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DiGaetano R, Dohrmann S, Taylor EV, Everard CD, Castleman V, Yan T, Kimmel HL, Zandberg I, Piesse A, Opsomer JD, Borek N, Silveira ML, Hubbard F, Taylor K, Creamer MR, Salim AH, Sharma E, Cheng YC, Vignare V, Cook T, Szeszel-Fedorowicz W, Siegfried Y, Carusi C, Stark D, Skara S, Hyland A. 2020 design and methods of the Population Assessment of Tobacco and Health (PATH) study during the COVID-19 pandemic. Tob Control 2024:tc-2023-058466. [PMID: 38670795 DOI: 10.1136/tc-2023-058466] [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: 10/26/2023] [Accepted: 04/06/2024] [Indexed: 04/28/2024]
Abstract
The Population Assessment of Tobacco and Health (PATH) Study is a nationally representative, longitudinal study of the US population on tobacco use and its effects on health, collecting data annually since 2013. The COVID-19 pandemic interrupted in-person survey data collections around the world. In the USA, this included a PATH Study data collection focused on youth (13-17) and young adults (18-19) as well as other US surveys on tobacco use. Given that it was necessary to pause data collection and considering that tobacco-use behaviours could be expected to change along with pandemic-related changes in the social environment, the original design for the 2020 PATH Study data collection for youth and young adults was modified. Also, the PATH Study Adult Telephone Survey was developed to address the need for adult tobacco use monitoring in this unprecedented time. This article describes the modifications made to the 2020 PATH Study design and protocol to provide nationally representative data for youth and adults after the onset of the COVID-19 pandemic as well as the implications of these modifications for researchers.
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Affiliation(s)
| | | | - Ethel V Taylor
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Colm D Everard
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, USA
- Kelly Government Solutions, Rockville, Maryland, USA
| | | | - Ting Yan
- Westat Inc, Rockville, Maryland, USA
| | - Heather L Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, USA
| | - Izabella Zandberg
- Center for Scientific Review, National Institutes of Health, Bethesda, Maryland, USA
| | | | | | - Nicolette Borek
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Marushka L Silveira
- Kelly Government Solutions, Rockville, Maryland, USA
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, USA
| | | | | | - MeLisa R Creamer
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, USA
| | - Anikah H Salim
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, USA
| | | | - Yu-Ching Cheng
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, USA
| | | | | | - Wioletta Szeszel-Fedorowicz
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, USA
- Health Resources and Services Administration, Rockville, Maryland, USA
| | | | | | - Debra Stark
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Silvana Skara
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Andrew Hyland
- Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
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Sharma E, Tang Z, Lauten K, Silveira ML, Delnevo CD, Edwards KC, Marshall D, Gaalema DE, Zandberg I, Graham-Glover B, Rivers DL, Imoisili OE, Neal K, Niaura R, Bansal-Travers M, Hyland A, Michael Cummings K. Cardiovascular disease outcomes among established cigar users 40 years and older: Findings from the population assessment of tobacco and health (PATH) study, waves 1-5 (2013-2019). Prev Med Rep 2024; 37:102569. [PMID: 38186661 PMCID: PMC10767260 DOI: 10.1016/j.pmedr.2023.102569] [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: 08/14/2023] [Revised: 12/15/2023] [Accepted: 12/16/2023] [Indexed: 01/09/2024] Open
Abstract
This study examined associations between established cigar use and prevalence and incidence of cardiovascular diseases (CVD; congestive heart failure, stroke, or heart attack/needed bypass surgery) among U.S. adults, 40 years or older. Using Waves 1-5 (2013-2019) of the Population Assessment of Tobacco and Health (PATH) Study, incidence (Nindividuals (Nind) = 6,692; Nobservations (Nobs) = 23,738) and prevalence (Nind = 7,819; Nobs = 33,952) of CVD outcomes were examined using weighted generalized estimating equations (WGEEs) among adults who were exclusive current/former established cigar smokers (ever cigar smokers who have smoked fairly regularly), exclusive current/former established cigarette smokers (lifetime smokers of 100 or more cigarettes), dual current/former established cigarette and cigar smokers compared with never smokers of cigars or cigarettes, adjusting for covariates. The population-averaged incidence of CVD from one wave to next among exclusive current/former established cigar smokers during a six-year period based on WGEEs was low (overall average rate of 3.0 %; 95 % CI: 1.2, 7.0). Compared with never users, exclusive current/former established cigar smokers (OR = 1.67, 95 % CI: 1.11, 2.51) and exclusive current/former established cigarette smokers (OR = 2.12, 95 % CI: 1.45, 3.09) were more likely to have any CVD outcome in unadjusted analyses. When adjusted for covariates, only exclusive current/former established cigarette use was associated with CVD outcomes (AOR = 1.60, CI: 1.07, 2.40). Results suggest that exclusive established use of cigars or duration of exclusive cigar use was not associated with lifetime CVD prevalence compared with never cigar or cigarette smokers, which is important in understanding health outcomes in cigar users.
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Affiliation(s)
| | | | | | - Marushka L. Silveira
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
- Kelly Government Solutions, Rockville, MD, USA
| | - Cristine D. Delnevo
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, Rutgers University, New Brunswick, NJ, USA
| | | | - Daniela Marshall
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
- Axle Informatics, Rockville, MD, USA
| | - Diann E. Gaalema
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Izabella Zandberg
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Bria Graham-Glover
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Derick L. Rivers
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Omoye E. Imoisili
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Kirstie Neal
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Raymond Niaura
- Department of Social and Behavioral Sciences, NYU College of Global Public Health, New York University, NY, USA
| | - Maansi Bansal-Travers
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Andrew Hyland
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - K. Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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Strong DR, Pierce JP, White M, Stone MD, Abrams DB, Glasser AM, Wackowski OA, Cummings KM, Hyland A, Taylor K, Edwards KC, Silveira ML, Kimmel HL, Compton WM, Hull LC, Niaura R. Changes in Tobacco Dependence and Association With Onset and Progression of Use by Product Type From Waves 1 to 3 of the Population Assessment of Tobacco and Health (PATH) Study. Nicotine Tob Res 2023; 25:1781-1790. [PMID: 37410879 PMCID: PMC10475603 DOI: 10.1093/ntr/ntad107] [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: 11/17/2022] [Revised: 06/25/2023] [Accepted: 06/28/2023] [Indexed: 07/08/2023]
Abstract
INTRODUCTION This study examined trajectories of tobacco dependence (TD) in relationship to changes in tobacco product use, and explored the effects of product-specific adding, switching, or discontinued use on dependence over time. AIMS AND METHODS Data were analyzed from the first three waves from the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative, longitudinal study of adults and youth in the United States. Data included 9556 wave 1 (2013-2014) adult current established tobacco users aged 18 or older who completed all three interviews and had established use at ≥2 assessments. Mutually exclusive groups included: users of cigarettes only, e-cigarettes only, cigars only, hookah only, any smokeless only, cigarette + e-cigarette dual users, and other multiple product users. A validated 16-item scale assessed TD across product users. RESULTS People who used e-cigarettes exclusively at wave 1 had small increases in TD through wave 3. Wave 1 multiple product users' TD decreased across waves. TD for all other wave 1 user groups remained about the same. For wave 1 cigarette only smokers, switching to another product was associated with lower levels of TD than smokers whose use stayed the same. Movement to no established use of any tobacco product was consistently associated with lower TD for all product users. CONCLUSIONS Except for wave 1 e-cigarette only users (who experienced small increases in TD), TD among U.S. tobacco product users was stable over time, with daily users less likely to vary from baseline. IMPLICATIONS The level of TD among most U.S. tobacco users was stable over the first three waves of the PATH Study and trends in levels of TD were predominantly unrelated to changes in patterns of continued product use. Stable levels of TD suggest a population at persistent risk of health impacts from tobacco. Wave 1 e-cigarette users experienced small increases in levels of TD over time, perhaps due to increases in quantity or frequency of their e-cigarette use or increasing efficiency of nicotine delivery over time.
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Affiliation(s)
- David R Strong
- Cancer Prevention and Control Program, Moores Cancer Center University of California, San Diego, CA, USA
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - John P Pierce
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - Martha White
- Cancer Prevention and Control Program, Moores Cancer Center University of California, San Diego, CA, USA
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - Matthew D Stone
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - David B Abrams
- School of Global Public Health, New York University, New York, NY, USA
| | - Allison M Glasser
- School of Global Public Health, New York University, New York, NY, USA
| | - Olivia A Wackowski
- Center for Tobacco Studies, Rutgers School of Public Health, New Brunswick, NJ, USA
| | - K Michael Cummings
- Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Andrew Hyland
- Department of Health Behavior, Division of Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, Buffalo, NY, USA
| | | | | | - Marushka L Silveira
- Kelly Government Solutions, Rockville, MD, USA
- National Institute of Dental and Craniofacial Research (NIDCR/NIH), Bethesda, MD, USA
| | | | | | - Lynn C Hull
- Center for Tobacco Products, FDA, Silver Spring, MD, USA
| | - Raymond Niaura
- School of Global Public Health, New York University, New York, NY, USA
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Strong DR, Glasser AM, Leas EC, Pierce JP, Abrams DB, Hrywna M, Hyland A, Cummings KM, Hatsukami DK, Fong GT, Elton-Marshall T, Sharma E, Edwards KC, Stanton CA, Sawdey MD, Ramôa CP, Silveira ML, Kimmel HL, Niaura RS. Indicators of Tobacco Dependence Among Youth: Findings From Wave 1 (2013-2014) of the Population Assessment of Tobacco and Health Study. Nicotine Tob Res 2023; 25:1565-1574. [PMID: 37156636 PMCID: PMC10439486 DOI: 10.1093/ntr/ntad072] [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: 06/21/2022] [Revised: 05/01/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Prior work established a measure of tobacco dependence (TD) among adults that can be used to compare TD across different tobacco products. We extend this approach to develop a common, cross-product metric for TD among youth. METHODS One thousand one hundred and forty-eight youth aged 12-17 who used a tobacco product in the past 30 days were identified from 13 651 youth respondents in Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study. FINDINGS Analyses confirmed a single primary latent construct underlying responses to TD indicators for all mutually exclusive tobacco product user groups. Differential Item Functioning analyses supported the use of 8 of 10 TD indicators for comparisons across groups. With TD levels anchored at 0.0 (standard deviation [SD] = 1.0) among cigarette only (n = 265) use group, mean TD scores were more than a full SD lower for e-cigarette only (n = 150) use group (mean = -1.09; SD = 0.64). Other single product use group (cigar, hookah, pipe, or smokeless; n = 262) on average had lower TD (mean = -0.60; SD = 0.84), and the group with the use of multiple tobacco products (n = 471) experienced similar levels of TD (mean = 0.14; SD = 0.78) as the cigarette only use group. Concurrent validity was established with product use frequency among all user groups. A subset of five TD items comprised a common metric permitting comparisons between youth and adults. CONCLUSION The PATH Study Youth Wave 1 Interview provided psychometrically valid measures of TD that enable future regulatory investigations of TD across tobacco products and comparisons between youth and adult tobacco product use group. IMPLICATIONS A measure of tobacco dependence (TD) has been established previously among adults to compare TD across tobacco products. This study established the validity of a similar, cross-product measure of TD among youth. Findings suggest a single latent TD construct underlying this measure, concurrent validity of the scale with product use frequency across different types of tobacco users, and a subset of common items that can be used to compare TD between youth and adults who use tobacco.
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Affiliation(s)
- David R Strong
- Cancer Prevention and Control Program, Moores Cancer Center University of California, San Diego, CA, USA
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - Allison M Glasser
- School of Global Public Health, New York University, New York, NY, USA
| | - Eric C Leas
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - John P Pierce
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - David B Abrams
- School of Global Public Health, New York University, New York, NY, USA
| | - Mary Hrywna
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, New Brunswick, NJ, USA
| | | | | | - Dorothy K Hatsukami
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Geoffrey T Fong
- School of Public Health Sciences, University of Waterloo, Waterloo, ON,Canada
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Tara Elton-Marshall
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | | | | | | | - Michael D Sawdey
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Carolina P Ramôa
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Marushka L Silveira
- Kelly Government Solutions, Rockville, MD, USA
- National Institute of Dental and Craniofacial Research (NIDCR/NIH), Bethesda, MD, USA
| | | | - Raymond S Niaura
- School of Global Public Health, New York University, New York, NY, USA
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5
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Ashley DL, Zhu W, Wang L, Sosnoff C, Feng J, Del Valle-Pinero AY, Cheng YC, Chang CM, van Bemmel D, Borek N, Kimmel HL, Silveira ML, Blount BC. Variability in Urinary Nicotine Exposure Biomarker Levels Between Waves 1 (2013-2014) and 2 (2014-2015) in the Population Assessment of Tobacco and Health Study. Nicotine Tob Res 2023; 25:616-623. [PMID: 35348750 PMCID: PMC10032194 DOI: 10.1093/ntr/ntac056] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 02/17/2022] [Accepted: 02/24/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION To date, no studies have evaluated the consistency of biomarker levels in people who smoke over a long-time period in real-world conditions with a large number of subjects and included use behavior and measures of nicotine metabolism. We evaluated the variability of biomarkers of nicotine exposure over approximately a 1-year period in people who exclusively smoke cigarettes, including intensity and recency of use and brand switching to assess impact on understanding associations with product characteristics. AIMS AND METHODS Multivariate regression analysis of longitudinal repeated measures of urinary biomarkers of nicotine exposure from 916 adults in the Population Assessment of Tobacco and Health (PATH) Study with demographic characteristics and use behavior variables. Intraclass correlation coefficients (ICCs) were calculated to examine individual variation of nicotine biomarkers and the uncertainty of repeat measures at two time points (Waves 1 and 2). RESULTS Age, race, and urinary creatinine were significant covariates of urinary cotinine. When including use behavior, recency, and intensity of use were highly significant and variance decreased to a higher extent between than within subjects. The ICC for urinary cotinine decreased from 0.7530 with no use behavior variables in the model to 0.5763 when included. Similar results were found for total nicotine equivalents. CONCLUSIONS Urinary nicotine biomarkers in the PATH Study showed good consistency between Waves 1 and 2. Use behavior measures such as time since last smoked a cigarette and number of cigarettes smoked in the past 30 days are important to include when assessing factors that may influence biomarker concentrations. IMPLICATIONS The results of this study show that the consistency of the nicotine biomarkers cotinine and total nicotine equivalents in spot urine samples from Waves 1 to 2 of the PATH Study is high enough that these data are useful to evaluate the association of cigarette characteristics with biomarkers of exposure under real-world use conditions.
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Affiliation(s)
- David L Ashley
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Wanzhe Zhu
- Division of Laboratory Sciences, National Center for Environmental Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lanqing Wang
- Division of Laboratory Sciences, National Center for Environmental Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Connie Sosnoff
- Division of Laboratory Sciences, National Center for Environmental Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jun Feng
- Division of Laboratory Sciences, National Center for Environmental Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Arseima Y Del Valle-Pinero
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Yu-Ching Cheng
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Cindy M Chang
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Dana van Bemmel
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Nicolette Borek
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Heather L Kimmel
- Division of Epidemiology, Services and Prevention Research, National Institute for Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Marushka L Silveira
- Division of Epidemiology, Services and Prevention Research, National Institute for Drug Abuse, National Institutes of Health, Bethesda, MD, USA
- Kelly Government Solutions, Rockville, MD, USA
| | - Benjamin C Blount
- Division of Laboratory Sciences, National Center for Environmental Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
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6
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Han B, Aung TW, Volkow ND, Silveira ML, Kimmel HL, Blanco C, Compton WM. Tobacco Use, Nicotine Dependence, and Cessation Methods in US Adults With Psychosis. JAMA Netw Open 2023; 6:e234995. [PMID: 36976558 PMCID: PMC10051107 DOI: 10.1001/jamanetworkopen.2023.4995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
Importance Adults with psychotic disorders have high premature mortality, partly due to the high prevalence of smoking in this population. Yet recent data are lacking on tobacco product use among US adults with a history of psychosis. Objective To examine the sociodemographic characteristics and behavioral health status; types of tobacco products used; prevalence of use by age, sex, and race and ethnicity; and nicotine dependence severity and smoking cessation methods among community-dwelling adults with vs without psychosis. Design, Setting, and Participants This cross-sectional study analyzed nationally representative, self-reported, cross-sectional data of adults (aged ≥18 years) who participated in the Wave 5 survey (conducted from December 2018 to November 2019) of the Population Assessment of Tobacco and Health (PATH) Study. Data analyses were conducted between September 2021 and October 2022. Exposure PATH Study respondents were classified as having lifetime psychosis if they answered yes to whether they had ever received from a clinician (eg, physician, therapist, or other mental health professional) a diagnosis of schizophrenia, schizoaffective disorder, psychosis, or psychotic illness or episode. Main Outcomes and Measures Use of any and major types of tobacco products, severity of nicotine dependence, and cessation methods. Results Among the 29 045 community-dwelling adults who participated in the PATH Study (weighted median [IQR] age, 30.0 [22.0-50.0] years; weighted percentage estimates: 14 976 females (51.5%); 16.0% Hispanic, 11.1% non-Hispanic Black, 65.0% non-Hispanic White, and 8.0% non-Hispanic other race and ethnicity [American Indian or Alaska Native, Asian, Native Hawaiian or other Pacific Islander, and more than 1 race]), 2.9% (95% CI, 2.62%-3.10%) reported receiving a lifetime psychosis diagnosis. Compared with those without psychosis, people with psychosis had a higher adjusted prevalence of past-month any tobacco use (41.3% vs 27.7%; adjusted risk ratio [RR], 1.49 [95% CI, 1.36-1.63]) as well as cigarette smoking, e-cigarette use, and other tobacco product use overall and in most examined subgroups; they also had a higher past-month prevalence of dual cigarette and e-cigarette use (13.5% vs 10.1%; P = .02), polycombustible tobacco use (12.1% vs 8.6%; P = .007), and polycombustible and noncombustible tobacco use (22.1% vs 12.4%; P < .001). Among adults with past-month cigarette use, those with vs without psychosis had a higher adjusted mean nicotine dependence scores overall (54.6 vs 49.5; P < .001) and within the 45-years-or-older (61.7 vs 54.9; P = .002), female (56.9 vs 49.8; P = .001), Hispanic (53.7 vs 40.0; P = .01), and Black (53.4 vs 46.0; P = .005) groups. They were also more likely to make a quit attempt (60.0% vs 54.1%; adjusted RR, 1.11 [95% CI, 1.01-1.21]) and use counseling, a quitline, or a support group for tobacco cessation (5.6% vs 2.5%; adjusted RR, 2.25 [95% CI, 1.21-3.30]). Conclusions and Relevance In this study, the high prevalence of tobacco use, polytobacco use, and making a quit attempt as well as the severity of nicotine dependence among community-dwelling adults with a history of psychosis highlighted the urgency for tailored tobacco cessation interventions for this population. Such strategies must be evidence-based and age, sex, and race and ethnicity appropriate.
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Affiliation(s)
- Beth Han
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Ther W Aung
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
- Kelly Government Solutions, Rockville, Maryland
| | - Nora D Volkow
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Marushka L Silveira
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland
- Kelly Government Solutions, Rockville, Maryland
| | - Heather L Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Carlos Blanco
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Wilson M Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
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7
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Stanton CA, Tang Z, Sharma E, Seaman E, Gardner LD, Silveira ML, Hatsukami D, Day HR, Cummings KM, Goniewicz ML, Limpert J, Everard C, Bansal-Travers M, Ambrose B, Kimmel HL, Borek N, Compton WM, Hyland AJ, Pearson JL. Predictors of E-cigarette and Cigarette Use Trajectory Classes from Early Adolescence to Emerging Adulthood Across Four Years (2013-2017) of the PATH Study. Nicotine Tob Res 2023; 25:421-429. [PMID: 35554569 PMCID: PMC9910140 DOI: 10.1093/ntr/ntac119] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 02/10/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION This study examines predictors of trajectories of cigarette and e-cigarette use among a cohort of US adolescents transitioning into young adulthood. Comparing trajectories of each tobacco product is important to determine if different intervention targets are needed to prevent progression to daily use. METHODS Latent trajectory class analyses identified cigarette and e-cigarette use (never, ever excluding past 12-month, past 12-month (excluding past 30-day (P30D)), P30D 1-5 days, P30D 6+ days) trajectory classes, separately, among US youth (12-17; N = 10,086) using the first 4 waves (2013-2017) of data from the nationally representative PATH Study. Weighted descriptive analyses described the class characteristics. Weighted multinomial logistic regression analyses examined demographic, psychosocial, and behavioral predictors of class membership. RESULTS Younger adolescents 12-15 years had lower tobacco use compared to 16-17 year olds and less stable classes. In the 16-17 year group, there were five unique trajectories of cigarette smoking, including a Persistent High Frequency class. Four e-cigarette use trajectories were identified; but not a persistent use class. Shared predictors of class membership for cigarettes and e-cigarettes included mental health problems, other tobacco use, marijuana use, and poorer academic achievement. Male sex and household tobacco use were unique e-cigarette trajectory class predictors. CONCLUSIONS There was no evidence that initiation with e-cigarettes as the first product tried was associated with cigarette progression (nor cigarettes as first product and e-cigarette progression). Interventions should focus on well-established risk factors such as mental health and other substance use to prevent progression of use for both tobacco products. IMPLICATIONS Using nationally representative data and definitions of use that take into account frequency and recency of use, longitudinal 4-year trajectories of e-cigarette and cigarette use among US adolescents transitioning into young adulthood were identified. Results among 16-17-year olds revealed a class of persistent high frequency cigarette smoking that was not identified for e-cigarette use. Cigarette use progression was not associated with e-cigarettes as the first product tried. Risk factors for progression of use of both products included mental health and other substance use, which are important prevention targets for both tobacco products.
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Affiliation(s)
- Cassandra A Stanton
- Behavioral Health and Health Policy Practice, Westat Inc, Rockville, MD, USA
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA
| | - Zhiqun Tang
- Behavioral Health and Health Policy Practice, Westat Inc, Rockville, MD, USA
| | - Eva Sharma
- Behavioral Health and Health Policy Practice, Westat Inc, Rockville, MD, USA
| | - Elizabeth Seaman
- Behavioral Health and Health Policy Practice, Westat Inc, Rockville, MD, USA
| | - Lisa D Gardner
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Marushka L Silveira
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
- Kelly Government Solutions, Rockville, MD, USA
| | - Dorothy Hatsukami
- Masonic Cancer Center, Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Hannah R Day
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - K Michael Cummings
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Maciej L Goniewicz
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Jean Limpert
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Colm Everard
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
- Kelly Government Solutions, Rockville, MD, USA
| | - Maansi Bansal-Travers
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Bridget Ambrose
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Heather L Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Nicolette Borek
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Wilson M Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Andrew J Hyland
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Jennifer L Pearson
- School of Community Health Sciences, University of Nevada, Reno, Reno, NV, USA
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Strong DR, Pierce JP, White M, Stone MD, Abrams DB, Glasser AM, Wackowski OA, Cummings KM, Hyland A, Taylor K, Edwards KC, Silveira ML, Kimmel HL, Lambert EY, Compton WM, Hull LC, Niaura R. RETRACTED: Changes in Tobacco Dependence and Association With Onset and Progression of Use by Product Type From Wave 1 to Wave 3 of the Population Assessment of Tobacco and Health (PATH) Study. Nicotine Tob Res 2023; 25:571-579. [PMID: 35801819 DOI: 10.1093/ntr/ntac167] [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] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 06/13/2022] [Accepted: 07/06/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION This study examined trajectories of tobacco dependence (TD) in relation to changes in tobacco product use and explored the effects of product-specific adding, switching, or discontinued use on dependence over time. AIMS AND METHODS Data were analyzed from the first three waves of the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative, longitudinal study of adults and youth in the United States. Data included 9556 Wave 1 (2013/2014) adult current established tobacco users who completed all three interviews and had established use at ≥2 assessments. Groups included cigarettes-only users, e-cigarettes-only users, cigars-only users, hookah-only users, any smokeless-only users, cigarette + e-cigarette dual users, and multiple product users. A validated 16-item scale assessed TD across product users. RESULTS Wave 1 e-cigarette-only users' who maintained exclusive e-cigarette use increased levels of TD through Wave 3 as did those who added or switched to another product. Wave 1 multiple product users' TD decreased across waves. TD for all other Wave 1 user groups remained about the same. For Wave 1 cigarette-only smokers, switching to another product or moving to a pattern of no established use was associated with lower levels of TD than smokers whose use stayed the same. Movement to no established use of any tobacco product was consistently associated with lower TD for all other product users. CONCLUSIONS Except for Wave 1 e-cigarette-only users, TD among US tobacco product users was stable over time, with daily users less likely to vary from baseline. IMPLICATIONS The level of TD among most US tobacco users was stable over the first three waves of the PATH Study and trends in levels of TD were predominantly unrelated to changes in patterns of continued product use. Stable levels of TD suggest a population at persistent risk of health impacts from tobacco. Wave 1 e-cigarette users, including those maintaining exclusive e-cigarette use, experienced increasing levels of TD over time, perhaps because of increases in quantity or frequency of their e-cigarette product use or increasing efficiency of nicotine delivery over time.
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Affiliation(s)
- David R Strong
- Cancer Prevention and Control Program, Moores Cancer Center University of California, San Diego, CA, USA.,Herbert Wertheim School of Public Health, University of California, San Diego, CA, USA
| | - John P Pierce
- Herbert Wertheim School of Public Health, University of California, San Diego, CA, USA
| | - Martha White
- Cancer Prevention and Control Program, Moores Cancer Center University of California, San Diego, CA, USA.,Herbert Wertheim School of Public Health, University of California, San Diego, CA, USA
| | - Matthew D Stone
- Herbert Wertheim School of Public Health, University of California, San Diego, CA, USA
| | - David B Abrams
- School of Global Public Health, New York University, New York, NY, USA
| | - Allison M Glasser
- School of Global Public Health, New York University, New York, NY, USA
| | - Olivia A Wackowski
- Center for Tobacco Studies, Rutgers School of Public Health, New Brunswick, NJ, USA
| | | | | | | | | | - Marushka L Silveira
- National Institute on Drug Abuse (NIDA/NIH), Bethesda, MD, USA.,Kelly Government Solutions, Rockville, MD, USA
| | | | | | | | - Lynn C Hull
- Center for Tobacco Products, FDA, Silver Spring, MD, USA
| | - Raymond Niaura
- School of Global Public Health, New York University, New York, NY, USA
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Compton WM, Flannagan KSJ, Silveira ML, Creamer MR, Kimmel HL, Kanel M, Blanco C, Volkow ND. Tobacco, Alcohol, Cannabis, and Other Drug Use in the US Before and During the Early Phase of the COVID-19 Pandemic. JAMA Netw Open 2023; 6:e2254566. [PMID: 36719678 PMCID: PMC9890285 DOI: 10.1001/jamanetworkopen.2022.54566] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
IMPORTANCE Information about national substance use trends among youths and adults after mid-March 2020 is limited due to constraints on surveillance during the COVID-19 pandemic. OBJECTIVE To evaluate whether substance use prevalence in the early part of the pandemic (2020) differed from the prepandemic periods of 2018 to 2019 and 2016 to 2018. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study was a repeated analysis of 2016 to 2020 data from a nationally representative sample of youths and adults in the Population Assessment of Tobacco and Health (PATH) Study. Participants were representative of the US civilian noninstitutionalized population. Household residents age 13 years or older were interviewed in person from 2016 to 2019 and via telephone in 2020. EXPOSURES Age, calendar year. MAIN OUTCOMES AND MEASURES Past 30-day self-reported use of any tobacco, any alcohol, binge drinking, cannabis, and any other illegal or misused prescription drugs. RESULTS The overall nationally representative 2020 sample included 7129 youths (ages 13-17 years), 3628 young adults (ages 18-20 years), and 8874 adults (ages ≥21 years). Comparing 2018 to 2019 with 2020 among youths, prevalence of all substances used declined (eg, cannabis use declined in those aged 16-17 years from 14.9% to 7.6%; absolute difference, -7.3 percentage points [95% CI -8.8 to -5.8 percentage points]). Among young adults, prevalence of all substances other than any alcohol decreased significantly (eg, tobacco use declined from 37.8% to 22.8%; absolute difference, -15.1 percentage points [95% CI -16.8 to -13.3 percentage points]). In adults ages 21 to 24 years, any tobacco use declined from 39.0% to 30.9% (absolute difference, -8.2 percentage points [95% CI, -10.6 to -5.7 percentage points]), and alcohol use increased from 60.2% to 65.2% (absolute difference, 5.0 percentage points [95% CI, 2.3 to 7.7 percentage points]). Among adults aged 25 years or older, any tobacco use declined from 39.0% to 30.9% (absolute difference, -8.2 percentage points [95% CI, -10.6 to -5.7 percentage points]), cannabis use increased from 11.3% to 12.4% (absolute difference, 1.2 percentage points [95% CI, 0.3 to 2.0 percentage points]), and other substance use declined from 5.8% to 3.7% (absolute difference, -2.1 percentage points [95% CI, -2.9 to -1.4 percentage points]). CONCLUSIONS AND RELEVANCE In this cross-sectional study, substance use decreased between 2019 and 2020 among those aged 13 to 20 years; consistent declines were not seen in older persons other than tobacco use reductions, and cannabis use increased among adults ages 25 years and older. While social changes during the COVID-19 pandemic could have affected substance use, findings should be interpreted with caution due to differences in data collection methods in 2016 to 2019 and 2020.
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Affiliation(s)
- Wilson M. Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Kerry S. J. Flannagan
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
- Kelly Government Solutions, Rockville, Maryland
| | - Marushka L. Silveira
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
- Kelly Government Solutions, Rockville, Maryland
| | - MeLisa R. Creamer
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Heather L. Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Moana Kanel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
- Kelly Government Solutions, Rockville, Maryland
| | - Carlos Blanco
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Nora D. Volkow
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
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10
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Silveira ML, Everard CD, Sharma E, Lauten K, Alexandridis AA, Duffy K, Taylor EV, Tolliver EA, Blanco C, Compton WM, Kimmel HL, Iafolla T, Hyland A, Chaffee BW. Tobacco Use and Incidence of Adverse Oral Health Outcomes Among US Adults in the Population Assessment of Tobacco and Health Study. JAMA Netw Open 2022; 5:e2245909. [PMID: 36484986 PMCID: PMC9856400 DOI: 10.1001/jamanetworkopen.2022.45909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 10/24/2022] [Indexed: 12/13/2022] Open
Abstract
Importance Evolving tobacco use patterns, including increasing electronic nicotine delivery systems (ENDS) use, warrant re-examination of the associations between tobacco use and oral health. Objective To examine associations between tobacco product use and incidence of adverse oral health outcomes. Design, Setting, and Participants This cohort study used nationally representative data from wave (W) 1 to W5 (2013-2019) of the Population Assessment of Tobacco and Health Study. Recruitment used a stratified address-based, area-probability household sample of the noninstitutionalized US civilian population. The W1 cohort included respondents aged 18 years and older without lifetime history of oral health outcomes at W1 or W3, depending on when the outcome was first assessed. Data analysis was performed from October 2021 to September 2022. Exposures Current (every day or someday use) established (lifetime use of at least 100 cigarettes or "fairly regular" use of other products) use of cigarettes, ENDS, cigars, pipes, hookah, snus, and smokeless tobacco, excluding snus at W1 to W4. Main Outcomes and Measures The primary outcomes were past 12-month self-reported diagnosis of gum disease and precancerous oral lesions (W2-W5) and bone loss around teeth, bleeding after brushing or flossing, loose teeth, and 1 or more teeth removed (W4-W5). Results Sample sizes varied across the 6 oral health outcomes (13 149 respondents for the gum disease sample, 14 993 respondents for the precancerous oral lesions sample, 16 312 respondents for the bone loss around teeth sample, 10 286 respondents for the bleeding after brushing or flossing sample, 15 686 respondents for the loose teeth sample, and 12 061 respondents for the 1 or more teeth removed sample). Slightly more than half of adults (52%-54% across the 6 samples) were women, and the majority were of non-Hispanic White race and ethnicity. Cox proportional hazards models were developed with covariates that included time-dependent tobacco use variables mutually adjusted for each other. Cigarette smoking was positively associated with incidence of gum disease diagnosis (adjusted hazard ratio [AHR], 1.33; 95% CI, 1.11-1.60), loose teeth (AHR, 1.35; 95% CI, 1.05-1.75), and 1 or more teeth removed (AHR, 1.43; 95% CI, 1.18-1.74). Cigar smoking was positively associated with incidence of precancerous oral lesions (AHR, 2.18; 95% CI, 1.38-3.43). In addition, hookah smoking was positively associated with incidence of gum disease diagnosis (AHR, 1.78; 95% CI, 1.20-2.63), and ENDS use was positively associated with incidence of bleeding after brushing or flossing (AHR, 1.27; 95% CI, 1.04-1.54). No associations were observed between snus and smokeless tobacco excluding snus and incidence of oral health outcomes. Conclusions and Relevance The observed associations of combustible tobacco use with incidence of several adverse oral health outcomes and ENDS use with incidence of bleeding after brushing or flossing highlight the importance of longitudinal studies and emphasize the continued importance of tobacco cessation counseling and resources in clinical practice.
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Affiliation(s)
- Marushka L. Silveira
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland
- Kelly Government Solutions, Rockville, Maryland
| | - Colm D. Everard
- Kelly Government Solutions, Rockville, Maryland
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | | | | | | | - Kara Duffy
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland
| | - Ethel V. Taylor
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland
| | - Eric A. Tolliver
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland
| | - Carlos Blanco
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Wilson M. Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Heather L. Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Timothy Iafolla
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Benjamin W. Chaffee
- Division of Oral Epidemiology and Dental Public Health, University of California, San Francisco
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11
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Cooper M, Day HR, Ren C, Oniyide O, Corey CG, Ambrose BK, Michael Cummings K, Sargent J, Niaura R, Pierce JP, Kaufman A, Choi K, Goniewicz ML, Stanton CA, Villanti A, Kasza K, Bansal-Travers M, Silveira ML, Kimmel HL, Hull LC, Koblitz A, Poonai K, Paredes A, Taylor K, Borek N, Hyland AJ. Correlates of tobacco product initiation among youth and young adults between waves 1-4 of the population assessment of tobacco and Health (PATH) study (2013-2018). Addict Behav 2022; 134:107396. [PMID: 35749867 PMCID: PMC9726988 DOI: 10.1016/j.addbeh.2022.107396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 05/13/2022] [Accepted: 06/05/2022] [Indexed: 11/20/2022]
Abstract
INTRODUCTION While risk factors for cigarette smoking among youth and young adults are well-documented, less is known about the correlates of initiation of other tobacco products. This study aims to provide estimates and correlates of initiation among U.S. youth and young adults. METHODS Data on youth aged 12-17 (n = 10,072) and young adults aged 18-24 (N = 5,727) who provided information on cigarettes, electronic nicotine delivery systems (ENDS), cigars, pipe, hookah and smokeless tobacco use in Wave 1 (W1: 2013-2014)-Wave 4 (W4: 2016-2018) of the nationally-representative PATH Study were used to calculate ever use initiation and correlates of initiation by W4. RESULTS Nearly 6 million youth and 2.5 million young adults used tobacco for the first time between W1-W4. Approximately one quarter of youth and young adult ENDS never users initiated ENDS between W1-W4 of the PATH Study. Among youth, use of other tobacco products, ever substance use, and high externalizing problems were associated with initiation of most products. Among young adults, use of other tobacco products and ever substance use were associated with initiation of most products. In both youth and young adults, Hispanics were more likely to initiate hookah use than their non-Hispanic White counterparts. While male sex was a risk factor for most tobacco product initiation across both age groups, it was not associated with hookah initiation. CONCLUSIONS Cigarette and non-cigarette products shared many correlates of initiation, although there are noteworthy demographic differences. Findings can help tailor product specific interventions to reach populations at risk during preliminary stages of use.
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Affiliation(s)
- Maria Cooper
- US Food and Drug Administration, Center for Tobacco Products, United States.
| | - Hannah R Day
- US Food and Drug Administration, Center for Tobacco Products, United States
| | - Chunfeng Ren
- US Food and Drug Administration, Center for Tobacco Products, United States
| | - Olusola Oniyide
- US Food and Drug Administration, Center for Tobacco Products, United States
| | - Catherine G Corey
- US Food and Drug Administration, Center for Tobacco Products, United States
| | - Bridget K Ambrose
- US Food and Drug Administration, Center for Tobacco Products, United States
| | - K Michael Cummings
- Medical University of South Carolina, Department of Psychiatry & Behavioral Sciences, United States
| | - James Sargent
- Dartmouth Medical School, Data Sciences Norris Cotton Cancer Center Dartmouth-Hitchcock Medical Center, United States
| | - Ray Niaura
- New York University, College of Global Public Health, United States
| | - John P Pierce
- University of California, San Diego, Herbert Wertheim School of Public Health, United States
| | - Annette Kaufman
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, United States
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, United States
| | | | | | | | - Karin Kasza
- Roswell Park Comprehensive Cancer Center, United States
| | | | - Marushka L Silveira
- Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse, National Institutes of Health, United States; Kelly Government Solutions, United States
| | - Heather L Kimmel
- Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse, National Institutes of Health, United States
| | - Lynn C Hull
- US Food and Drug Administration, Center for Tobacco Products, United States
| | - Amber Koblitz
- US Food and Drug Administration, Center for Tobacco Products, United States
| | - Karl Poonai
- US Food and Drug Administration, Center for Tobacco Products, United States
| | - Antonio Paredes
- US Food and Drug Administration, Center for Tobacco Products, United States
| | - Kristie Taylor
- Westat, Behavioral Health and Health Policy, United States
| | - Nicolette Borek
- US Food and Drug Administration, Center for Tobacco Products, United States
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12
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Spiegal S, Vendramini JMB, Bittman S, Silveira ML, Gifford C, Rotz CA, Ragosta JP, Kleinman PJA. Recycling nutrients in the beef supply chain through circular manuresheds: Data to assess tradeoffs. J Environ Qual 2022; 51:494-509. [PMID: 35567799 DOI: 10.1002/jeq2.20365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 04/13/2022] [Indexed: 06/15/2023]
Abstract
Nutrient circularity can help supply chain participants meet sustainability targets. Across the segmented beef supply chain, opportunity exists to reinforce and introduce nutrient circularity by recycling surplus manure nutrients from cattle feedlots to lands where cattle feed is produced. We describe four datasets developed to evaluate options in U.S. and Canadian beef systems. The datasets delineate three "circular manuresheds," each encompassing a hay-grazing landscape where beef cattle are raised on grazingland and supplemented with hay grown nearby, and the distant feedlots where those cattle produce manure nutrients for potential import back to the hayfields. We selected the hay-grazing landscapes of New Mexico, USA; Florida, USA; and western Canada (Manitoba, Saskatchewan, Alberta, British Columbia) because of their significant grazingland production and potential to substitute feedlot manure for commercial fertilizer on hayfields. In each circular manureshed, the manure nutrients from major feedlot destinations could supply a considerable proportion of the P used by hay for grazing cattle: 34% of the P requirements in New Mexico, 36% in Florida, and 6% in western Canada. The average distance to return the resource was 647 km for New Mexico, 1,884 km for Florida, and 1,587 km for western Canada. These magnitudes and distances suggest that the New Mexico circular manureshed may be the most economically viable in the current agri-food system, but this reflects only part of a greater, multi-factor assessment of tradeoffs. The circular manureshed concept provides a platform for simultaneous consideration of competing factors for sustainability via circularity.
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Affiliation(s)
- S Spiegal
- USDA-ARS, Jornada Experimental Range, Las Cruces, NM, 88003, USA
| | - J M B Vendramini
- Univ. of Florida, Range Cattle Research Experiment Station, Ona, FL, 33865, USA
| | - S Bittman
- Agriculture and Agri-Food Canada, Agassiz Research and Development Centre, Agassiz, BC, V0M 1A2, Canada
| | - M L Silveira
- Univ. of Florida, Range Cattle Research Experiment Station, Ona, FL, 33865, USA
| | - C Gifford
- New Mexico State Univ. Extension Animal Sciences and Natural Resources, Las Cruces, NM, 88003, USA
| | - C A Rotz
- USDA-ARS, Pasture Systems and Watershed Management Research Unit, University Park, PA, 16802, USA
| | - J P Ragosta
- New Mexico State Univ. Jornada Experimental Range, Las Cruces, NM, 88003, USA
| | - P J A Kleinman
- USDA-ARS, Soil Management and Sugar Beet Research Unit, Fort Collins, CO, 80526, USA
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13
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Bansal-Travers M, Rivard C, Silveira ML, Kimmel H, Poonai K, Bernat JK, Jackson K, Rudy S, Johnson A, Cullen KA, Goniewicz M, Travers M, Hyland A, Villanti A, Hrywna M, Abrams D, Fong G, Elton-Marshall T, Stanton C, Sharma E. Factors associated with changes in flavored tobacco products used: Findings from wave 2 and wave 3 (2014-2016) of the population assessment of tobacco and health (PATH) study. Addict Behav 2022; 130:107290. [PMID: 35220150 PMCID: PMC9316535 DOI: 10.1016/j.addbeh.2022.107290] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 12/07/2021] [Accepted: 02/18/2022] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Flavored non-cigarette tobacco product use is widespread in the U.S. The availability of flavor options could be playing a role in recent increases in use, especially for non-cigarette tobacco products, among youth and young adults. Little is known about specific flavor preferences of youth and adult flavored tobacco product users, as well as how preferences may change over time. METHODS This study analyzes PATH Study data from completed Wave 2 (2014-2015) and Wave 3 (2015-2016) youth (12-17 years), and adult (18 + years) interviews to estimate the prevalence of flavored non-cigarette tobacco product use. We assess flavor switching by examining changes between flavors and characteristics of those who changed flavors between waves. RESULTS Across age groups, and at both waves, fruit-flavored products were the most frequently used flavor by past 30-day electronic nicotine delivery systems (ENDS), cigar, cigarillo, and hookah users. In the past 30 days, a higher proportion of youth and young adults used candy/sweets-flavored ENDS than adults. Among adult ENDS users, the odds of changing flavors were highest among younger users and decreased with increasing age. CONCLUSIONS Flavored tobacco product use is prevalent across non-cigarette tobacco products. Stability in the number of flavors used, as well as specific flavors, is higher among adult tobacco users, while the use of multiple flavors, and change in specific flavor, is more prevalent among youth tobacco users. Additional longitudinal research can further examine the role flavors play in appeal, product trial, and switching.
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Affiliation(s)
- Maansi Bansal-Travers
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
| | - Cheryl Rivard
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Marushka L Silveira
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA; Kelly Government Solutions, Rockville, MD, USA
| | - Heather Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Karl Poonai
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Jennifer K Bernat
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Kia Jackson
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Susan Rudy
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Amanda Johnson
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Karen A Cullen
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Maciej Goniewicz
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Mark Travers
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Andrew Hyland
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Andrea Villanti
- University of Vermont, College of Arts and Sciences, Department of Psychological Science, Burlington, VT, USA
| | - Mary Hrywna
- Rutgers School of Public Health, Department of Health Behavior, Society and Policy, Newark, NJ, USA
| | - David Abrams
- New York University, College of Global Public Health, New York, NY, USA
| | - Geoffrey Fong
- University of Waterloo, Department of Psychology, Waterloo, ON, Canada
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14
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Mahoney MC, Rivard C, Kimmel HL, Hammad HT, Sharma E, Halenar MJ, Sargent J, Cummings KM, Niaura R, Goniewicz ML, Bansal-Travers M, Hatsukami D, Gaalema D, Fong G, Gravely S, Christensen CH, Haskins R, Silveira ML, Blanco C, Compton W, Stanton CA, Hyland A. Cardiovascular Outcomes among Combustible-Tobacco and Electronic Nicotine Delivery System (ENDS) Users in Waves 1 through 5 of the Population Assessment of Tobacco and Health (PATH) Study, 2013-2019. Int J Environ Res Public Health 2022; 19:4137. [PMID: 35409819 PMCID: PMC8998731 DOI: 10.3390/ijerph19074137] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 03/30/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Prior studies have not clearly established risk of cardiovascular disease (CVD) among smokers who switch to exclusive use of electronic nicotine delivery systems (ENDS). We compared cardiovascular disease incidence in combustible-tobacco users, those who transitioned to ENDS use, and those who quit tobacco with never tobacco users. METHODS This prospective cohort study analyzes five waves of Population Assessment of Tobacco and Health (PATH) Study data, Wave 1 (2013-2014) through Wave 5 (2018-2019). Cardiovascular disease (CVD) incidence was captured over three intervals (Waves 1 to 3, Waves 2 to 4, and Waves 3 to 5). Participants were adults (40+ years old) without a history of CVD for the first two waves of any interval. Change in tobacco use status, from exclusive past 30 day use of any combustible-tobacco product to either exclusive past 30 day ENDS use, dual past 30 day use of ENDS and combustible-tobacco, or no past 30 day use of any tobacco, between the first two waves of an interval was used to predict onset of CVD between the second and third waves in the interval. CVD incidence was defined as a new self-report of being told by a health professional that they had congestive heart failure, stroke, or a myocardial infarction. Generalized estimating equation (GEE) analyses combined 10,548 observations across intervals from 7820 eligible respondents. RESULTS Overall, there were 191 observations of CVD among 10,548 total observations (1.7%, standard error (SE) = 0.2), with 40 among 3014 never users of tobacco (1.5%, SE = 0.3). In multivariable models, CVD incidence was not significantly different for any tobacco user groups compared to never users. There were 126 observations of CVD among 6263 continuing exclusive combustible-tobacco users (adjusted odds ratio [AOR] = 1.44; 95% confidence interval (CI) 0.87-2.39), 15 observations of CVD among 565 who transitioned to dual use (AOR = 1.85; 0.78-4.37), and 10 observations of CVD among 654 who quit using tobacco (AOR = 1.18; 0.33-4.26). There were no observations of CVD among 53 who transitioned to exclusive ENDS use. CONCLUSIONS This study found no difference in CVD incidence by tobacco status over three 3 year intervals, even for tobacco quitters. It is possible that additional waves of PATH Study data, combined with information from other large longitudinal cohorts with careful tracking of ENDS use patterns may help to further clarify this relationship.
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Affiliation(s)
- Martin C. Mahoney
- Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (M.C.M.); (M.L.G.); (M.B.-T.); (A.H.)
| | - Cheryl Rivard
- Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (M.C.M.); (M.L.G.); (M.B.-T.); (A.H.)
| | - Heather L. Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MS 20892, USA; (H.L.K.); (M.L.S.); (C.B.); (W.C.)
| | - Hoda T. Hammad
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA; (H.T.H.); (C.H.C.); (R.H.)
| | - Eva Sharma
- Westat, Rockville, MD 20850, USA; (E.S.); (M.J.H.); (C.A.S.)
| | | | - Jim Sargent
- The C. Everette Koop Institute at Dartmouth, Geisel School of Medicine at Dartmouth, Lebanon, NH 03756, USA;
| | | | - Ray Niaura
- NYU School of Global Public Health, New York, NY 10003, USA;
| | - Maciej L. Goniewicz
- Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (M.C.M.); (M.L.G.); (M.B.-T.); (A.H.)
| | - Maansi Bansal-Travers
- Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (M.C.M.); (M.L.G.); (M.B.-T.); (A.H.)
| | | | | | - Geoffrey Fong
- University of Waterloo, Waterloo, ON N2L 3G1, Canada; (G.F.); (S.G.)
| | - Shannon Gravely
- University of Waterloo, Waterloo, ON N2L 3G1, Canada; (G.F.); (S.G.)
| | - Carol H. Christensen
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA; (H.T.H.); (C.H.C.); (R.H.)
| | - Ryan Haskins
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA; (H.T.H.); (C.H.C.); (R.H.)
| | - Marushka L. Silveira
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MS 20892, USA; (H.L.K.); (M.L.S.); (C.B.); (W.C.)
- Kelly Government Solutions, Troy, MI 48084, USA
| | - Carlos Blanco
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MS 20892, USA; (H.L.K.); (M.L.S.); (C.B.); (W.C.)
| | - Wilson Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MS 20892, USA; (H.L.K.); (M.L.S.); (C.B.); (W.C.)
| | | | - Andrew Hyland
- Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (M.C.M.); (M.L.G.); (M.B.-T.); (A.H.)
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15
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Strong DR, Leas E, Noble M, White M, Glasser A, Taylor K, Edwards KC, Frissell KC, Compton WM, Conway KP, Lambert E, Kimmel HL, Silveira ML, Hull LC, van Bemmel D, Schroeder MJ, Cummings KM, Hyland A, Feng J, Blount B, Wang L, Niaura R. Validation of the Wave 1 and Wave 2 Population Assessment of Tobacco and Health (PATH) Study Indicators of Tobacco Dependence Using Biomarkers of Nicotine Exposure Across Tobacco Products. Nicotine Tob Res 2022; 24:10-19. [PMID: 34383052 PMCID: PMC8666120 DOI: 10.1093/ntr/ntab162] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 03/09/2021] [Accepted: 08/11/2021] [Indexed: 11/13/2022]
Abstract
INTRODUCTION This study examined the predictive relationships between biomarkers of nicotine exposure and 16-item self-reported level of tobacco dependence (TD) and subsequent tobacco use outcomes. AIMS AND METHODS The Population Assessment of Tobacco and Health (PATH) Study surveyed adult current established tobacco users who provided urine biospecimens at Wave 1 (September 2013-December 2014) and completed the Wave 2 (October 2014-October 2015) interview (n = 6872). Mutually exclusive user groups at Wave 1 included: Cigarette Only, E-cigarette Only, Cigar Only, Hookah Only, Smokeless Tobacco Only, Cigarette Plus E-cigarette, multiple tobacco product users who smoked cigarettes, and multiple tobacco product users who did not smoke cigarettes. Total Nicotine Equivalents (TNE-2) and TD were measured at Wave 1. Approximate one-year outcomes included frequency/quantity used, quitting, and adding/switching to different tobacco products. RESULTS For Cigarette Only smokers and multiple tobacco product users who smoked cigarettes, higher TD and TNE-2 were associated with: a tendency to smoke more, smoking more frequently over time, decreased likelihood of switching away from cigarettes, and decreased probability of quitting after one year. For other product user groups, Wave 1 TD and/or TNE-2 were less consistently related to changes in quantity and frequency of product use, or for adding or switching products, but higher TNE-2 was more consistently predictive of decreased probability of quitting. CONCLUSIONS Self-reported TD and nicotine exposure assess common and independent aspects of dependence in relation to tobacco use behaviors for cigarette smokers. For other product user groups, nicotine exposure is a more consistent predictor of quitting than self-reported TD. IMPLICATIONS This study suggests that smoking cigarettes leads to the most coherent pattern of associations consistent with a syndrome of TD. Because cigarettes continue to be prevalent and harmful, efforts to decrease their use may be accelerated via conventional means (eg, smoking cessation interventions and treatments), but also perhaps by decreasing their dependence potential. The implications for noncombustible tobacco products are less clear as the stability of tobacco use patterns that include products such as e-cigarettes continue to evolve. TD, nicotine exposure measures, and consumption could be used in studies that attempt to understand and predict product-specific tobacco use behavioral outcomes.
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Affiliation(s)
- David R Strong
- Cancer Prevention & Control Program, Moores Cancer Center University of California, San Diego, CA, USA
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - Eric Leas
- Cancer Prevention & Control Program, Moores Cancer Center University of California, San Diego, CA, USA
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - Madison Noble
- Cancer Prevention & Control Program, Moores Cancer Center University of California, San Diego, CA, USA
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - Martha White
- Cancer Prevention & Control Program, Moores Cancer Center University of California, San Diego, CA, USA
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - Allison Glasser
- Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York, NY, USA
| | | | | | | | | | - Kevin P Conway
- National Institute on Drug Abuse (NIDA/NIH), Bethesda, MD, USA
| | | | | | - Marushka L Silveira
- National Institute on Drug Abuse (NIDA/NIH), Bethesda, MD, USA
- Kelly Government Solutions, Rockville, MD, USA
| | - Lynn C Hull
- Center for Tobacco Products, FDA, Silver Spring, MD, USA
| | | | | | | | | | - June Feng
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Benjamin Blount
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lanqing Wang
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ray Niaura
- Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York, NY, USA
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16
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Kasza KA, Edwards KC, Kimmel HL, Anesetti-Rothermel A, Cummings KM, Niaura RS, Sharma A, Ellis EM, Jackson R, Blanco C, Silveira ML, Hatsukami DK, Hyland A. Association of e-Cigarette Use With Discontinuation of Cigarette Smoking Among Adult Smokers Who Were Initially Never Planning to Quit. JAMA Netw Open 2021; 4:e2140880. [PMID: 34962556 PMCID: PMC8715340 DOI: 10.1001/jamanetworkopen.2021.40880] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Cigarette smokers not planning to quit are often overlooked in population studies evaluating the risk-benefit potential of electronic nicotine delivery products (e-cigarettes). OBJECTIVE To evaluate whether e-cigarette use is associated with discontinuing cigarette smoking among smokers who were initially never planning to quit. DESIGN, SETTING, AND PARTICIPANTS This cohort study used US nationally representative data from the longitudinal Population Assessment of Tobacco and Health Study (waves 2-5 conducted between October 2014 and November 2019), with participants evaluated in 3 pairs of interviews. Adult daily cigarette smokers initially not using e-cigarettes and with no plans to ever quit smoking for good (2489 observations from 1600 individuals) were included. EXPOSURES e-Cigarette use (ie, daily use, nondaily use, or no use) at follow-up interview among smokers not using e-cigarettes at baseline interview. MAIN OUTCOMES AND MEASURES The main outcomes were discontinuation of cigarette smoking (ie, no cigarette smoking) and discontinuation of daily cigarette smoking (ie, no daily cigarette smoking) at follow-up interview. Generalized estimating equations were used to evaluate the association between the exposure and each outcome, controlling for demographic characteristics and cigarettes smoked per day at baseline interview; all estimates were weighted. RESULTS The weighted population of adult daily cigarette smokers who were not using e-cigarettes and had no plans to ever quit smoking, based on data from 1600 participants, was 56.1% male (95% CI, 53.4%-58.7%), 10.1% Hispanic (95% CI, 8.2%-12.3%), 10.1% non-Hispanic Black (95% CI, 8.7%-11.7%), 75.6% non-Hispanic White (95% CI, 72.9%-78.2%), and 4.2% of other non-Hispanic race (95% CI, 3.3%-5.4%); 29.3% were aged 55 to 69 years (95% CI, 26.2%-32.6%), 8.9% were aged 70 years or older (95% CI, 6.8%-11.5%), 36.8% did not graduate from high school (95% CI, 34.1%-39.6%), 55.2% had an annual household income of less than $25 000 (95% CI, 52.3%-58.1%), 37.6% smoked 20 to 29 cigarettes per day (95% CI, 34.7%-40.6%), and 12.7% smoked 30 or more cigarettes per day (95% CI, 10.9%-14.7%). Overall, 6.2% of the population (95% CI, 5.0%-7.5%) discontinued cigarette smoking. Discontinuation rates were higher among those who used e-cigarettes daily (28.0%; 95% CI, 15.2%-45.9%) compared with not at all (5.8%; 95% CI, 4.7%-7.2%; adjusted odds ratio [aOR], 8.11; 95% CI, 3.14-20.97). Furthermore, 10.7% (95% CI, 9.1%-12.5%) discontinued daily cigarette smoking, with higher rates of discontinuation observed among those who used e-cigarettes daily (45.5%; 95% CI, 27.4%-64.9%) compared with not at all (9.9%; 95% CI, 8.2%-11.8%; aOR, 9.67; 95% CI, 4.02-23.25). Nondaily e-cigarette use was not associated with cigarette discontinuation (aOR, 0.53; 95% CI, 0.08-3.35) or daily cigarette discontinuation (aOR, 0.96; 95% CI, 0.44-2.09). CONCLUSIONS AND RELEVANCE In this cohort study, daily e-cigarette use was associated with greater odds of cigarette discontinuation among smokers who initially had no plans to ever quit smoking. These findings support the consideration of smokers who are not planning to quit when evaluating the risk-benefit potential of e-cigarettes for smoking cessation in the population.
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Affiliation(s)
- Karin A. Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | | | - Heather L. Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | | | | | | | - Akshika Sharma
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Erin M. Ellis
- Center for Tobacco Products Food and Drug Administration, Silver Spring, Maryland
| | - Rebecca Jackson
- Center for Tobacco Products Food and Drug Administration, Silver Spring, Maryland
| | - Carlos Blanco
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Marushka L. Silveira
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
- Kelly Government Solutions, Rockville, Maryland
| | | | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
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Kasza KA, Goniewicz ML, Edwards KC, Sawdey MD, Silveira ML, Gravely S, Zandberg I, Gardner LD, Fong GT, Hyland A. E-Cigarette Flavors and Frequency of E-Cigarette Use among Adult Dual Users Who Attempt to Quit Cigarette Smoking in the United States: Longitudinal Findings from the PATH Study 2015/16-2016/17. Int J Environ Res Public Health 2021; 18:4373. [PMID: 33924109 PMCID: PMC8074329 DOI: 10.3390/ijerph18084373] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/14/2021] [Accepted: 04/17/2021] [Indexed: 01/18/2023]
Abstract
Potential mechanisms by which e-cigarette use may relate to combustible cigarette smoking cessation are not well-understood. We used U.S. nationally representative data to prospectively evaluate the relationship between e-cigarette flavor use and frequency of e-cigarette use among adult cigarette/e-cigarette dual users who attempted to quit smoking cigarettes. Analyses used Population Assessment of Tobacco and Health (PATH) Study data from adult dual users (2015/16) who attempted to quit smoking between 2015/16 and 2016/17 (Wave 3-Wave 4, n = 685, including those who did/did not quit by 2016/17). E-cigarette flavor use (usual/last flavor, past 30-day flavor; assessed in 2015/16) was categorized into Only tobacco; Only menthol/mint; Only non-tobacco, non-menthol/mint; and Any combination of tobacco, menthol/mint, other flavor(s). The key outcome, evaluated at follow-up in 2016/17, was frequent e-cigarette use, which was defined as use on 20+ of past 30 days. Logistic regression was used to evaluate associations between e-cigarette flavor use in 2015/16 and frequent e-cigarette use at follow-up in 2016/17. Dual users who attempted to quit smoking had greater odds of frequent e-cigarette use at follow-up when they used only non-tobacco, non-menthol/mint flavor than when they used only tobacco flavor as their regular/last e-cigarette flavor (OR = 1.9, 95% CI: 1.1-3.4); findings were no longer significant when adjusted for factors including e-cigarette device type (AOR = 1.4, 95% CI: 0.7-2.8). Past 30-day e-cigarette flavor use results were generally similar, although frequent e-cigarette use at follow-up was highest among those who used any combination of tobacco, menthol/mint, or other flavors. Findings indicate that e-cigarette flavor use among dual users who attempt to quit smoking may be related to e-cigarette use frequency overall, which may indicate a mechanism underlying findings for e-cigarette use and smoking cessation. Further longitudinal research may help to disentangle how e-cigarette characteristics uniquely impact e-cigarette use frequency and smoking cessation/sustained use.
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Affiliation(s)
- Karin A. Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (M.L.G.); (A.H.)
| | - Maciej L. Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (M.L.G.); (A.H.)
| | - Kathryn C. Edwards
- Behavioral Health & Health Policy Practice, Westat Inc., Rockville, MD 20850, USA;
| | - Michael D. Sawdey
- Office of Science, Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD 20993, USA; (M.D.S.); (I.Z.); (L.D.G.)
| | - Marushka L. Silveira
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20852, USA;
- Kelly Government Solutions, Rockville, MD 20850, USA
| | - Shannon Gravely
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (S.G.); (G.T.F.)
| | - Izabella Zandberg
- Office of Science, Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD 20993, USA; (M.D.S.); (I.Z.); (L.D.G.)
| | - Lisa D. Gardner
- Office of Science, Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD 20993, USA; (M.D.S.); (I.Z.); (L.D.G.)
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (S.G.); (G.T.F.)
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada
- Ontario Institute for Cancer Research, Toronto, ON M5G 0A3, Canada
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (M.L.G.); (A.H.)
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18
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Alexander JP, Liu ST, Cullen KA, Xiao H, Hammad HT, Silveira ML, Toblin RL. School Use and Normative Perceptions of Electronic Nicotine Product Use Among Middle and High School Students-November 2018. J Adolesc Health 2021; 68:612-614. [PMID: 32753342 PMCID: PMC7855636 DOI: 10.1016/j.jadohealth.2020.06.035] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/13/2020] [Accepted: 06/18/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE This study examined U.S. middle and high school student observations of electronic nicotine product (ENP) use in and around the school building and students' normative perceptions of use among peers. METHODS Adolescents and young adult participants enrolled in middle (n = 672) or high school (n = 962) were recruited from an online nationally representative panel and surveyed from November 2 to 15, 2018. They answered questions on observed ENP use in and around the school building as well as perceptions of use among peers. RESULTS Nearly one in five U.S. middle and high school students believed that at least half of their peers used ENPs. Confirming anecdotal reports, nearly six in 10 reported ever seeing someone use ENPs in or around their school, most often outside the school building and in bathrooms or locker rooms. CONCLUSIONS The findings of this study underscore the importance of targeted prevention strategies and education efforts to prevent and combat adolescent ENP use in and around schools.
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Affiliation(s)
- Jennifer P. Alexander
- Center for Tobacco Products, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, Maryland, 20903 USA
| | - Sherry T. Liu
- Center for Tobacco Products, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, Maryland, 20903 USA
| | - Karen A. Cullen
- Center for Tobacco Products, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, Maryland, 20903 USA
| | - Haijun Xiao
- Center for Tobacco Products, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, Maryland, 20903 USA
| | - Hoda T. Hammad
- Center for Tobacco Products, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, Maryland, 20903 USA
| | - Marushka L. Silveira
- National Institute on Drug Abuse, National Institutes of Health, 6001 Executive Blvd # 5153, Rockville, Maryland, 20852 USA,Kelly Government Solutions, 6101 Executive Blvd., Suite 392, Rockville, Maryland, 20852 USA
| | - Robin L. Toblin
- Center for Tobacco Products, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, Maryland, 20903 USA
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Pearson JL, Sharma E, Rui N, Halenar MJ, Johnson AL, Cummings KM, Hammad HT, Kaufman AR, Tworek C, Goniewicz ML, Kimmel HL, Tanski S, Compton WM, Day H, Ambrose BK, Bansal-Travers M, Silveira ML, Abrams D, Limpert J, Travers MJ, Borek N, Hyland AJ, Stanton CA. Association of Electronic Nicotine Delivery System Use With Cigarette Smoking Progression or Reduction Among Young Adults. JAMA Netw Open 2020; 3:e2015893. [PMID: 33231634 PMCID: PMC7686868 DOI: 10.1001/jamanetworkopen.2020.15893] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 06/12/2020] [Indexed: 12/27/2022] Open
Abstract
Importance The prevalence of electronic nicotine delivery systems (ENDS) use, including e-cigarettes, among US young adults (YAs) has raised questions about how these products may affect future tobacco and nicotine use among YAs. Given this prevalence and that young adulthood is a critical period for the establishment of tobacco and nicotine use, it is important to consider the association between ENDS use and cigarette smoking specifically in this age group. Objective To examine whether ENDS use frequency or intensity is associated with changes in cigarette smoking among US YA ever smokers during 1 year. Design, Setting, and Participants This cohort study used 3 waves of data (2013-2014, 2014-2015, and 2015-2016) from the Population Assessment of Tobacco and Health (PATH) Study, an ongoing longitudinal cohort study of adults and youth. Unweighted 1:6 propensity score matching was used to match participants on wave 1 risk factors for ENDS use at wave 2. The changes in smoking between wave 2 and wave 3 were assessed using the matched sample. In total, 1096 ENDS-naive, ever cigarette-smoking YAs (18-24 years of age) at wave 1 who participated in wave 2 and wave 3 and who had complete data in the PATH Study were included in the analyses, which were conducted from August 2018 to October 2019. Exposures Never ENDS use (n = 987), any previous 30-day ENDS use (n = 109), 1 to 5 days of ENDS use in the previous 30 days (n = 75), and 6 or more days ENDS use in the previous 30 days at wave 2 (n = 34). Main Outcomes and Measures The analytic sample was selected using multiple variables based on peer-reviewed literature supporting associations with ENDS use. The main outcomes-changes in cigarette smoking behavior between wave 2 and wave 3-were defined using 2 measures: (1) change in smoking frequency, defined as the number of smoking days in the previous 30 days at wave 3 vs wave 2, and (2) change in smoking intensity, defined as the number smoking days in the previous 30 days multiplied by the mean number of cigarettes consumed on smoking days at wave 3 vs wave 2. Results The present cohort analyses included 1096 YA ever smokers who were ENDS naive at wave 1. The majority of the sample were women (609 [55.6%]) and White individuals (698 [63.7%]), and the mean (SD) age was 21.4 (1.9) years. In wave 1, 161 YAs (14.7%) were daily smokers in the previous 30 days. After propensity score matching, no statistically significant associations were observed between any definition of wave 2 ENDS use and changes in either the frequency or intensity of smoking at wave 3. Conclusions and Relevance In this cohort study of US YA ever smokers, ENDS use was not associated with either decreased or increased cigarette smoking during a 1-year period. However, it is possible that the rapidly evolving marketplace of vaping products may lead to different trajectories of YA cigarette and ENDS use in the future.
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Affiliation(s)
- Jennifer L. Pearson
- Division of Social and Behavioral Science/Health Administration and Policy, School of Community Health Sciences, University of Nevada, Reno
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | | | | | - Amanda L. Johnson
- Office of Science, Center for Tobacco Products Food and Drug Administration, Silver Spring, Maryland
| | - K. Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston
| | - Hoda T. Hammad
- Office of Science, Center for Tobacco Products Food and Drug Administration, Silver Spring, Maryland
| | - Annette R. Kaufman
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Cindy Tworek
- Office of Science, Center for Tobacco Products Food and Drug Administration, Silver Spring, Maryland
| | - Maciej L. Goniewicz
- Division of Cancer Prevention and Population Sciences, Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Heather L. Kimmel
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Susanne Tanski
- Norris Cotton Cancer Center and Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Wilson M. Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Hannah Day
- Office of Science, Center for Tobacco Products Food and Drug Administration, Silver Spring, Maryland
| | - Bridget K. Ambrose
- Office of Science, Center for Tobacco Products Food and Drug Administration, Silver Spring, Maryland
| | - Maansi Bansal-Travers
- Division of Cancer Prevention and Population Sciences, Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Marushka L. Silveira
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
- Kelly Government Solutions, Rockville, Maryland
| | - David Abrams
- Department of Social and Behavioral Sciences, NYU College of Global Public Health, New York University, New York
| | - Jeannie Limpert
- Office of Science, Center for Tobacco Products Food and Drug Administration, Silver Spring, Maryland
| | - Mark J. Travers
- Division of Cancer Prevention and Population Sciences, Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Nicolette Borek
- Office of Science, Center for Tobacco Products Food and Drug Administration, Silver Spring, Maryland
| | - Andrew J. Hyland
- Division of Cancer Prevention and Population Sciences, Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Cassandra A. Stanton
- Westat, Rockville, Maryland
- Department of Oncology, Georgetown University Medical Center, Washington, DC
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20
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Pierce JP, Benmarhnia T, Chen R, White M, Abrams DB, Ambrose BK, Blanco C, Borek N, Choi K, Coleman B, Compton WM, Cummings KM, Delnevo CD, Elton-Marshall T, Goniewicz ML, Gravely S, Fong GT, Hatsukami D, Henrie J, Kasza KA, Kealey S, Kimmel HL, Limpert J, Niaura RS, Ramôa C, Sharma E, Silveira ML, Stanton CA, Steinberg MB, Taylor E, Bansal-Travers M, Trinidad DR, Gardner LD, Hyland A, Soneji S, Messer K. Role of e-cigarettes and pharmacotherapy during attempts to quit cigarette smoking: The PATH Study 2013-16. PLoS One 2020; 15:e0237938. [PMID: 32877429 PMCID: PMC7467279 DOI: 10.1371/journal.pone.0237938] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [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: 04/04/2020] [Accepted: 08/05/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND More smokers report using e-cigarettes to help them quit than FDA-approved pharmacotherapy. OBJECTIVE To assess the association of e-cigarettes with future abstinence from cigarette and tobacco use. DESIGN Cohort study of US sample, with annual follow-up. PARTICIPANTS US adult (ages 18+) daily cigarette smokers identified at Wave 1 (W1; 2013-14) of the PATH Study, who reported a quit attempt before W2 and completed W3 (n = 2443). EXPOSURES Use of e-cigarettes, pharmacotherapy (including nicotine replacement therapy), or no product for last quit attempt (LQA), and current daily e-cigarette use at W2. ANALYSIS Propensity score matching (PSM) of groups using different methods to quit. OUTCOME MEASURES 12+ months abstinence at W3 from cigarettes and from all tobacco (including e-cigarettes). 30+ days abstinence at W3 was a secondary outcome. RESULTS Among daily smokers with an LQA, 23.5% used e-cigarettes, 19.3% used pharmacotherapy only (including NRT) and 57.2% used no product. Cigarette abstinence for 12+ months at W3 was ~10% in each group. Half of the cigarette abstainers in the e-cigarette group were using e-cigarettes at W3. Different methods to help quitting had statistically comparable 12+ month cigarette abstinence at W3 (e-cigarettes vs no product: Risk Difference (RD) = 0.01, 95% CI: -0.04 to 0.06; e-cigarettes vs pharmacotherapy: RD = 0.02, 95% CI:-0.04 to 0.09). Likewise, daily e-cigarette users at W2 did not show a cessation benefit over comparable no-e-cigarette users and this finding was robust to sensitivity analyses. Abstinence for 30+ days at W3 was also similar across products. LIMITATIONS The frequency of e-cigarette use during the LQA was not assessed, nor was it possible to assess continuous abstinence from the LQA. CONCLUSION Among US daily smokers who quit cigarettes in 2014-15, use of e-cigarettes in that attempt compared to approved cessation aids or no products showed similar abstinence rates 1-2 years later.
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Affiliation(s)
- John P. Pierce
- Moores Cancer Center, University of California San Diego, San Diego, California, United States of America
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, California, United States of America
| | - Tarik Benmarhnia
- Moores Cancer Center, University of California San Diego, San Diego, California, United States of America
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, California, United States of America
| | - Ruifeng Chen
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, California, United States of America
| | - Martha White
- Moores Cancer Center, University of California San Diego, San Diego, California, United States of America
| | - David B. Abrams
- Department of Social and Behavioral Sciences, NYU College of Global Public Health, New York University, New York, New York, United States of America
| | - Bridget K. Ambrose
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland, United States of America
| | - Carlos Blanco
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Nicolette Borek
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland, United States of America
| | - Kelvin Choi
- National Institute for Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Blair Coleman
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland, United States of America
| | - Wilson M. Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, United States of America
| | - K. Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, United States of America
| | - Cristine D. Delnevo
- Rutgers Center for Tobacco Studies, New Brunswick, New Jersey, United States of America
| | - Tara Elton-Marshall
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, London, Ontario, Canada
| | - Maciej L. Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, United States of America
| | - Shannon Gravely
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Geoffrey T. Fong
- Department of Psychology and School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- Ontario Institute for Cancer Research, MaRS Centre, Toronto, Ontario, Canada
| | - Dorothy Hatsukami
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - James Henrie
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland, United States of America
| | - Karin A. Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, United States of America
| | - Sheila Kealey
- Moores Cancer Center, University of California San Diego, San Diego, California, United States of America
| | - Heather L. Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Jean Limpert
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland, United States of America
| | - Raymond S. Niaura
- Department of Social and Behavioral Sciences, NYU College of Global Public Health, New York University, New York, New York, United States of America
| | - Carolina Ramôa
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland, United States of America
| | - Eva Sharma
- Westat, Rockville, Maryland, United States of America
| | - Marushka L. Silveira
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, United States of America
- Kelly Government Solutions, Rockville, Maryland, United States of America
| | | | - Michael B. Steinberg
- Rutgers Center for Tobacco Studies, New Brunswick, New Jersey, United States of America
| | - Ethel Taylor
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland, United States of America
| | - Maansi Bansal-Travers
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, United States of America
| | - Dennis R. Trinidad
- Moores Cancer Center, University of California San Diego, San Diego, California, United States of America
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, California, United States of America
| | - Lisa D. Gardner
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland, United States of America
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, United States of America
- Westat, Rockville, Maryland, United States of America
| | - Samir Soneji
- Department of Health Behavior, Gillings School of Global Public Health, Chapel Hill, North Carolina, United States of America
| | - Karen Messer
- Moores Cancer Center, University of California San Diego, San Diego, California, United States of America
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, California, United States of America
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21
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Strong DR, Leas E, Noble M, White M, Frissell KC, Glasser A, Katz L, Taylor K, Compton WM, Conway KP, Lambert E, Kimmel HL, Silveira ML, Green V, Hull LC, Cummings KM, Hyland A, Niaura R. Predictive validity of the adult tobacco dependence index: Findings from waves 1 and 2 of the Population Assessment of Tobacco and Health (PATH) study. Drug Alcohol Depend 2020; 214:108134. [PMID: 32629146 PMCID: PMC7446939 DOI: 10.1016/j.drugalcdep.2020.108134] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/19/2020] [Accepted: 06/09/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND AND AIMS Building on published work1 establishing concurrent validity of a self-report tobacco dependence (TD) index among users of different tobacco products in Wave 1 (W1) of the Population Assessment of Tobacco and Health (PATH) Study, the current study examines prospective relationships with tobacco use behaviors to establish predictive validity of the TD index. Hypotheses suggested high levels of W1 TD would be associated with persistent tobacco use at Wave 2 (W2). PARTICIPANTS A U.S. nationally representative sample of 32,320 adult W1 and W2 interviews focused on 11,615 W1 adults who were current established tobacco users and completed the W2 interview. FINDINGS Higher TD scores and greater changes in TD scores were associated with greater quantity and frequency of tobacco use at the W2 interview for Cigarette Only (n = 7068), Smokeless (smokeless or snus pouches) Only (n = 772), Cigarette plus E-Cigarette (n = 592), and Multiple Products (n = 1866) users, although not significantly so for E-Cigarette Only (n = 367), Cigar Only (traditional, cigarillo, or filtered) (n = 584), or Hookah Only (n = 366) users. Higher TD was associated with decreased odds of successful quitting for Cigarette and Multiple Product users. Higher TD was associated with increased odds of a quit attempt for those in the Hookah and Multiple Products user groups and was not associated with quit attempts or deceased odds of quit success among exclusive E-Cigarette, Cigar, Smokeless and Cigarette plus E-Cigarette users. CONCLUSION Support for the predictive validity of the PATH Study measures of adult TD will enable regulatory investigations of TD across several tobacco products.
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Affiliation(s)
- David R Strong
- Cancer Prevention & Control Program, Moores Cancer Center University of California, San Diego, United States; Department of Family Medicine and Public Health, University of California, San Diego, United States.
| | - Eric Leas
- Cancer Prevention & Control Program, Moores Cancer Center University of California, San Diego, United States; Department of Family Medicine and Public Health, University of California, San Diego, United States
| | - Madison Noble
- Cancer Prevention & Control Program, Moores Cancer Center University of California, San Diego, United States; Department of Family Medicine and Public Health, University of California, San Diego, United States
| | - Martha White
- Cancer Prevention & Control Program, Moores Cancer Center University of California, San Diego, United States; Department of Family Medicine and Public Health, University of California, San Diego, United States
| | | | - Allison Glasser
- College of Global Public Health, New York University, United States
| | - Lauren Katz
- College of Global Public Health, New York University, United States
| | | | - Wilson M Compton
- National Institute on Drug Abuse (NIDA/NIH), Bethesda, MD, United States(1)
| | - Kevin P Conway
- National Institute on Drug Abuse (NIDA/NIH), Bethesda, MD, United States(1)
| | - Elizabeth Lambert
- National Institute on Drug Abuse (NIDA/NIH), Bethesda, MD, United States(1)
| | - Heather L Kimmel
- National Institute on Drug Abuse (NIDA/NIH), Bethesda, MD, United States(1)
| | - Marushka L Silveira
- National Institute on Drug Abuse (NIDA/NIH), Bethesda, MD, United States(1); Kelly Government Solutions, Rockville, MD, United States
| | - Victoria Green
- National Institute on Drug Abuse (NIDA/NIH), Bethesda, MD, United States(1); Kelly Government Solutions, Rockville, MD, United States
| | - Lynn C Hull
- Center for Tobacco Products, FDA, Silver Spring, MD, United States
| | | | - Andrew Hyland
- Roswell Park Cancer Institute, Buffalo, NY, United States
| | - Ray Niaura
- College of Global Public Health, New York University, United States
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22
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Stanton CA, Bansal-Travers M, Johnson AL, Sharma E, Katz L, Ambrose BK, Silveira ML, Day H, Sargent J, Borek N, Compton WM, Johnson SE, Kimmel HL, Kaufman AR, Limpert J, Abrams D, Cummings KM, Goniewicz ML, Tanski S, Travers MJ, Hyland AJ, Pearson JL. Longitudinal e-Cigarette and Cigarette Use Among US Youth in the PATH Study (2013-2015). J Natl Cancer Inst 2020; 111:1088-1096. [PMID: 30689915 DOI: 10.1093/jnci/djz006] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 11/01/2018] [Accepted: 01/10/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Evidence is accumulating that youth who try Electronic Nicotine Delivery Systems (ENDS, e-cigarettes) may go on to try cigarettes. This analysis examines the bidirectional patterns of ENDS and cigarette use among US youth over one year and uses propensity score matching (PSM) to examine frequency of ENDS use on changes in cigarette smoking. METHODS Our analysis included 11 996 participants who had two waves of available data (Wave 1 [W1] 2013-2014; Wave 2 [W2] 2014-2015) drawn from the longitudinal Population Assessment of Tobacco and Health Study. Cross-sectional weighted prevalence estimates are reported for cigarettes and ENDS. We used PSM to estimate the likelihood of ENDS use at W1 and to draw matched analytic samples, then used regression (logistic or linear) models to examine the effect of W1 ENDS use on W2 cigarette smoking. All statistical tests were two-sided. RESULTS In weighted analyses, 69.3% of W1 past-30-day cigarette smokers exhibited past-30-day smoking at W2; 42.2% of W1 past-30-day ENDS users were using ENDS at W2. W1 ever use of either product was similarly associated with W2 new use of the other product. Unweighted PSM models indicated W1 cigarette-naïve ENDS use was associated with W2 ever-cigarette smoking (n = 676; adjusted odds ratio = 3.21, 95% confidence interval [CI] = 1.95 to 5.45, P < .001); W1 ever-ENDS use did not affect change in cigarette frequency at W2 (n = 1020, beta = 0.31, 95% CI = -0.76 to 1.39, P = .57); 1-5 days ENDS use compared with ever, no past-30-day ENDS use was associated with a statistically significant decrease of W2 smoking days (n = 256, beta = -2.64, 95% CI = -4.96 to -0.32; P = .03); and W1 6+ day ENDS users did not show a decrease in frequency of cigarette smoking. CONCLUSIONS Ever-ENDS use predicts future cigarette smoking, and frequency of ENDS use has a differential impact on subsequent cigarette smoking uptake or reduction. These results suggest that both cigarettes and ENDS should be targeted in early tobacco prevention efforts with youth.
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23
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Everard CD, Silveira ML, Kimmel HL, Marshall D, Blanco C, Compton WM. Association of Electronic Nicotine Delivery System Use With Cigarette Smoking Relapse Among Former Smokers in the United States. JAMA Netw Open 2020; 3:e204813. [PMID: 32501492 PMCID: PMC7275247 DOI: 10.1001/jamanetworkopen.2020.4813] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
IMPORTANCE Relapse to smoking among former smokers is a serious clinical concern, and use of electronic nicotine delivery systems (ENDS) has been proposed as a new risk factor for relapse. Understanding the specificity of this risk can help guide clinical practice and lead to improved health outcomes. OBJECTIVE To assess the associations of ENDS use with cigarette smoking relapse among adult former cigarette smokers. DESIGN, SETTING, AND PARTICIPANTS This cohort study examined data from the Population Assessment of Tobacco and Health Study, waves 1 to 4 (2013-2018). Cox proportional hazards models were developed. This is an ongoing, nationally representative, longitudinal cohort study in the US. Participants included adult (≥18 years) former cigarette smokers who reported no tobacco product use at wave 1 (unweighted n = 2273), separated into recent former cigarette smokers (last smoked ≤12 months previously) and long-term former smokers (last smoked >12 months previously). Data analysis was conducted from July to August 2019. EXPOSURES Self-reported use of cigarettes, ENDS, and other tobacco products (ie, cigars, pipe tobacco, hookah, snus tobacco, other smokeless tobacco, and dissolvable tobacco) was assessed. MAIN OUTCOMES AND MEASURES Self-reported current (every day or some days) use of cigarettes at follow-up interviews. RESULTS Of 2273 adult former cigarette smokers, 51.8% (95% CI, 49.7%-53.8%) were women, 65.0% (95% CI, 62.6%-67.4%) were older than 50 years, and 79.5% (95% CI, 77.8%-81.2%) were non-Hispanic white participants. Use of ENDS was associated with significant risk of cigarette smoking relapse among recent former smokers (adjusted hazard ratio [AHR], 1.63; 95% CI, 1.04-2.53; unweighted n = 304) and among long-term former smokers (AHR, 3.79; 95% CI, 1.75-8.20; unweighted n = 1554). Use of other tobacco products was also associated with significant risk for cigarette smoking relapse among recent former smokers (AHR, 1.97; 95% CI, 1.27-3.05) and among long-term former smokers (AHR, 3.82; 95% CI, 1.91-7.66). CONCLUSIONS AND RELEVANCE In this study, use of ENDS and other tobacco products was associated with increased risk of cigarette smoking relapse among former cigarette smokers who did not use any tobacco product at wave 1 of the PATH Study. For clinicians treating former smokers who have successfully quit all nicotine products, the implications are that use of ENDS products should be discouraged, just as use of all other tobacco products is discouraged.
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Affiliation(s)
- Colm D. Everard
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
- Kelly Government Solutions, Rockville, Maryland
| | - Marushka L. Silveira
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
- Kelly Government Solutions, Rockville, Maryland
| | - Heather L. Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Daniela Marshall
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
- Kelly Government Solutions, Rockville, Maryland
| | - Carlos Blanco
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Wilson M. Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
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24
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Silveira ML, Dye BA, Iafolla TJ, Adesanya MR, Boroumand S, Youngblood ME, Salazar CR, Finlayson TL, Khambaty T, Beaver SM, Isabel Garcia A. Cultural factors and oral health-related quality of life among dentate adults: Hispanic community health study/study of Latinos. Ethn Health 2020; 25:420-435. [PMID: 29343079 PMCID: PMC6148392 DOI: 10.1080/13557858.2018.1427219] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 12/15/2017] [Indexed: 06/07/2023]
Abstract
Objective: Research on the relationships between acculturation, ethnic identity, and oral health-related quality of life (OHRQOL) among the U.S. Hispanic/Latino population is sparse. The aim of this study is to examine the association between acculturation, ethnic identity, and OHRQOL among 13,172 adults in the 2008-2011 Hispanic Community Health Study/Study of Latinos (HCHS/SOL).Design: Participants self-reported their acculturation (immigrant generation, birthplace, residence in the U.S., language, and social acculturation), ethnic identity (sense of belonging and pride), and four OHRQOL measures. Key socio-demographic, behavioral, and oral health outcomes were tested as potential confounders.Results: Overall, 57% of individuals experienced poor OHRQOL in at least one of the domains examined. In multivariable analyses, some elements of higher acculturation were associated with greater food restriction and difficulty doing usual jobs/attending school, but not associated with pain or difficulty chewing, tasting, or swallowing. While sense of belonging to one's ethnic group was not associated with poor OHRQOL, low sense of pride was associated with food restriction. Socio-behavioral characteristics were significant effect modifiers.Conclusion: This study contributes to the understanding of the role of Hispanic/Latino's cultural factors in OHRQOL perception and can inform targeted strategies to improve OHRQOL in this diverse population.
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Affiliation(s)
- Marushka L. Silveira
- National Institute of Dental and Craniofacial Research,
National Institutes of Health, Building 31, Room 5B55, 31 Center Dr, Bethesda, MD
– 20892
| | - Bruce A. Dye
- National Institute of Dental and Craniofacial Research,
National Institutes of Health, Building 31, Room 5B55, 31 Center Dr, Bethesda, MD
– 20892
| | - Timothy J. Iafolla
- National Institute of Dental and Craniofacial Research,
National Institutes of Health, Building 31, Room 5B55, 31 Center Dr, Bethesda, MD
– 20892
| | - Margo R. Adesanya
- National Institute of Dental and Craniofacial Research,
National Institutes of Health, Building 31, Room 5B55, 31 Center Dr, Bethesda, MD
– 20892
| | - Shahdokht Boroumand
- National Institute of Dental and Craniofacial Research,
National Institutes of Health, Building 31, Room 5B55, 31 Center Dr, Bethesda, MD
– 20892
| | - Marston E. Youngblood
- University of North Carolina at Chapel Hill, Collaborative
Studies Coordinating Center, 123 West Franklin Street, Suite 450, Chapel Hill, NC
– 27516
| | - Christian R. Salazar
- Department of Epidemiology and Health Promotion, New York
University College of Dentistry, 433 1 Ave, 7 floor, New
York, NY 10010
| | - Tracy L. Finlayson
- San Diego State University, Graduate School of Public
Health, 5500 Campanile Drive, San Diego, CA – 92182-4162
| | - Tasneem Khambaty
- University of Maryland, Baltimore County (UMBC), Department
of Psychology, 1000 Hilltop Circle, Math/Psychology 326, Baltimore, MD 21250
| | - Shirley M Beaver
- University of Illinois at Chicago, College of Dentistry,
Department of Periodontics, 801 S. Paulina street, Chicago, IL – 60077
| | - A. Isabel Garcia
- University of Florida, College of Dentistry, Health Science
Center, Room D4-6B, 1395 Center Drive, Gainesville, FL – 32610
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25
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Risch AC, Zimmermann S, Ochoa-Hueso R, Schütz M, Frey B, Firn JL, Fay PA, Hagedorn F, Borer ET, Seabloom EW, Harpole WS, Knops JMH, McCulley RL, Broadbent AAD, Stevens CJ, Silveira ML, Adler PB, Báez S, Biederman LA, Blair JM, Brown CS, Caldeira MC, Collins SL, Daleo P, di Virgilio A, Ebeling A, Eisenhauer N, Esch E, Eskelinen A, Hagenah N, Hautier Y, Kirkman KP, MacDougall AS, Moore JL, Power SA, Prober SM, Roscher C, Sankaran M, Siebert J, Speziale KL, Tognetti PM, Virtanen R, Yahdjian L, Moser B. Soil net nitrogen mineralisation across global grasslands. Nat Commun 2019; 10:4981. [PMID: 31672992 PMCID: PMC6823350 DOI: 10.1038/s41467-019-12948-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [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: 02/20/2019] [Accepted: 10/10/2019] [Indexed: 11/17/2022] Open
Abstract
Soil nitrogen mineralisation (Nmin), the conversion of organic into inorganic N, is important for productivity and nutrient cycling. The balance between mineralisation and immobilisation (net Nmin) varies with soil properties and climate. However, because most global-scale assessments of net Nmin are laboratory-based, its regulation under field-conditions and implications for real-world soil functioning remain uncertain. Here, we explore the drivers of realised (field) and potential (laboratory) soil net Nmin across 30 grasslands worldwide. We find that realised Nmin is largely explained by temperature of the wettest quarter, microbial biomass, clay content and bulk density. Potential Nmin only weakly correlates with realised Nmin, but contributes to explain realised net Nmin when combined with soil and climatic variables. We provide novel insights of global realised soil net Nmin and show that potential soil net Nmin data available in the literature could be parameterised with soil and climate data to better predict realised Nmin.
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Affiliation(s)
- A C Risch
- Swiss Federal Institute for Forest, Snow and Landscape Research WSL, Zuercherstrasse 111, 8903, Birmensdorf, Switzerland.
| | - S Zimmermann
- Swiss Federal Institute for Forest, Snow and Landscape Research WSL, Zuercherstrasse 111, 8903, Birmensdorf, Switzerland
| | - R Ochoa-Hueso
- Department of Biology, IVAGRO, University of Cádiz, Campus de Excelencia Internacional Agroalimentario (ceiA3), Campus Rio San Pedro, 11510, Puerto Real, Cádiz, Spain
| | - M Schütz
- Swiss Federal Institute for Forest, Snow and Landscape Research WSL, Zuercherstrasse 111, 8903, Birmensdorf, Switzerland
| | - B Frey
- Swiss Federal Institute for Forest, Snow and Landscape Research WSL, Zuercherstrasse 111, 8903, Birmensdorf, Switzerland
| | - J L Firn
- Queensland University of Technology (QUT), School of Earth, Environmental and Biological Sciences, Science and Engineering Faculty, Brisbane, QLD, 4001, Australia
| | - P A Fay
- USDA-ARS Grassland Soil, and Water Research Laboratory, Temple, TX, 76502, USA
| | - F Hagedorn
- Swiss Federal Institute for Forest, Snow and Landscape Research WSL, Zuercherstrasse 111, 8903, Birmensdorf, Switzerland
| | - E T Borer
- Department of Ecology, Evolution, and Behavior, University of Minnesota, St. Paul, MN, USA
| | - E W Seabloom
- Department of Ecology, Evolution, and Behavior, University of Minnesota, St. Paul, MN, USA
| | - W S Harpole
- Department of Physiological Diversity, Helmholtz Center for Environmental Research-UFZ, Permoserstrasse 15, Leipzig, 04318, Germany
- German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Deutscher Platz 5e, Leipzig, 04103, Germany
- Institute of Biology, Martin Luther University Halle-Wittenberg, Am Kirchtor 1, Halle (Saale), 06108, Germany
| | - J M H Knops
- School of Biological Sciences, University of Nebraska, 211A Manter Hall, Lincoln, NE, 68588, USA
- Department of Health and Environmental Sciences, Xi'an Jiaotong Liverpool University, Suzhou, 215213, China
| | - R L McCulley
- Department of Plant & Soil Sciences, University of Kentucky, Lexington, KY, 40546-0312, USA
| | - A A D Broadbent
- School of Earth and Environmental Sciences, Michael Smith Building, The University of Manchester, Oxford Road, Manchester, M13 9PT, UK
- Lancaster Environment Centre, Lancaster University, Lancaster, LA1 4YQ, UK
| | - C J Stevens
- Lancaster Environment Centre, Lancaster University, Lancaster, LA1 4YQ, UK
| | - M L Silveira
- University of Florida, Range Cattle Research and Education Center, Ona, FL, 33865, USA
| | - P B Adler
- Department of Wildland Resources and the Ecology Center, Utah State University, 5230 Old Main, Logan, UT, 84103, USA
| | - S Báez
- Departamento de Biología, Escuela Politécnica Nacional del Ecuador, Ladrón de Guevera E11-253 y Andalucía, Quito, Ecuador
| | - L A Biederman
- Department of Ecology, Evolution, and Organismal Biology, Iowa State University, Ames, IA, 50011, USA
| | - J M Blair
- Division of Biology, Kansas State University, Manhattan, KS, 66502, USA
| | - C S Brown
- Department of Bioagricultural Sciences and Pest Management, Graduate Degree Program in Ecology, Colorado State University, 1177 Campus Delivery, Fort Collins, CO, USA
| | - M C Caldeira
- Centro de Estudos Florestais, Instituto Superior de Agronomia, Universidade de Lisboa, Tapada da Ajuda, 1349-017, Lisboa, Portugal
| | - S L Collins
- Department of Biology, University of New Mexico, Albuquerque, NM, 87131, USA
| | - P Daleo
- Instituto de Investigaciones Marinas y Costeras (IIMyC), Universidad Nacional de Mar del Plata, CONICET, Mar del Plata, Argentina
| | - A di Virgilio
- INIBIOMA (CONICET-UNCOMA), Universidad Nacional del Comahue, Grupo de Investigaciones en Biología de la Conservación (GrInBiC) Laboratorio Ecotono, Quintral, 1250, Bariloche, Argentina
| | - A Ebeling
- Institute of Ecology and Evolution, Friedrich-Schiller-University Jena, Dornburger Str. 159, 07743, Jena, Germany
| | - N Eisenhauer
- German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Deutscher Platz 5e, Leipzig, 04103, Germany
- Institute of Biology, Leipzig University, Deutscher Platz 5e, 04103, Leipzig, Germany
| | - E Esch
- University of California San Diego, 9500 Gilman Dr, La Jolla, CA, 92037, USA
| | - A Eskelinen
- Department of Physiological Diversity, Helmholtz Center for Environmental Research-UFZ, Permoserstrasse 15, Leipzig, 04318, Germany
- German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Deutscher Platz 5e, Leipzig, 04103, Germany
- Department of Ecology and Genetics, University of Oulu, Pentti Kaiteran katu 1, 90014, Oulu, Finland
| | - N Hagenah
- Mammal Research Institute, Department of Zoology & Entomology, University of Pretoria, Pretoria, South Africa
| | - Y Hautier
- Ecology and Biodiversity Group, Department of Biology, Utrecht University, Padualaan 8, 3584 CH, Utrecht, The Netherlands
| | - K P Kirkman
- University of KwaZulu-Natal, Pietermaritzburg, Private Bag X01, Scottsville, 3209, South Africa
| | - A S MacDougall
- Department of Integrative Biology, University of Guelph, Guelph, N1G 2W1, ON, Canada
| | - J L Moore
- School of Biological Sciences, Monash University, Claytion, VIC, 3800, Australia
| | - S A Power
- Hawkesbury Institute for the Environment, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - S M Prober
- CSIRO Land and Water, Private Bag 5, Wembley, WA, 6913, Australia
| | - C Roscher
- Department of Physiological Diversity, Helmholtz Center for Environmental Research-UFZ, Permoserstrasse 15, Leipzig, 04318, Germany
- German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Deutscher Platz 5e, Leipzig, 04103, Germany
| | - M Sankaran
- National Centre for Biological Sciences, TIFR, Bangalore, 560065, India
- School of Biology, University of Leeds, Leeds, LS2 9JT, UK
| | - J Siebert
- German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Deutscher Platz 5e, Leipzig, 04103, Germany
- Institute of Biology, Leipzig University, Deutscher Platz 5e, 04103, Leipzig, Germany
| | - K L Speziale
- INIBIOMA (CONICET-UNCOMA), Universidad Nacional del Comahue, Grupo de Investigaciones en Biología de la Conservación (GrInBiC) Laboratorio Ecotono, Quintral, 1250, Bariloche, Argentina
| | - P M Tognetti
- Universidad de Buenos Aires, Facultad de Agronomía, Instituto de Investigaciones Fisiológicas y Ecológicas vinculadas a la Agricultura (IFEVA), CONICET, Buenos Aires, Argentina
| | - R Virtanen
- Department of Physiological Diversity, Helmholtz Center for Environmental Research-UFZ, Permoserstrasse 15, Leipzig, 04318, Germany
- German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Deutscher Platz 5e, Leipzig, 04103, Germany
- Department of Ecology and Genetics, University of Oulu, Pentti Kaiteran katu 1, 90014, Oulu, Finland
| | - L Yahdjian
- Universidad de Buenos Aires, Facultad de Agronomía, Instituto de Investigaciones Fisiológicas y Ecológicas vinculadas a la Agricultura (IFEVA), CONICET, Buenos Aires, Argentina
| | - B Moser
- Swiss Federal Institute for Forest, Snow and Landscape Research WSL, Zuercherstrasse 111, 8903, Birmensdorf, Switzerland
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Villanti AC, Johnson AL, Glasser AM, Rose SW, Ambrose BK, Conway KP, Cummings KM, Stanton CA, Edwards KC, Delnevo CD, Wackowski OA, Feirman SP, Bansal-Travers M, Bernat JK, Holder-Hayes E, Green VR, Silveira ML, Hyland A. Association of Flavored Tobacco Use With Tobacco Initiation and Subsequent Use Among US Youth and Adults, 2013-2015. JAMA Netw Open 2019; 2:e1913804. [PMID: 31642927 PMCID: PMC6820032 DOI: 10.1001/jamanetworkopen.2019.13804] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
IMPORTANCE Flavors in tobacco products may appeal to young and inexperienced users. OBJECTIVE To examine among youth (aged 12-17 years), young adults (aged 18-24 years), and adults (aged ≥25 years) the prevalence of first use of flavored tobacco products among new tobacco users and the association between first flavored use of a given tobacco product and tobacco use 1 year later, including progression of tobacco use. DESIGN, SETTING, AND PARTICIPANTS This cohort study represents a longitudinal analysis of data from the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative study with data collected in 2013 to 2014 (wave 1) and 2014 to 2015 (wave 2). Participants were noninstitutionalized individuals, including 11 996 youth and 26 447 adults, in selected households who participated in both waves of the PATH Study. Data analysis was conducted from July 2016 to June 2019. MAIN OUTCOMES AND MEASURES Prevalence of tobacco product use at wave 2. RESULTS The mean (SE) age of the participants was 14.5 (0.0) years for youth, 21.1 (0.0) years for young adults, and 50.3 (0.0) for adults. Most youth (71.9%; 95% CI, 69.7%-74.0%) and young adults (57.6%; 95% CI, 54.9%-60.3%) who were new users of tobacco products over the 10- to 13-month follow-up period used flavored products. First use of a menthol or mint or other flavored cigarette documented at wave 1 was positively associated with past 12-month and past 30-day cigarette use in all age groups at wave 2 compared with first use of a nonflavored cigarette (youth, flavored cigarette, past 12-month use adjusted prevalence ratio [aPR], 1.14 [95% CI, 1.05-1.25] and past 30-day use aPR, 1.15 [95% CI, 1.00-1.31]; youth, menthol or mint cigarette, past 12-month use aPR, 1.18 [95% CI, 1.08-1.29] and past 30-day use aPR, 1.19 [95% CI, 1.04-1.37]; young adult, flavored cigarette, past 12-month use aPR, 1.09 [95% CI, 1.04-1.15] and past 30-day use aPR, 1.13 [95% CI, 1.06-1.21]; young adult menthol or mint cigarette, past 12-month use aPR, 1.10 [95% CI, 1.05-1.16] and past 30-day use aPR, 1.15 [95% CI, 1.07-1.23]; adult flavored cigarette, past 12-month use aPR, 1.10 [95% CI, 1.05-1.15] and past 30-day use aPR, 1.09 [95% CI, 1.04-1.14]; adult menthol or mint cigarette, past 12-month use aPR, 1.13 [95% CI, 1.08-1.18] and past 30-day use aPR, 1.12 [95% CI, 1.07-1.17]). Among young adults, first use of flavored e-cigarettes (aPR, 2.05; 95% CI, 1.61-2.61), any cigars (aPR, 1.60; 95% CI, 1.26-2.02), cigarillos (aPR, 1.49; 95% CI, 1.08-2.05), filtered cigars (aPR, 3.69; 95% CI, 2.08-6.57), hookah (aPR, 1.91; 95% CI, 1.23-2.98), and any smokeless tobacco (aPR, 1.54; 95% CI, 1.08-2.20) was prospectively associated with current regular use of those products at wave 2 compared with first nonflavored use. Among adults aged 25 years and older, first use of flavored e-cigarettes (aPR, 1.60; 95% CI, 1.41-1.82), any cigars (aPR, 1.56; 95% CI, 1.29-1.87), cigarillos (aPR, 1.29; 95% CI, 1.01-1.64), filtered cigars (aPR, 1.79; 95% CI, 1.25-2.54), hookah (aPR, 5.66; 95% CI, 2.04-15.71), and any smokeless tobacco (aPR, 1.55; 95% CI, 1.32-1.82) was prospectively associated with current regular use of those products at wave 2 compared with first nonflavored use. CONCLUSIONS AND RELEVANCE In this longitudinal cohort study, flavors in tobacco products were associated with youth and young adult tobacco experimentation. First use of a flavored tobacco product may place youth, young adults, and adults at risk of subsequent tobacco use.
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Affiliation(s)
- Andrea C. Villanti
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC
- Vermont Center on Behavior and Health, Department of Psychiatry, The University of Vermont, Burlington
| | - Amanda L. Johnson
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Allison M. Glasser
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC
| | - Shyanika W. Rose
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC
| | - Bridget K. Ambrose
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Kevin P. Conway
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, Maryland
| | - K. Michael Cummings
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston
| | - Cassandra A. Stanton
- Westat, Rockville, Maryland
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | | | - Cristine D. Delnevo
- Department of Health Education and Behavioral Science, Center for Tobacco Studies, Rutgers School of Public Health, Piscataway, New Jersey
| | - Olivia A. Wackowski
- Department of Health Education and Behavioral Science, Center for Tobacco Studies, Rutgers School of Public Health, Piscataway, New Jersey
| | - Shari P. Feirman
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Maansi Bansal-Travers
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Cancer Institute, Buffalo, New York
| | - Jennifer K. Bernat
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Enver Holder-Hayes
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Victoria R. Green
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, Maryland
- Kelly Government Solutions, Rockville, Maryland
| | - Marushka L. Silveira
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, Maryland
- Kelly Government Solutions, Rockville, Maryland
| | - Andrew Hyland
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Cancer Institute, Buffalo, New York
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Rose SW, Johnson AL, Glasser AM, Villanti AC, Ambrose BK, Conway K, Cummings KM, Stanton CA, Delnevo C, Wackowski OA, Edwards KC, Feirman SP, Bansal-Travers M, Bernat J, Holder-Hayes E, Green V, Silveira ML, Zhou Y, Abudayyeh H, Hyland A. Flavour types used by youth and adult tobacco users in wave 2 of the Population Assessment of Tobacco and Health (PATH) Study 2014-2015. Tob Control 2019; 29:432-446. [PMID: 31542778 DOI: 10.1136/tobaccocontrol-2018-054852] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 05/18/2019] [Accepted: 05/28/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Most youth and young adult (YA) tobacco users use flavoured products; however, little is known about specific flavours used. METHODS We report flavour types among US tobacco users from the Population Assessment of Tobacco and Health Study, wave 2, 2014-2015. At wave 2, we examined (1) flavour use and type at past 30-day use; (2) new flavoured tobacco product use and type; (3) product-specific flavour patterns across youth (ages 12-17) (n=920), YA (18-24) (n=3726) and adult (25+) (n=10 346) past 30-day and new tobacco users and (4) concordance between self-coded and expert-coded brand flavour type among all adults (18+). RESULTS Prevalence of flavoured tobacco product use was highest among youth, followed by YA and adult 25+ any tobacco users. Within each age group, flavoured use was greatest among hookah, e-cigarette and snus users. Overall, menthol/mint, fruit and candy/sweet were the most prevalent flavour types at first and past 30-day use across age groups. For past 30-day use, all flavour types except menthol/mint exhibited an inverse age gradient, with more prevalent use among youth and YAs, followed by adults 25+. Prevalence of menthol/mint use was high (over 50% youth, YAs; 76% adults 25+) and exhibited a positive age gradient overall, though the reverse for cigarettes. Brand-categorised and self-reported flavour use measures among adults 18+ were moderately to substantially concordant across most products. CONCLUSIONS Common flavours like menthol/mint, fruit and candy/sweet enhance appeal to young tobacco users. Information on flavour types used by product and age can inform tobacco flavour regulations to addess flavour appeal especially among youth.
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Affiliation(s)
| | - Amanda L Johnson
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, USA
| | | | - Andrea C Villanti
- Truth Initiative Schroeder Institute, Washington, DC, USA.,Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, Vermont, USA
| | - Bridget K Ambrose
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Kevin Conway
- Division of Epidemiology, Services, and Prevention Branch, National Institute on Drug Abuse, Bethesda, Maryland, USA
| | - K Michael Cummings
- Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Cassandra A Stanton
- Westat Inc, Rockville, Maryland, USA.,Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, United States
| | - Cristine Delnevo
- Center for Tobacco Studies, School of Public Health, Rutgers University, Piscataway, New Jersey, USA
| | - Olivia A Wackowski
- Center for Tobacco Studies, School of Public Health, Rutgers University, Piscataway, New Jersey, USA
| | | | - Shari P Feirman
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, USA
| | | | - Jennifer Bernat
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Enver Holder-Hayes
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Victoria Green
- Division of Epidemiology, Services, and Prevention Branch, National Institute on Drug Abuse, Bethesda, Maryland, USA.,Kelly Government Solutions, Rockville, Maryland, USA
| | - Marushka L Silveira
- Division of Epidemiology, Services, and Prevention Branch, National Institute on Drug Abuse, Bethesda, Maryland, USA.,Kelly Government Solutions, Rockville, Maryland, USA
| | - Yitong Zhou
- Truth Initiative Schroeder Institute, Washington, DC, USA
| | | | - Andrew Hyland
- Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA
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Silveira ML, Green VR, Iannaccone R, Kimmel HL, Conway KP. Patterns and correlates of polysubstance use among US youth aged 15-17 years: wave 1 of the Population Assessment of Tobacco and Health (PATH) Study. Addiction 2019; 114:907-916. [PMID: 30614093 PMCID: PMC6609515 DOI: 10.1111/add.14547] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [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: 09/06/2018] [Revised: 11/21/2018] [Accepted: 01/02/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Youth aged 15-17 years are at high risk of tobacco, alcohol and drug use. Given the changing landscape with respect to availability, use of emerging products and regulatory environments, we examined patterns and correlates of polysubstance use among US youth aged 15-17 years. DESIGN Cross-sectional self-reported data. SETTING United States. PARTICIPANTS A total of 6127 US youth aged 15-17 years from wave 1 (2013-14) of the nationally representative Population Assessment of Tobacco and Health (PATH) Study. MEASUREMENTS Latent class analysis was used to identify subgroups of polysubstance use, including 12 tobacco products, alcohol, marijuana, prescription drugs and other drugs. Socio-demographic characteristics, residence in urban area, sensation-seeking, sexual orientation and internalizing and externalizing problems were examined as correlates. FINDINGS Approximately 43.5% of 15-17-year-olds had used at least one substance in the past 12 months. A 5-class model was identified: class 1 'abstainers' (67.3%), class 2 'alcohol users' (19.2%), class 3 'alcohol, marijuana and tobacco (AMTpredominant AM ) users' (8.2%), class 4 'alcohol, marijuana and tobacco (AMTpredominant T ) users' (3.9%) and class 5 'alcohol, marijuana, tobacco and other drug (AMTOD) users' (1.4%). Abstainers were considered the reference class. Higher sensation-seeking scores, higher age and lower academic grades were each associated with greater likelihood of membership in all user classes. Gender, race/ethnicity, parents/guardians' education, residence in non-urban areas and sexual minority groups were associated with membership in some, but not all, user classes. Compared with no/low/moderate severity, high severity internalizing problems were associated with membership in classes 2, 3 and 5, whereas high severity externalizing problems were associated with membership in classes 3 and 5 only. CONCLUSIONS There appear to be three heterogeneous polysubstance use classes among US youth aged 15-17 years. Correlates of substance use among US youth include higher sensation-seeking, poor academic performance, non-urban residence, minority sexual orientation and mental health problems.
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Affiliation(s)
- Marushka L. Silveira
- National Institute on Drug Abuse, National Institutes of
Health, Bethesda, MD,Kelly Government Solutions, Rockville, MD
| | | | - Robert Iannaccone
- Georgetown University, Washington, DC,Rutgers New Jersey Medical School, Newark, NJ
| | - Heather L. Kimmel
- National Institute on Drug Abuse, National Institutes of
Health, Bethesda, MD
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Adunola F, Garcia I, Iafolla T, Boroumand S, Silveira ML, Adesanya M, Dye BA. Self‐perceived oral health, normative need, and dental services utilization among dentate adults in the United States: National Health and Nutrition Examination Survey (NHANES) 2011‐2014. J Public Health Dent 2019; 79:79-90. [DOI: 10.1111/jphd.12300] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 10/11/2018] [Accepted: 11/01/2018] [Indexed: 11/28/2022]
Affiliation(s)
| | - Isabel Garcia
- College of Dentistry, University of Florida Gainesville FL USA
| | - Timothy Iafolla
- National Institute of Dental and Craniofacial Research, National Institutes of Health Bethesda MD USA
| | - Shahdokht Boroumand
- National Institute of Dental and Craniofacial Research, National Institutes of Health Bethesda MD USA
| | | | - Margo Adesanya
- National Institute of Dental and Craniofacial Research, National Institutes of Health Bethesda MD USA
| | - Bruce A. Dye
- National Institute of Dental and Craniofacial Research, National Institutes of Health Bethesda MD USA
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Green VR, Conway KP, Silveira ML, Kasza KA, Cohn A, Cummings KM, Stanton CA, Callahan-Lyon P, Slavit W, Sargent JD, Hilmi N, Niaura RS, Reissig CJ, Lambert E, Zandberg I, Brunette MF, Tanski SE, Borek N, Hyland AJ, Compton WM. Mental Health Problems and Onset of Tobacco Use Among 12- to 24-Year-Olds in the PATH Study. J Am Acad Child Adolesc Psychiatry 2018; 57:944-954.e4. [PMID: 30522740 PMCID: PMC7439766 DOI: 10.1016/j.jaac.2018.06.029] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 05/25/2018] [Accepted: 06/21/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To examine whether mental health problems predict incident use of 12 different tobacco products in a nationally representative sample of youth and young adults. METHOD This study analyzed Wave (W) 1 and W2 data from 10,533 12- to 24-year-old W1 never tobacco users in the Population Assessment of Tobacco and Health (PATH) Study. Self-reported lifetime internalizing and externalizing symptoms were assessed at W1. Past 12-month use of cigarettes, electronic nicotine delivery systems (ENDS), traditional cigars, cigarillos, filtered cigars, pipe, hookah, snus pouches, other smokeless tobacco, bidis and kreteks (youth only), and dissolvable tobacco was assessed at W2. RESULTS In multivariable regression analyses, high-severity W1 internalizing (adjusted odds ratio [AOR] = 1.5, 95% CI = 1.3-1.8) and externalizing (AOR = 1.3, 95% CI = 1.1-1.5) problems predicted W2 onset of any tobacco use compared to no/low/moderate severity. High-severity W1 internalizing problems predicted W2 use onset across most tobacco products. High-severity W1 externalizing problems predicted onset of any tobacco (AOR = 1.6, 95% CI = 1.3-1.8), cigarettes (AOR = 1.4, 95% CI = 1.0-2.0), ENDS (AOR = 1.8, 95% CI = 1.5-2.1), and cigarillos (AOR = 1.5, 95% CI = 1.0-2.1) among youth only. CONCLUSION Internalizing and externalizing problems predicted onset of any tobacco use. However, findings differed for internalizing and externalizing problems across tobacco products, and by age, gender, and race/ethnicity. In addition to screening for tobacco product use, health care providers should screen for a range of mental health problems as a predictor of tobacco use. Interventions addressing mental health problems may prevent youth from initiating tobacco use.
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Affiliation(s)
- Victoria R Green
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD; Kelly Government Solutions, Rockville, MD
| | - Kevin P Conway
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD
| | - Marushka L Silveira
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD; Kelly Government Solutions, Rockville, MD.
| | | | - Amy Cohn
- Truth Initiative, Washington, DC
| | | | | | | | - Wendy Slavit
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD
| | | | - Nahla Hilmi
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD; Kelly Government Solutions, Rockville, MD
| | | | - Chad J Reissig
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD
| | - Elizabeth Lambert
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD
| | - Izabella Zandberg
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD
| | | | | | - Nicolette Borek
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD
| | | | - Wilson M Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD
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Silveira ML, Hilmi NN, Conway KP. Reasons for Young Adult Waterpipe Use in Wave 1 (2013-2014) of the Population Assessment of Tobacco and Health Study. Am J Prev Med 2018; 55:650-655. [PMID: 30219210 DOI: 10.1016/j.amepre.2018.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 10/25/2017] [Revised: 04/25/2018] [Accepted: 06/04/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Waterpipe use is common among U.S. young adults (aged 18-24 years), with estimates considerably higher than other age groups. Although studies have examined attitudes and beliefs associated with waterpipe use, no study has examined reasons for use in a nationally representative sample. METHODS Using latent class analyses, this study examined subgroups based on self-reported reasons for use of past 30-day young adult (aged 18-24 years) waterpipe users (n=1,198) from Wave 1 (2013-2014) of the Population Assessment of Tobacco and Health Study. Data analyses were conducted in 2017. Covariates included sociodemographic characteristics, substance use, and internalizing and externalizing problems. RESULTS A three-class model was identified: Class 1 (socializing and flavors, 57%), Class 2 (many reasons [flavors, socializing, less harmful than cigarettes, and affordability], 20%), and Class 3 (socializing, 23%). Class 3 was considered the referent group. Compared with non-Hispanic whites, non-Hispanic blacks were less likely to belong to Class 1, whereas Hispanics were more likely to belong to Class 2. Compared with less than high school education, greater than high school education was associated with membership in Class 1; however, high school graduation was associated with membership in Class 2. Past-year alcohol users compared with non-users were less likely to belong to Class 2. Past 30-day poly-tobacco users compared with non-users were more likely to belong to Class 2. CONCLUSIONS This study revealed distinct classes of waterpipe users based on self-reported reasons for use. Findings inform targeted policies for waterpipe tobacco control as part of public health efforts to mitigate harms associated with tobacco use.
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Affiliation(s)
- Marushka L Silveira
- National Institute on Drug Abuse, NIH, Bethesda, Maryland; Kelly Government Solutions, Rockville, Maryland.
| | - Nahla N Hilmi
- National Institute on Drug Abuse, NIH, Bethesda, Maryland; Kelly Government Solutions, Rockville, Maryland
| | - Kevin P Conway
- National Institute on Drug Abuse, NIH, Bethesda, Maryland
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Silveira ML, Conway KP, Green VR, Kasza KA, Sargent JD, Borek N, Stanton CA, Cohn A, Hilmi N, Cummings KM, Niaura RS, Lambert EY, Brunette MF, Zandberg I, Tanski SE, Reissig CJ, Callahan-Lyon P, Slavit WI, Hyland AJ, Compton WM. Longitudinal associations between youth tobacco and substance use in waves 1 and 2 of the Population Assessment of Tobacco and Health (PATH) Study. Drug Alcohol Depend 2018; 191:25-36. [PMID: 30077053 PMCID: PMC6239207 DOI: 10.1016/j.drugalcdep.2018.06.018] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 06/12/2018] [Accepted: 06/16/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND While evidence suggests bidirectional associations between cigarette use and substance (alcohol or drug) use, how these associations are reflected across the range of currently available tobacco products is unknown. This study examined whether ever tobacco use predicted subsequent substance use, and ever substance use predicted subsequent tobacco use among 11,996 U.S. youth (12-17 years) from Waves 1 (2013-2014) and 2 (2014-2015) of the Population Assessment of Tobacco and Health (PATH) Study. METHODS Ever use of cigarettes, e-cigarettes, traditional cigars, cigarillos, filtered cigars, pipe, hookah, snus pouches, smokeless tobacco excluding snus pouches, dissolvable tobacco, bidis, kreteks, alcohol, marijuana, prescription drugs, and other drugs (cocaine and other stimulants, heroin, inhalants, solvents, and hallucinogens) was assessed at Wave 1 followed by past 12-month use assessments at Wave 2. The analyses included covariates (demographics, mental health, sensation seeking, prior use) to mitigate confounding. RESULTS Ever tobacco use predicted subsequent substance use. The magnitude of the associations was lowest for alcohol, higher for marijuana, and highest for other drugs. Ever substance use also predicted subsequent tobacco use. Specifically, ever alcohol, marijuana, and non-prescribed Ritalin/Adderall use predicted tobacco-product use. Ever e-cigarette and cigarette use exclusively and concurrently predicted subsequent any drug (including and excluding alcohol) use. E-cigarette and cigarette use associations in the opposite direction were also significant; the strongest associations were observed for exclusive cigarette use. CONCLUSION Tobacco and substance use prevention efforts may benefit from comprehensive screening and interventions across tobacco products, alcohol, and drugs, and targeting risk factors shared across substances.
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Affiliation(s)
- Marushka L Silveira
- National Institute on Drug Abuse, National Institutes of Health, 6001 Executive Blvd., Bethesda, MD 20892, USA; Kelly Government Solutions, Rockville, MD, USA.
| | - Kevin P Conway
- National Institute on Drug Abuse, National Institutes of Health, 6001 Executive Blvd., Bethesda, MD 20892, USA
| | - Victoria R Green
- National Institute on Drug Abuse, National Institutes of Health, 6001 Executive Blvd., Bethesda, MD 20892, USA; Kelly Government Solutions, Rockville, MD, USA
| | - Karin A Kasza
- Department of Health Behavior, Roswell Park Cancer Institute, 665 Elm St, Buffalo, NY 14203, USA
| | - James D Sargent
- Cancer Control Research Program, Norris Cotton Cancer Center, and Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Geisel School of Medicine, Rubin 8 Lebanon, NH 03756, USA
| | - Nicolette Borek
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | | | - Amy Cohn
- The Schroeder Institute for Tobacco Research and Policy Studies, Truth Initiative, 900 G Street, NW, Fourth Floor, Washington, DC 20001, USA
| | - Nahla Hilmi
- National Institute on Drug Abuse, National Institutes of Health, 6001 Executive Blvd., Bethesda, MD 20892, USA; Kelly Government Solutions, Rockville, MD, USA
| | - K Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, MSC 861, Charleston, SC 29425, USA
| | - Raymond S Niaura
- The Schroeder Institute for Tobacco Research and Policy Studies, Truth Initiative, 900 G Street, NW, Fourth Floor, Washington, DC 20001, USA
| | - Elizabeth Y Lambert
- National Institute on Drug Abuse, National Institutes of Health, 6001 Executive Blvd., Bethesda, MD 20892, USA
| | - Mary F Brunette
- Cancer Control Research Program, Norris Cotton Cancer Center, and Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Geisel School of Medicine, Rubin 8 Lebanon, NH 03756, USA
| | - Izabella Zandberg
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | - Susanne E Tanski
- Cancer Control Research Program, Norris Cotton Cancer Center, and Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Geisel School of Medicine, Rubin 8 Lebanon, NH 03756, USA
| | - Chad J Reissig
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | - Priscilla Callahan-Lyon
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | - Wendy I Slavit
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | - Andrew J Hyland
- Department of Health Behavior, Roswell Park Cancer Institute, 665 Elm St, Buffalo, NY 14203, USA
| | - Wilson M Compton
- National Institute on Drug Abuse, National Institutes of Health, 6001 Executive Blvd., Bethesda, MD 20892, USA
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Green VR, Silveira ML, Kimmel HL, Conway KP. Body mass index and tobacco-product use among U.S. youth: Findings from wave 1 (2013-2014) of the Population Assessment of Tobacco and Health (PATH) Study. Addict Behav 2018; 81:91-95. [PMID: 29452981 DOI: 10.1016/j.addbeh.2018.02.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 02/02/2018] [Accepted: 02/03/2018] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Tobacco and obesity are leading contributors to mortality in the United States. Due to emerging changes in youth tobacco use, further examination of co-occurrence of these issues is warranted. METHODS This study examined associations between body mass index (BMI) and tobacco-product use and whether these varied by gender in a nationally representative sample of 12,416 Wave 1 (2013-2014) U.S. youth (12-17 years) from the Population Assessment of Tobacco and Health Study. Multivariable logistic regression analyses examined the odds of past 30-day tobacco-product use according to BMI. BMI was analyzed categorically using the Centers for Disease Control and Prevention (CDC) BMI-for-age weight status categories (underweight/healthy weight, overweight, and obese) and as a continuous variable. RESULTS Youth classified as overweight or obese were not more likely to use any tobacco, cigarettes, e-cigarettes, any cigar, or hookah. However, youth who were obese were more likely to use smokeless tobacco (Adjusted Odds Ratio (AOR) = 1.68, 95% Confidence Interval (CI): 1.01, 2.81). There were no significant gender interactions for these associations. When BMI was analyzed continuously, a 5-unit and 10-unit increase was significantly associated with using any tobacco, cigarettes, any cigar, and smokeless tobacco. This linear association was supported by similar results for a log-transformed BMI variable. CONCLUSIONS Findings suggest a continuum between weight increase and tobacco-product use among American youth. Clinicians should consider screening for tobacco use among youth who gain weight within any weight class, not just those considered overweight or obese.
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Affiliation(s)
- Victoria R Green
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, United States; Kelly Government Solutions, Rockville, MD, United States
| | - Marushka L Silveira
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, United States; Kelly Government Solutions, Rockville, MD, United States.
| | - Heather L Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, United States
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Pierce JP, Sargent JD, Portnoy DB, White M, Noble M, Kealey S, Borek N, Carusi C, Choi K, Green VR, Kaufman AR, Leas E, Lewis MJ, Margolis KA, Messer K, Shi Y, Silveira ML, Snyder K, Stanton CA, Tanski SE, Bansal-Travers M, Trinidad D, Hyland A. Association Between Receptivity to Tobacco Advertising and Progression to Tobacco Use in Youth and Young Adults in the PATH Study. JAMA Pediatr 2018; 172:444-451. [PMID: 29582078 PMCID: PMC5875336 DOI: 10.1001/jamapediatrics.2017.5756] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [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] [Indexed: 12/29/2022]
Abstract
IMPORTANCE Cigarette marketing contributes to initiation of cigarette smoking among young people, which has led to restrictions on use of cigarette advertising. However, little is known about other tobacco advertising and progression to tobacco use in youth and young adults. OBJECTIVE To investigate whether receptivity to tobacco advertising among youth and young adults is associated with progression (being a susceptible never user or ever user) to use of the product advertised, as well as conventional cigarette smoking. DESIGN, SETTING, AND PARTICIPANTS The Population Assessment of Tobacco and Health (PATH) Study at wave 1 (2013-2014) and 1-year follow-up at wave 2 (2014-2015) was conducted in a US population-based sample of never tobacco users aged 12 to 24 years from wave 1 of the PATH Study (N = 10 989). Household interviews using audio computer-assisted self-interviews were conducted. EXPOSURES Advertising for conventional cigarettes, electronic cigarettes (e-cigarettes), cigars, and smokeless tobacco products at wave 1. MAIN OUTCOMES AND MEASURES Progression to susceptibility or ever tobacco use at 1-year follow-up in wave 2. RESULTS Of the 10 989 participants (5410 male [weighted percentage, 48.3%]; 5579 female [weighted percentage, 51.7%]), receptivity to any tobacco advertising at wave 1 was high for those aged 12 to 14 years (44.0%; 95% confidence limit [CL], 42.6%-45.4%) but highest for those aged 18 to 21 years (68.7%; 95% CL, 64.9%-72.2%). e-Cigarette advertising had the highest receptivity among all age groups. For those aged 12 to 17 years, susceptibility to use a product at wave 1 was significantly associated with product use at wave 2 for conventional cigarettes, e-cigarettes, cigars, and smokeless tobacco products. Among committed never users aged 12 to 17 years at wave 1, any receptivity was associated with progression toward use of the product at wave 2 (conventional cigarettes: adjusted odds ratio [AOR], 1.43; 95% CL, 1.23-1.65; e-cigarettes: AOR, 1.62; 95% CL, 1.41-1.85; cigars: AOR, 2.01; 95% CL, 1.62-2.49; and smokeless [males only]: AOR, 1.42; 95% CL, 1.07-1.89) and with use of the product (conventional cigarettes: AOR, 1.54; 95% CL, 1.03-2.32; e-cigarettes: AOR, 1.45; 95% CL, 1.19-1.75; cigars: AOR, 2.07; 95% CL, 1.26-3.40). Compared with those not receptive to any product advertising, receptivity to e-cigarette advertising, but not to cigarette advertising, was independently associated with those aged 12 to 21 years having used a cigarette at wave 2 (AOR, 1.60; 95% CL, 1.08-2.38). CONCLUSIONS AND RELEVANCE Receptivity to tobacco advertising was significantly associated with progression toward use in adolescents. Receptivity was highest for e-cigarette advertising and was associated with trying a cigarette.
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Affiliation(s)
- John P. Pierce
- Cancer Prevention Program, Moores Cancer Center, University of California, San Diego, La Jolla, California,Department of Family Medicine and Public Health, University of California, San Diego
| | - James D. Sargent
- C. Everett Koop Institute, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - David B. Portnoy
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland
| | - Martha White
- Cancer Prevention Program, Moores Cancer Center, University of California, San Diego, La Jolla, California
| | - Madison Noble
- Cancer Prevention Program, Moores Cancer Center, University of California, San Diego, La Jolla, California,Department of Family Medicine and Public Health, University of California, San Diego
| | - Sheila Kealey
- Cancer Prevention Program, Moores Cancer Center, University of California, San Diego, La Jolla, California
| | - Nicolette Borek
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland
| | | | - Kelvin Choi
- National Institute on Minority Health and Health Disparities, Bethesda, Maryland
| | - Victoria R. Green
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland,Kelly Government Solutions, Rockville, Maryland
| | - Annette R. Kaufman
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Eric Leas
- Cancer Prevention Program, Moores Cancer Center, University of California, San Diego, La Jolla, California,Department of Family Medicine and Public Health, University of California, San Diego
| | - M. Jane Lewis
- Department of Health Education and Behavioral Science, Rutgers School of Public Health, New Brunswick, New Jersey
| | - Katherine A. Margolis
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland
| | - Karen Messer
- Cancer Prevention Program, Moores Cancer Center, University of California, San Diego, La Jolla, California,Department of Family Medicine and Public Health, University of California, San Diego
| | - Yuyan Shi
- Cancer Prevention Program, Moores Cancer Center, University of California, San Diego, La Jolla, California,Department of Family Medicine and Public Health, University of California, San Diego
| | - Marushka L. Silveira
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland,Kelly Government Solutions, Rockville, Maryland
| | - Kimberly Snyder
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland
| | - Cassandra A. Stanton
- Westat, Rockville, Maryland,Department of Oncology, Cancer Prevention & Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Susanne E. Tanski
- C. Everett Koop Institute, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | | | - Dennis Trinidad
- Cancer Prevention Program, Moores Cancer Center, University of California, San Diego, La Jolla, California,Department of Family Medicine and Public Health, University of California, San Diego
| | - Andrew Hyland
- Roswell Park Cancer Institute, Department of Health Behavior, Buffalo, New York
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Coleman B, Rostron B, Johnson SE, Persoskie A, Pearson J, Stanton C, Choi K, Anic G, Goniewicz ML, Cummings KM, Kasza KA, Silveira ML, Delnevo C, Niaura R, Abrams DB, Kimmel HL, Borek N, Compton WM, Hyland A. Transitions in electronic cigarette use among adults in the Population Assessment of Tobacco and Health (PATH) Study, Waves 1 and 2 (2013-2015). Tob Control 2018; 28:50-59. [PMID: 29695458 DOI: 10.1136/tobaccocontrol-2017-054174] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 03/06/2018] [Accepted: 03/21/2018] [Indexed: 12/27/2022]
Abstract
INTRODUCTION This study assessed patterns of e-cigarette and cigarette use from Wave 1 to Wave 2 among adult e-cigarette users at Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study. METHODS We examined changes in e-cigarette use frequency at Wave 2 among adult e-cigarette users at Wave 1 (unweighted n=2835). Adjusted prevalence ratios (aPR) were calculated using a predicted marginal probability approach to assess correlates of e-cigarette discontinuance and smoking abstinence at Wave 2. RESULTS Half (48.8%) of adult e-cigarette users at Wave 1 discontinued their use of e-cigarettes at Wave 2. Among dual users of e-cigarettes and cigarettes at Wave 1, 44.3% maintained dual use, 43.5% discontinued e-cigarette use and maintained cigarette smoking and 12.1% discontinued cigarette use at Wave 2, either by abstaining from cigarette smoking only (5.1%) or discontinuing both products (7.0%). Among dual users at Wave 1, daily e-cigarette users were more likely than non-daily users to report smoking abstinence at Wave 2 (aPR=1.40, 95% CI 1.02 to 1.91). Using a customisable device (rather than a non-customisable one) was not significantly related to smoking abstinence at Wave 2 (aPR=1.14, 95% CI 0.81 to 1.60). CONCLUSIONS This study suggests that e-cigarette use patterns are highly variable over a 1-year period. This analysis provides the first nationally representative estimates of transitions among US adult e-cigarette users. Future research, including additional waves of the PATH Study, can provide further insight into long-term patterns of e-cigarette use critical to understanding the net population health impact of e-cigarettes in USA.
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Affiliation(s)
- Blair Coleman
- Office of Science, Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Brian Rostron
- Office of Science, Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Sarah E Johnson
- Office of Science, Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Alexander Persoskie
- Office of Science, Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Jennifer Pearson
- School of Community Health Sciences, University of Nevada, Reno, Nevada, USA
| | | | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
| | - Gabriella Anic
- Office of Science, Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Maciej Lukasz Goniewicz
- Division of Cancer Prevention and Population Sciences, Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Kenneth Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Medical University of South Carolina, South Carolina, USA
| | - Karin A Kasza
- Division of Cancer Prevention and Population Sciences, Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Marushka L Silveira
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, Maryland, USA.,Kelly Government Solutions, Rockville, Maryland, USA
| | - Cristine Delnevo
- Center for Tobacco Studies, School of Public Health, Rutgers University, New Brunswick, New Jersey, USA
| | | | - David B Abrams
- Department of Social and Behavioral Sciences, NYU College of Global Public Health, New York, USA
| | - Heather L Kimmel
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, Maryland, USA
| | - Nicolette Borek
- Office of Science, Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Wilson M Compton
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, Maryland, USA
| | - Andrew Hyland
- Division of Cancer Prevention and Population Sciences, Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA
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Conway KP, Green VR, Kasza KA, Silveira ML, Borek N, Kimmel HL, Sargent JD, Stanton CA, Lambert E, Hilmi N, Reissig CJ, Jackson KJ, Tanski SE, Maklan D, Hyland AJ, Compton WM. Co-occurrence of tobacco product use, substance use, and mental health problems among youth: Findings from wave 1 (2013-2014) of the population assessment of tobacco and health (PATH) study. Addict Behav 2018; 76:208-217. [PMID: 28846942 DOI: 10.1016/j.addbeh.2017.08.009] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 08/04/2017] [Accepted: 08/16/2017] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Cigarette use is associated with substance use and mental health problems among youth, but associations are unknown for non-cigarette tobacco product use, as well as the increasingly common poly-tobacco use. METHODS The current study examined co-occurrence of substance use and mental health problems across tobacco products among 13,617 youth aged 12-17years from Wave 1 (2013-2014) of the nationally representative Population Assessment of Tobacco and Health (PATH) Study. Participants self-reported ever cigarette, e-cigarette, smokeless tobacco, traditional cigar, cigarillo, filtered cigar, hookah, and other tobacco product use; alcohol, marijuana, and other drugs; and lifetime substance use, internalizing and externalizing problems. RESULTS In multivariable regression analyses, use of each tobacco product was associated with substance use, particularly cigarillos and marijuana (AOR=18.9, 95% CI: 15.3-23.4). Cigarette (AOR=14.7, 95% CI: 11.8-18.2) and cigarillo (AOR=8.1, 95% CI: 6.3-10.3) use were strongly associated with substance use problems and tobacco users were more likely to report internalizing (AOR=1.6, 95% CI: 1.4-1.8) and externalizing (AOR=1.4, 95% CI: 1.3-1.6) problems. Female tobacco users were more likely to have internalizing problems than male tobacco users. Poly-tobacco users were more likely than exclusive users to use substances (AOR=3.4, 95% CI: 2.7-4.3) and have mental health (AOR=1.2, 95% CI: 1.0-1.5) and substance use (AOR=4.7, 95% CI: 3.4-6.6) problems. CONCLUSIONS Regardless of the tobacco product used, findings reveal high co-occurrence of substance use and mental health problems among youth tobacco users, especially poly-tobacco users. These findings suggest the need to address comorbidities among high risk youth in prevention and treatment settings.
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Silveira ML, Wexler L, Chamberlain J, Money K, Spencer RMC, Reich NG, Bertone-Johnson ER. Seasonality of suicide behavior in Northwest Alaska: 1990-2009. Public Health 2016; 137:35-43. [PMID: 27021788 DOI: 10.1016/j.puhe.2016.02.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 02/06/2016] [Accepted: 02/12/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Suicide is a leading cause of death worldwide, and disproportionately affects Indigenous populations. Seasonal suicide patterns are variable in the literature, and could offer novel approaches to the timing and focus of prevention efforts if better understood. With a suicide surveillance system in place since 1989, this study offers an unprecedented opportunity to explore seasonal variations in both fatal and non-fatal suicide behavior in an Indigenous Arctic region. STUDY DESIGN Cross-sectional. METHODS In this descriptive study, we analyzed data collected from 1990 to 2009 in the rural northwest region of Alaska, both graphically and using the chi-squared test for multinomials. RESULTS We found a significant monthly variation for suicide attempts, with a peak in suicide behavior observed between April and August (P = 0.0002). Monthly variation was more pronounced among individuals ≤29 years of age, and was present in both males and females, although the seasonal pattern differed by sex. CONCLUSIONS Our findings of a significant seasonal pattern in suicide behavior, with monthly variation (summer peak) in non-fatal suicide behavior among younger age groups, and among both males and females can assist planners in targeting subpopulations for prevention at different times of the year.
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Affiliation(s)
- M L Silveira
- Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - L Wexler
- Division of Community Health Education, Department of Public Health, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA.
| | - J Chamberlain
- Swiss Paraplegic Research, Nottwil, Switzerland; Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - K Money
- Women's Psychological Services, USA
| | - R M C Spencer
- Department of Psychological & Brain Sciences, University of Massachusetts, Amherst, MA, USA
| | - N G Reich
- Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - E R Bertone-Johnson
- Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA
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Silveira ML, Whitcomb BW, Pekow P, Carbone ET, Chasan-Taber L. Anxiety, depression, and oral health among US pregnant women: 2010 Behavioral Risk Factor Surveillance System. J Public Health Dent 2015; 76:56-64. [PMID: 26270155 DOI: 10.1111/jphd.12112] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [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: 10/08/2014] [Accepted: 06/29/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Maternal periodontal disease is associated with adverse perinatal outcomes. Anxiety and depression adversely impact oral health in nonpregnant women; however, this association has not been evaluated during pregnancy, a time characterized by higher rates of anxiety and depression. Therefore, we examined the association between these factors and oral disease and oral healthcare utilization among 402 pregnant respondents to the 2010 Behavioral Risk Factor Surveillance System. METHODS Self-reported lifetime diagnoses of anxiety, depression, and current depression were assessed. Oral health outcomes included self-reported tooth loss and dental visits in the past year. RESULTS One-fifth (21.2 percent) of respondents reported a tooth loss and 32.5 percent reported nonuse of oral health services. The prevalence of lifetime diagnosed anxiety and depression was 13.6 percent and 11.3 percent, respectively, whereas 10.6 percent reported current depression. After adjusting for risk factors, pregnant women with diagnosed anxiety had increased odds of one or more tooth loss [odds ratio (OR) = 3.30; 95 percent confidence interval (CI): 1.01-10.77] compared with those without the disorder. Similarly, after adjusting for socioeconomic factors, women with anxiety had increased odds of nonuse of oral health services (OR = 2.67; 95 percent CI: 1.03-6.90); however, this was no longer significant after adjusting for health behaviors and body mass index. We observed no significant association with depression. CONCLUSIONS In this population-based sample, we found a two- to threefold increased odds of tooth loss and nonuse of oral health services among pregnant women with a lifetime diagnosis of anxiety. To our knowledge, this is the first study to examine these associations among pregnant women.
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Affiliation(s)
- Marushka L Silveira
- Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - Brian W Whitcomb
- Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - Penelope Pekow
- Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - Elena T Carbone
- Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - Lisa Chasan-Taber
- Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA
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Ertel KA, Silveira ML, Pekow PS, Dole N, Markenson G, Chasan-Taber L. Prepregnancy body mass index, gestational weight gain, and elevated depressive symptoms in a Hispanic cohort. Health Psychol 2014; 34:274-8. [PMID: 25110848 DOI: 10.1037/hea0000137] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Our objective was to assess the associations among prepregnancy Body Mass Index (BMI), gestational weight gain (GWG), and elevated depressive symptoms across pregnancy. METHODS We evaluated these associations among 1,090 participants in Proyecto Buena Salud, a prospective cohort study of Hispanic (predominantly Puerto Rican) women in Western Massachusetts. BMI and GWG were self-reported; GWG was classified according to the 2009 Institute of Medicine guidelines. Depressive symptoms were assessed in early, mid-, and late pregnancy using the 10-item Edinburgh Postnatal Depression Scale (EPDS). We defined elevated depressive symptoms as EPDS scores ≥13 and ≥15. RESULTS In multivariable, longitudinal modeling, overweight (25.0 to <30 kg/m2) women had an odds ratio of 0.53 (95% CI [0.31, 0.90]) for EPDS scores ≥13 and 0.51 (95% CI [0.28, 0.91]) for EPDS scores ≥15 compared to normal weight women. We did not observe an association between GWG or an interaction between BMI and GWG, in predicting elevated depressive symptoms. CONCLUSIONS Our findings provide preliminary support for an association of prepregnancy overweight status and lower depressive symptoms across pregnancy in Hispanic women. Future research should focus on potential social and cultural differences in perceptions of weight and weight gain in the perinatal period and how these influence psychological health.
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Affiliation(s)
- Karen A Ertel
- Division of Biostatistics and Epidemiology, Department of Public Health, School of Public Health and Health Sciences, University of Massachusetts
| | - Marushka L Silveira
- Division of Biostatistics and Epidemiology, Department of Public Health, School of Public Health and Health Sciences, University of Massachusetts
| | - Penelope S Pekow
- Division of Biostatistics and Epidemiology, Department of Public Health, School of Public Health and Health Sciences, University of Massachusetts
| | - Nancy Dole
- Carolina Population Center, University of North Carolina
| | | | - Lisa Chasan-Taber
- Division of Biostatistics and Epidemiology, Department of Public Health, School of Public Health and Health Sciences, University of Massachusetts
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Silveira ML, Whitcomb BW, Pekow P, Braun B, Markenson G, Dole N, Manson JE, Solomon CG, Carbone ET, Chasan-Taber L. Perceived psychosocial stress and glucose intolerance among pregnant Hispanic women. Diabetes Metab 2014; 40:466-75. [PMID: 24948416 DOI: 10.1016/j.diabet.2014.05.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 04/30/2014] [Accepted: 05/04/2014] [Indexed: 12/13/2022]
Abstract
AIM Prior literature suggests a positive association between psychosocial stress and the risk of diabetes in non-pregnant populations, but studies during pregnancy are sparse. We evaluated the relationship between stress and glucose intolerance among 1115 Hispanic (predominantly Puerto Rican) prenatal care patients in Proyecto Buena Salud, a prospective cohort study in Western Massachusetts (2006-2011). METHODS Cohen's Perceived Stress Scale (PSS-14) was administered in early (mean = 12.3 weeks gestation; range 4.1-18 weeks) and mid- (mean = 21.3 weeks gestation; range 18.1-26 weeks) pregnancy. Participants were classified as having a pregnancy complicated by gestational diabetes mellitus, impaired glucose tolerance, and abnormal glucose tolerance, based on the degree of abnormality on glucose tolerance testing between 24 and 28 weeks of gestation. RESULTS The prevalence of gestational diabetes mellitus, impaired glucose tolerance, and abnormal glucose tolerance was 4.1%, 7.2%, and 14.5%, respectively. Absolute levels of early or mid-pregnancy stress were not significantly associated with glucose intolerance. However, participants with an increase in stress from early to mid-pregnancy had a 2.6-fold increased odds of gestational diabetes mellitus (95% confidence intervals: 1.0-6.9) as compared to those with no change or a decrease in stress after adjusting for age and pre-pregnancy body mass index. In addition, every one-point increase in stress scores was associated with a 5.5mg/dL increase in screening glucose level (β=5.5; standard deviation=2.8; P=0.05), after adjusting for the same variables. CONCLUSION In this population of predominantly Puerto Rican women, stress patterns during pregnancy may influence the risk of glucose intolerance.
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Affiliation(s)
- M L Silveira
- Division of Biostatistics & Epidemiology, Department of Public Health, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - B W Whitcomb
- Division of Biostatistics & Epidemiology, Department of Public Health, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - P Pekow
- Division of Biostatistics & Epidemiology, Department of Public Health, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - B Braun
- Department of Kinesiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - G Markenson
- Baystate Medical Center, Springfield, MA, USA
| | - N Dole
- Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
| | - J E Manson
- Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
| | - C G Solomon
- Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - E T Carbone
- Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - L Chasan-Taber
- Division of Biostatistics & Epidemiology, Department of Public Health, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA.
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Wexler L, Silveira ML, Bertone-Johnson E. Factors associated with Alaska Native fatal and nonfatal suicidal behaviors 2001-2009: trends and implications for prevention. Arch Suicide Res 2012; 16:273-86. [PMID: 23137218 DOI: 10.1080/13811118.2013.722051] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [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] [Indexed: 10/27/2022]
Abstract
Suicide rates among American Indian and Alaska Native (AI/AN) young people are significantly higher than other ethnic groups in the United States. Not only are there great differences when comparing AI/AN rates and those of other Americans, some tribal groups have very low rates of suicide while other Native communities have much higher rates. Despite this obvious variability, there is little research to help understand the factors associated with these differences. The current study considers the correlates of suicidal behavior in one rural Alaska Native region that suffers disproportionately from suicide. The analysis describes suicide behavior between the years 2001-2009, and considers the characteristics associated with both suicide deaths and nonfatal suicidal behavior. In multivariate analyses we identified gender, method of suicide and history of previous attempt as significant predictors of fatal suicide behavior, similar to results obtained from analyses on the same community's data from the previous decade. This descriptive study can offer some insights to shape prevention efforts in this and other rural, tribal communities.
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Affiliation(s)
- Lisa Wexler
- Community Health Education, Department of Public Health, School of Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts 01003, USA.
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Silveira ML, Alleoni LRF, O'Connor GA, Chang AC. Heavy metal sequential extraction methods--a modification for tropical soils. Chemosphere 2006; 64:1929-38. [PMID: 16487572 DOI: 10.1016/j.chemosphere.2006.01.018] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2005] [Revised: 01/06/2006] [Accepted: 01/09/2006] [Indexed: 05/06/2023]
Abstract
Sequential extractions of metals can be useful to study metal distributions in various soil fractions. Although several sequential extraction procedures have been suggested in the literature, most were developed for temperate soils and may not be suitable for tropical soils with high contents of Mn and Fe oxides. The objective of this study was to develop a sequential fractionation procedure for Cu and Zn in tropical soils. Extractions were performed on surface (0-20 cm) samples of ten representative soils of Sao Paulo State, Brazil. Chemically reactive Mn forms were satisfactorily assessed by the new modified procedure. Amorphous and crystalline Fe oxides were more selectively extracted in a new two-step extraction. Soil-born Zn and Cu were primarily associated with recalcitrant soil fractions. The proposed procedure provided more detailed information on metal distribution in tropical soils and better characterization of the various components of the soil matrix. The new procedure is expected to be an important tool for predicting the potential effects of environmental changes and land application of metals on the redistribution of chemical forms of metals in tropical soils.
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Affiliation(s)
- M L Silveira
- Soil and Water Science Department, University of Florida, Gainesville, 32611-0510, USA.
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Silveira ML, Miyittah MK, O'Connor GA. Phosphorus release from a manure-impacted spodosol: effects of a water treatment residual. J Environ Qual 2006; 35:529-41. [PMID: 16455854 DOI: 10.2134/jeq2005.0139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Long-term depositions of animal manures affect P dynamics in soils and can pose environmental risks associated with P losses. Laboratory studies were done on P solubility characteristics in a manure-impacted Immokalee soil (sandy, siliceous, hyperthermic Arenic Alaquod) and the effectiveness of water treatment residual (WTR) in controlling P leaching. Soil samples with contrasting initial total P concentrations were prepared by mixing samples of a manure-impacted surface A horizon and a minimally P-impacted E horizon. Effects of mixing various ratios of A and E horizons, WTR rates (0, 25, 50, and 100 g kg(-1)), and depths of WTR incorporation (mixed throughout the soil column or partially incorporated) on P leaching were determined. Between 62 and 77% of total P was released from the soil mixes by successive water extractions, suggesting a considerable buffering capacity of this manure-impacted soil to resupply P into solution. Between 224 and 408 mg kg(-1) P were leached during the 36-wk leaching period in the absence of WTR. Mixing WTRs with soil reduced soluble P concentration in leachates by as much as 99.8% compared with samples without WTR. Thoroughly mixing WTR with the entire soil column (15 cm) was much more efficient than mixing WTR with only the top 7.5 cm of soil. Calcium- and Mg-P forms appear to control P release in soils without WTR, whereas sorption-desorption reactions probably determine P leaching in WTR-treated samples. Soil P distribution in various chemical forms was affected by WTR additions. Data suggest that WTR-immobilized P is stable in the long term.
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Affiliation(s)
- M L Silveira
- Soil and Water Science Department, University of Florida, Gainesville, FL 32611-0510, USA.
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Salle JL, de Fraga JC, Amarante A, Silveira ML, Lambertz M, Schmidt M, Rosito NC. Urethral lengthening with anterior bladder wall flap for urinary incontinence: a new approach. J Urol 1994; 152:803-6. [PMID: 8022019 DOI: 10.1016/s0022-5347(17)32715-5] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Urethral irregularity (impeding catheterization) and failure to achieve continence are common complications in surgery for urinary incontinence. We describe a surgical technique using an anterior bladder wall flap that is sutured to the posterior wall in an onlay fashion creating a flap valve mechanism. Experimental work in dogs demonstrated a significant increase in the leak point pressure in the surgical group when compared to controls (p = 0.019). Voiding cystourethrography and bladder inspection demonstrated an anterior flap valve with no fistula formation in all animals. Histological examination showed a viable anterior bladder wall flap in all cases. This technique was then applied to 6 patients with neurogenic bladder and low urethral resistance that failed to resolve with medical treatment. Urinary continence was achieved in 4 patients. In 1 patient a vesicourethral fistula developed 3 months postoperatively, since the mother failed to catheterize for 12 hours. This technique is a useful alternative in the treatment of urinary incontinence.
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Affiliation(s)
- J L Salle
- Division of Pediatric Surgery and Urology, Hospital de Clinicas de Porto Alegre, Hospital de Criança Conceicão, Porto Alegre, Brazil
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Gil CA, Silveira ML, Soares FJ, Solé D, Naspitz C. Study of the effects of treatment with theophylline on the cognitive process and behaviour of children with bronchial asthma. Allergol Immunopathol (Madr) 1993; 21:204-6. [PMID: 8160567] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The effects of theophylline (T) on cognitive and emotional aspects were evaluated in nine children with mild bronchial asthma (7-14 years). The study was double blind crossover against placebo (P) for a period of 30 days for each. The children admitted to the study had an average IQ (80-101) and were able to perform pulmonary function studies (PFS). On days 0, 30 and 60 patients were evaluated by psychological tests (Wisc, Bender, Complex Figure A. Rey and Miss Goodenough/Machouver). PPS an T serum levels were performed on days 15 and 45. During the T period all patients had T serum levels greater than 5 mcg/ml (5 to 22). The final evaluation showed no changes in the psychological tests. Behaviour alterations were not reported by the parents. In conclusion, in this group of patients there was no influence of T on the asthmatic children's behavior. These results are in agreement with the recent data published by Schlieper et al. (J. Pediatr. 118: 449-455, 1991).
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Affiliation(s)
- C A Gil
- Department of Pediatrics, Escola Paulista de Medicina, São Paulo, Brasil
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