylvania State University, 413 Thomas Building, University Park, PA16802-2111USA
| | - James J Yang
- Department of Biostatistics and Data Science, University of Texas Health Science Center, 1200 Pressler St.Houston, TX77030USA
| | - Douglas E Jorenby
- Center for Tobacco Research & Intervention, University of Wisconsin, 1930 Monroe Street, Suite 200Madison, WI53711USA
| | - Anne Buu
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center, 7000 Fannin St.Houston, TX77030USA.
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Yang JJ, Ou TS, Lin HC, Kyung Nam J, Piper ME, Buu A. Retrospective and Real-time Measures of the Quantity of E-cigarette Use: An Ecological Momentary Assessment Study. Nicotine Tob Res 2023; 25:1667-1675. [PMID: 37327251 PMCID: PMC10445250 DOI: 10.1093/ntr/ntad094] [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: 11/22/2022] [Revised: 06/07/2023] [Accepted: 06/13/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Quantifying e-cigarette use is challenging because of the wide variety of products and the lack of a clear, objective demarcation of a use event. This study aimed to characterize the difference between retrospective and real-time measures of the quantity of e-cigarette use and identify the covariates that may account for discrepancies between the two types of measures. METHODS This study analyzed data from 401 college student e-cigarette users in Indiana and Texas who responded to a web survey (retrospective) and 7-day ecological momentary assessments (EMA) (real-time) on their e-cigarette use behavior, dependence symptomatology, e-cigarette product characteristics, and use contexts from Fall 2019 to Fall 2021. Generalized linear mixed models were used to model the real-time measures of quantity offset by the retrospective average quantity. RESULTS Although the number of times using e-cigarettes per day seems to be applicable to both retrospective and real-time measures, the number reported via EMA was 8.5 times the retrospective report. E-cigarette users with higher e-cigarette primary dependence motives tended to report more daily nicotine consumption via EMA than their retrospective reports (ie, perceived average consumption). Other covariates that were associated with discrepancies between real-time and retrospective reports included gender, nicotine concentration, using a menthol- or fruit-flavored product, co-use with alcohol, and being with others when vaping. CONCLUSIONS The study found extreme under-reporting of e-cigarette consumption on retrospective surveys. Important covariates identified to be associated with higher than average consumption may be considered as potential targets for future vaping interventions. IMPLICATIONS This is the first study that characterizes the direction and magnitude of the difference between retrospective and real-time measures of the quantity of e-cigarette use among young adults-the population most likely to use e-cigarettes. An average retrospective account of vaping events per day may significantly underestimate e-cigarette use frequency among young adults. The lack of insight into the degree of consumption among users with heavy primary dependence motives illustrates the importance of incorporating self-monitoring into cessation interventions.
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Affiliation(s)
- James J Yang
- Department of Biostatistics and Data Science, University of Texas Health Science Center, Houston, TX, USA
| | - Tzung-Shiang Ou
- Department of Applied Health Science, School of Public Health, Indiana University-Bloomington, Bloomington, IN, USA
| | - Hsien-Chang Lin
- Department of Applied Health Science, School of Public Health, Indiana University-Bloomington, Bloomington, IN, USA
| | - Joon Kyung Nam
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center, Houston, TX, USA
| | - Megan E Piper
- Center for Tobacco Research & Intervention, Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Anne Buu
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center, Houston, TX, USA
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Buu A, Yang JJ, Ou TS, Kyung Nam J, Suh G, Lin HC. An ecological momentary assessment study to examine covariates and effects of concurrent and simultaneous use of electronic cigarettes and marijuana among college students. Addict Behav 2023; 141:107662. [PMID: 36805815 DOI: 10.1016/j.addbeh.2023.107662] [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: 08/22/2022] [Revised: 01/30/2023] [Accepted: 02/09/2023] [Indexed: 02/13/2023]
Abstract
INTRODUCTION The prevalence of concurrent and simultaneous use of e-cigarette and marijuana among college students is high. Yet, the literature was mainly based on cross-sectional surveys with emphasis on the smoking route. This is the first ecological momentary assessment (EMA) study that examined the vaping route of nicotine-marijuana co-use and the associated short-term psychological effects. METHODS This study recruited 686 college student e-cigarette users to participate in an on-line survey and 7-day EMA. Frequent marijuana users (247) - using marijuana weekly or daily - were compared with infrequent/non-users (439) on academic performance, e-cigarette use patterns, and dependence and respiratory symptoms. EMA data from the frequent users were used to study the association between marijuana vaping and e-cigarette consumption and the short-term psychological effects of e-cigarette and marijuana use. RESULTS The results show that e-cigarette users who frequently used marijuana tended to have lower academic performance, be involved in higher-risk use patterns, and have higher levels of e-cigarette dependence, marijuana problems, and respiratory symptoms, compared to infrequent/non-users. Marijuana vaping was associated with a higher level of e-cigarette consumption. E-cigarette use and marijuana use were both associated with higher levels of positive affect, physiological sensation, and craving for e-cigarettes. While marijuana use was linked to a lower level of negative affect, e-cigarette use did not have a significant effect. Further, none of the interaction effects between e-cigarette and marijuana use on psychological states were significant. CONCLUSIONS The results showed additive effects of e-cigarette and marijuana use although the hypothesized synergistic effects were not supported.
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Affiliation(s)
- Anne Buu
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center, 7000 Fannin St., Houston, TX 77030, USA.
| | - James J Yang
- Department of Biostatistics and Data Science, University of Texas Health Science Center, 1200 Pressler St., Houston, TX 77030, USA.
| | - Tzung-Shiang Ou
- Department of Applied Health Science, School of Public Health, Indiana University-Bloomington, 1025 E. 7(th) Street, SPH 116, Bloomington, IN 47405, USA.
| | - Joon Kyung Nam
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center, 7000 Fannin St., Houston, TX 77030, USA.
| | - Ganghui Suh
- Department of Applied Health Science, School of Public Health, Indiana University-Bloomington, 1025 E. 7(th) Street, SPH 116, Bloomington, IN 47405, USA.
| | - Hsien-Chang Lin
- Department of Applied Health Science, School of Public Health, Indiana University-Bloomington, 1025 E. 7(th) Street, SPH 116, Bloomington, IN 47405, USA.
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Nam JK, Zatloff JP, Wong SW, Lin HC, Su WC, Buu A. An Exploratory Study on Strategies Adopted by Parents Who Use E-Cigarettes to Negotiate Risk Perceptions of Their Children's Secondhand Exposure and Parental Role Modeling. Int J Ment Health Addict 2023:1-12. [PMID: 37363765 PMCID: PMC10184636 DOI: 10.1007/s11469-023-01075-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/06/2023] [Indexed: 06/28/2023] Open
Abstract
Existing health messages mainly targeted youth susceptible to vaping or parents who do not have much knowledge about e-cigarettes. This study makes a unique contribution by conducting the first in-depth investigation of e-cigarette-using parents' risk perceptions and parental role modeling and how these two factors affect their vaping behaviors at home or implementation of any strategies to reduce their children's risk. Fifteen parents who used e-cigarettes participated in a semi-structured interview. Interview transcripts were coded and analyzed through a deductive approach of thematic analysis. This study demonstrates the need to develop and disseminate future health messages for e-cigarette-using parents who may have low-risk perceptions of secondhand exposure or who have adopted ineffective strategies to reduce their children's exposure. This study also identifies some possible targets for future intervention efforts through these parents including increasing their knowledge about the health risk of secondhand exposure to e-cigarettes, emphasizing the caregiver role, and effective communications with children about the consequences of vaping.
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Affiliation(s)
- Joon Kyung Nam
- Dept. of Health Promotion and Behavioral Sciences, Univ. of Texas Health Science Center, 7000 Fannin St, Houston, TX 77030 USA
| | - Jesse P. Zatloff
- Dept. of Health Promotion and Behavioral Sciences, Univ. of Texas Health Science Center, 7000 Fannin St, Houston, TX 77030 USA
| | - Su-Wei Wong
- Dept. of Health Promotion and Behavioral Sciences, Univ. of Texas Health Science Center, 7000 Fannin St, Houston, TX 77030 USA
| | - Hsien-Chang Lin
- Dept. of Applied Health Science, School of Public Health, Indiana Univ, Bloomington, IN USA
| | - Wei-Chung Su
- Dept. of Epidemiology, Human Genetics & Environmental Sciences, Univ. of Texas Health Science Center, Houston, TX USA
| | - Anne Buu
- Dept. of Health Promotion and Behavioral Sciences, Univ. of Texas Health Science Center, 7000 Fannin St, Houston, TX 77030 USA
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Buu A, Nam JK, Yang M, Su WC, Lin HC. Home e-cigarette rules and youth's vulnerability to initiate and sustain e-cigarette use. Prev Med 2022; 164:107334. [PMID: 36334686 PMCID: PMC9704116 DOI: 10.1016/j.ypmed.2022.107334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 10/24/2022] [Accepted: 10/30/2022] [Indexed: 11/11/2022]
Abstract
Existing studies of the impact of home rules on youth's vulnerability to e-cigarette use were based on cross-sectional data, youth or parent reports alone, as well as youth's perceptions and susceptibility. This study capitalizes on the restricted-use data of the Population Assessment of Tobacco and Health (PATH) Study to examine the longitudinal association between home rules for e-cigarette use and youth's vulnerability including initiation of use and regular use two years later. Secondary analysis was conducted on 1203 parent-youth pairs who participated in both Wave 4 (2016-2018) and Wave 5 (2018-2019) assessment of the PATH Study and while the youth were age 12-16 at Wave 4. Linear and logistic regressions were performed to examine the associations between having a strict home rule for e-cigarette use at Wave 4 and the youth's outcomes including perceived social norms, expectancies, susceptibility, initiation of use, and regular use of e-cigarettes at Wave 5, controlling for parent and youth factors. The results show that having a strict home rule for e-cigarette use was associated with youth's heightened level of perceived injunctive norms (β = 0.22, p < 0.01), higher expectancy of harmfulness (β = 0.28, p < 0.01) and lower odds for regular e-cigarette use (OR = 0.36, p < 0.05). In conclusion, the findings of this study support the potential protective effects of implementing a strict home rule for e-cigarette use. Future intervention efforts may promote parents' awareness of the potential protective effects of a strict home e-cigarette rule on youth's normative belief, harm expectancy, and behavior of e-cigarette use.
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Affiliation(s)
- Anne Buu
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center, 7000 Fannin St., Houston, TX 77030, USA.
| | - Joon Kyung Nam
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center, 7000 Fannin St., Houston, TX 77030, USA.
| | - Meng Yang
- Department of Applied Health Science, School of Public Health, Indiana University-Bloomington, 1025 E. 7(th) Street, SPH 116, Bloomington, IN 47405, USA.
| | - Wei-Chung Su
- Department of Epidemiology, Human Genetics & Environmental Sciences, University of Texas Health Science Center, 1200 Pressler St., Houston, TX 77030, USA.
| | - Hsien-Chang Lin
- Department of Applied Health Science, School of Public Health, Indiana University-Bloomington, 1025 E. 7(th) Street, SPH 116, Bloomington, IN 47405, USA.
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Affiliation(s)
- H J Park
- Urology, Pusan National University Hospital, Busan, Republic of Korea
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