E-cigarette use, perceptions, and cigarette smoking intentions in a community sample of young adult nondaily cigarette smokers.

E-cigarette use is increasing among young adult never smokers of conventional cigarettes, but the awareness of the factors associated with e-cigarette use in this population is limited. The goal of this work was to use machine learning (ML) algorithms to determine the factors associated with current e-cigarette use among US young adult never cigarette smokers. Young adult (18–34 years) never cigarette smokers from the 2016 and 2017 Behavioral Risk Factor Surveillance System (BRFSS) who reported current or never e-cigarette use were used for the analysis (n = 79,539). Variables associated with current e-cigarette use were selected by two ML algorithms (Boruta and Least absolute shrinkage and selection operator (LASSO)). Odds ratios were calculated to determine the association between e-cigarette use and the variables selected by the ML algorithms, after adjusting for age, gender and race/ethnicity and incorporating the BRFSS complex design. The prevalence of e-cigarette use varied across states. Factors previously reported in the literature, such as age, race/ethnicity, alcohol use, depression, as well as novel factors associated with e-cigarette use, such as disabilities, obesity, history of diabetes and history of arthritis were identified. These results can be used to generate further hypotheses for research, increase public awareness and help provide targeted e-cigarette education.

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E-Cigarette Use and Future Cigarette Initiation Among Never Smokers and Relapse Among Former Smokers in the PATH Study

Public Health Reports ◽

10.1177/0033354919864369 ◽

2019 ◽

Vol 134 (5) ◽

pp. 528-536 ◽

Cited By ~ 14

Author(s):

Robert McMillen ◽

Jonathan D. Klein ◽

Karen Wilson ◽

Jonathan P. Winickoff ◽

Susanne Tanski

Keyword(s):

Cigarette Smoking ◽

Harm Reduction ◽

Electronic Cigarettes ◽

Computer Assisted ◽

Cigarette Use ◽

Cigarette Smokers ◽

Potential Harm ◽

Increased Risk ◽

Never Smokers

Objectives: Any potential harm-reduction benefit of electronic cigarettes (e-cigarettes) could be offset by nonsmokers who initiate e-cigarette use and then smoke combustible cigarettes. We examined correlates of e-cigarette use at baseline with combustible cigarette smoking at 1-year follow-up among adult distant former combustible cigarette smokers (ie, quit smoking ≥5 years ago) and never smokers. Methods: The Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal study, surveyed 26 446 US adults during 2 waves: 2013-2014 (baseline) and 2014-2015 (1-year follow-up). Participants completed an audio computer-assisted interview in English or Spanish. We compared combustible cigarette smoking at 1-year follow-up by e-cigarette use at baseline among distant former combustible cigarette smokers and never smokers. Results: Distant former combustible cigarette smokers who reported e-cigarette past 30-day use (9.3%) and ever use (6.7%) were significantly more likely than those who had never used e-cigarettes (1.3%) to have relapsed to current combustible cigarette smoking at follow-up ( P < .001). Never smokers who reported e-cigarette past 30-day use (25.6%) and ever use (13.9%) were significantly more likely than those who had never used e-cigarettes (2.1%) to have initiated combustible cigarette smoking ( P < .001). Adults who reported past 30-day e-cigarette use (7.0%) and ever e-cigarette use (1.7%) were more likely than those who had never used e-cigarettes (0.3%) to have transitioned from never smokers to current combustible cigarette smokers ( P < .001). E-cigarette use predicted combustible cigarette smoking in multivariable analyses controlling for covariates. Conclusions: Policies and counseling should consider the increased risk for nonsmokers of future combustible cigarette smoking use as a result of using e-cigarettes and any potential harm-reduction benefits e-cigarettes might bring to current combustible cigarette smokers.

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Perceived addiction to vaping among youth and young adult regular vapers

Tobacco Control ◽

10.1136/tobaccocontrol-2019-055352 ◽

2020 ◽

pp. tobaccocontrol-2019-055352

Author(s):

Alexia Camara-Medeiros ◽

Lori Diemert ◽

Shawn O'Connor ◽

Robert Schwartz ◽

Thomas Eissenberg ◽

...

Keyword(s):

Young Adult ◽

Sensation Seeking ◽

Cigarette Use ◽

Cigarette Smokers ◽

Factors Associated ◽

Online Social Media ◽

Youth And Young Adults ◽

Social Media Platforms ◽

Quota Sampling ◽

People’S Perceptions

BackgroundThe prevalence of e-cigarette use among youth and young adults has increased markedly in recent years; however, little is known about young people’s perceptions of e-cigarette addiction. This study examines factors associated with self-reported addiction to e-cigarette use among this population.MethodsIn 2018, 1048 Canadians aged 16–25 years were recruited through online social media platforms to complete a survey. Quota sampling was used to oversample regular e-cigarette users (vaping at least weekly); these 578 regular users were included in this analysis. Self-perceived addiction was assessed by asking participants if they felt they were ‘very’, ‘somewhat’ or ‘not at all’ addicted to e-cigarettes. A proportional odds model was employed to identify factors associated with the ordinal outcome.ResultsAlmost half of regular users perceived themselves to be ‘not at all addicted’, 41% felt they were ‘somewhat addicted’ and 13% felt they were very addicted to e-cigarettes. Women, former cigarette smokers, daily vapers and those vaping for more than a year were more likely to report higher levels of perceived addiction. Similarly, high sensation-seeking youth, those reading blogs and websites about vaping, those frequently dripping and those using higher nicotine strengths had a greater likelihood of higher perceived addiction than their respective counterparts.ConclusionMore than half of youth and young adult regular e-cigarette users felt they had some level of addiction. The findings identify possible opportunities for targeted programming for education and treatment, as well as potential opportunities for policy change such as maximum allowable nicotine strengths.

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P032 E-CIGARETTE AND CIGARETTE USE AMONG U.S. ADULT IBD PATIENTS: POPULATION-LEVEL SURVEY

Inflammatory Bowel Diseases ◽

10.1093/ibd/zaa010.159 ◽

2020 ◽

Vol 26 (Supplement_1) ◽

pp. S62-S63

Author(s):

Ryan Suk ◽

Heetae Suk ◽

Kalyani Sonawane ◽

Ashish Deshmukh

Keyword(s):

Cigarette Smoking ◽

Lung Injury ◽

Survey Design ◽

Population Level ◽

Cigarette Use ◽

Cigarette Smokers ◽

The Us ◽

Current Cigarette ◽

Lung Injuries ◽

Nationally Representative

Abstract Background Cigarette smoking can negatively affect treatment response in inflammatory bowel disease (IBD) patients, especially among those with Crohn’s disease (CD). E-cigarette has been considered a safer alternative to delivering nicotine for IBD patients who smoke. However, given the recent large number of reported e-cigarette-related lung injury cases, CDC released an interim guidance update on those lung injuries. They also coined a term EVALI (e-cigarette, or vaping, product use associated lung injury) emphasizing the possible harms in e-cigarette smoking. To the best our knowledge, we currently do not know the recent smoking habits in American IBD patients, especially when it reveals that e-cigarette use might cause serious lung injuries. Methods We used National Health Interview Survey (NHIS) for 2015–2016, which is a nationally representative survey for noninstitutionalized adults in the US. Weighted counts and percentages were estimated using survey design for the population-level results. We identified those who reportedly were told by a doctor or healthcare professional that they have IBD. We first estimated the prevalence of current e-cigarette or cigarette use among IBD patients. We then estimated the frequency of use (every day or some days) among the current users. We also categorized IBD patients into 4 groups by smoking type: those using e-cigarette only, cigarette only, using both, and neither. To see the characteristics of e-cigarette users, we stratified e-cigarette users by current/former/never cigarette use status. Results We identified 951 participants (population estimate: 3.1 million) with IBD. Among those people, 5.0% (95% CI: 3.1–6.9) was current e-cigarette users while 17.9% (95% CI: 14.8–21.0) was current cigarette smokers. Prevalence of every-day use and some-day use of e-cigarette was similar (2.4% vs 2.6%), while there was much higher prevalence of every-day use than some-day use in cigarette (15.3% vs 2.6%). Those who were using both e-cigarette and cigarette was 3.2% (Table). Majority of e-cigarette users were also currently using cigarette (63.6%, 95% CI: 48.9–78.3), while 32.7% (95% CI: 18.4–47.0) of them were former cigarette smokers. Only 3.7% (0.0–8.9) of them never used cigarettes. Conclusion While numerous studies show e-cigarette use is generally increasing rapidly in the US, we found that 5% of IBD patients are currently using e-cigarette. Almost two-thirds of them were also currently smoking cigarette and one-third of them were former smokers. It is possible that most of the e-cigarette users are still in the process of transitioning from cigarette smoking and thus using both types. We lack information on effects of using e-cigarette or both e-cigarette and cigarette in IBD treatment outcomes, as well as how e-cigarette use will complicate other health risks in IBD patients (e.g. lung injuries). We need further research on these effects to properly guide IBD patients who are in need of smoking cessation.

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A Longitudinal Examination of Behavioral Transitions among Young Adult Menthol and Non-Menthol Cigarette Smokers Using a Three-State Markov Model

Nicotine & Tobacco Research ◽

10.1093/ntr/ntaa240 ◽

2020 ◽

Author(s):

Dale S Mantey ◽

Melissa B Harrell ◽

Baojiang Chen ◽

Steven H Kelder ◽

Cheryl L Perry ◽

...

Keyword(s):

Young Adults ◽

Young Adult ◽

Cigarette Smoking ◽

Markov Model ◽

Cigarette Smokers ◽

Menthol Cigarette ◽

Menthol Cigarettes ◽

Increased Risk ◽

Smoking Behaviors ◽

Hispanic Latinos

Abstract Introduction Young adult cigarette smoking behaviors are complex and dynamic. Emerging research suggests a growing rate of switching from non-menthol to menthol cigarettes. Transitions across cigarette smoking states are not well understood. This research longitudinally explores transitions in cigarette smoking behaviors among 18-29 year olds. Methods We applied a Markov model to data collected biannually for 1,542 initially 18-29-year old young adults (mean age: 20.9 years; SD=2.6) in Texas, who provided 7,021 total observations from Fall 2014 – Spring 2017. All participants were past 30-day menthol or non-menthol cigarette smokers at first observation. We examined transitions across three states of cigarette smoking (menthol, non-menthol, and nonsmoking) and compared predictors of each transition, during young adulthood. Results Descriptively, 22.2% of menthol and 14.3% of non-menthol smokers switched products while 25.6% of menthol and 26.0% of non-menthol smokers quit smoking. Among quitters, 20.0% relapsed via menthol and 28.2% relapsed via non-menthol cigarettes. Results from Markov model indicated that Hispanic/Latinos (Hazard Ratio [HR]: 3.69) and Asians (HR: 2.85) were significantly more likely to switch from non-menthol to menthol cigarettes, relative to non-Hispanic whites. Among recent quitters, use of non-cigarette products was associated with increased risk of relapse via menthol (HR: 1.54) and non-menthol (HR: 1.85) cigarettes. Conclusion A substantial proportion of young adult cigarette smokers transitioned across cigarette smoking states over the course of 2.5-years. Other tobacco use and nicotine dependence were impediments to becoming and remaining a non-smoker. Hispanic/Latinos and Asians, relative to non-Hispanic Whites, had greater odds of transitioning from non-menthol smoking to both non-smoking and to menthol smoking. Findings suggest racial/ethnic differences in cigarette smoking transitions during young adulthood. Implications This paper examined multidirectional transitions across cigarette smoking, including switching between menthol and non-menthol cigarettes, among young adults. Results indicate that Hispanic/Latino and Asian young adults are at increased risk to transition to menthol cigarette smoking compared with non-Hispanic white young adults. Findings highlight need for further study of Hispanic/Latino and Asian young adult smoking behaviors.

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Direct Outreach in Bars and Clubs to Enroll Cigarette Smokers in Mobile Cessation Services (Preprint)

10.2196/preprints.28059 ◽

2021 ◽

Author(s):

Patricia Chalela ◽

Alfred L. McAlister ◽

Cliff Despres ◽

Edgar Muñoz ◽

Pramod Sukumaran ◽

...

Keyword(s):

Smoking Cessation ◽

Young Adult ◽

Cigarette Smoking ◽

Rural Areas ◽

Text Messaging ◽

Public Health Importance ◽

Cigarette Smokers ◽

Team Members ◽

Face To Face ◽

Quit Attempt

BACKGROUND Quitxt is a mobile smoking cessation service delivered through text messaging (SMS) and Facebook Messenger chat. Cigarette smoking and alcohol use are well known to be concomitant behaviors, however there is a lack of studies related to recruitment of smokers for mobile cessation services at places where alcohol is consumed, such as bars and clubs. Adapting recruitment strategies to expand the program reach where tobacco users are may help decrease the gap in health equity among minorities. OBJECTIVE The purpose of this exploratory study was to assess the feasibility of direct outreach at bars, clubs and restaurants to as a strategy to recruit smokers to our mobile Quitxt program. METHODS We collaborated with an advertising agency to recruit young adult smokers aged 18-29, focusing on urban & rural Spanish speaking Latinos, as well as English speaking rural Caucasians and African Americans. Street team members were recruited and trained in a four-hour session including a brief introduction to the public health importance of cigarette smoking and the aims of the project. The street team made face to face contact with smokers in and near smoking areas in 25 bars, clubs, and other venues frequented by young smokers in urban San Antonio and nearby rural areas. RESULTS The 3,923 interactions by street teams produced 317 program enrollments (8%). Most participants were English speakers with a mean age of 29 years, 63% were women, about 57% were Hispanic/Latino, with a mean of 8 cigarettes smoked per day. Among users ready to make a quit attempt, 26% reported one tobacco free day and 15% reported maintaining cessation to achieve one week without smoking. Response rate to later follow-up questions were low. CONCLUSIONS Direct outreach in bars and clubs is a useful method for connecting young adult cigarette smokers with mobile cessation services. However, to learn more about how mobile services can influence long term smoking cessation, incentives are evidently required to obtain useful response rates. CLINICALTRIAL N/A

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E-cigarette use and quantity of cigarette smoking among adolescent cigarette smokers: A finite mixture model analysis

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2017.12.003 ◽

2018 ◽

Vol 185 ◽

pp. 33-39 ◽

Cited By ~ 6

Author(s):

Sunday Azagba ◽

Mark Wolfson

Keyword(s):

Cigarette Smoking ◽

Mixture Model ◽

Finite Mixture Model ◽

Model Analysis ◽

Finite Mixture ◽

Cigarette Use ◽

Cigarette Smokers

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User-Perceived Negative Respiratory Symptoms Associated with Electronic Cigarette Use

Nicotine & Tobacco Research ◽

10.1093/ntr/ntaa179 ◽

2020 ◽

Vol 22 (Supplement_1) ◽

pp. S45-S53

Author(s):

Eric K Soule ◽

Kendall M Bode ◽

Abigail C Desrosiers ◽

Mignonne Guy ◽

Alison Breland ◽

...

Keyword(s):

Cigarette Smoking ◽

Health Outcomes ◽

Respiratory System ◽

Respiratory Symptoms ◽

Online Survey ◽

Electronic Cigarettes ◽

Future Research ◽

Scaling Analysis ◽

Cigarette Use ◽

Cigarette Smokers

Abstract Introduction Electronic cigarettes (ECIGs) expose users to an aerosol containing chemicals, which could affect the respiratory system negatively. This study examined negative respiratory symptoms associated with ECIG use. Methods In 2019, adult current ECIG users from 24 US states who reported experiencing negative respiratory symptoms from ECIG use (n = 49; 44.9% women; mean age = 35.2, SD = 11.5) completed an online survey and brainstormed statements that completed the prompt: “A specific negative effect or symptom related to my breathing, nose, mouth, throat, or lungs that I have experienced from vaping/using my e-cigarette is...” Participants sorted the final list of 56 statements into groups of similar content and rated statements on how true they were for them. Multidimensional scaling analysis identified thematic clusters. Results Eight ECIG use respiratory symptom clusters identified in analysis included Mucus and Congestion, Fatigue, Throat Symptoms, Breathing Problems, Mouth Symptoms, Chest Symptoms, Illness Symptoms, and Nose and Sinus Symptoms. Highly rated (ie, most common) symptoms included dry throat or mouth, fatigue during physical activity, coughing, shortness of breath, excessive phlegm, and bad taste in mouth. Mean cluster ratings did not differ based on lifetime cigarette smoking status (100 lifetime cigarettes smoked), but current cigarette smokers (ie, dual users) rated the Fatigue, Breathing Problems, Mucus and Congestion, and Nose and Sinus Symptoms clusters higher than noncurrent cigarette smokers. Conclusions Participant-identified respiratory symptoms perceived to be ECIG related, many similar to cigarette smoking symptoms. Future research should assess if these symptoms are associated with other negative health outcomes. Implications ECIG use exposes users to chemicals that may have negative health impacts on the respiratory system. Limited research has examined the broad range of negative respiratory symptoms associated with e-cigarette use. This study identified that ECIG–cigarette users perceive their ECIG use to be associated with negative respiratory symptoms. Many e-cigarette user-reported negative respiratory symptoms are similar to those associated with cigarette smoking, though some appear unique to e-cigarette use. Future research should continue to monitor respiratory symptoms reported by ECIG users and whether these are associated with health outcomes over time.

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