scholarly journals Racial/Ethnic Differences in Associations of Noncigarette Tobacco Product Use with Subsequent Initiation of Cigarettes in US Youths

2020 ◽  
Author(s):  
Andrew Stokes ◽  
Anna E Wilson ◽  
Dielle J Lundberg ◽  
Wubin Xie ◽  
Kaitlyn M Berry ◽  
...  
Keyword(s):  
Policy Development ◽  
Black Youth ◽  
Critical Role ◽  
Health Study ◽  
Hispanic Youth ◽  
Cigarette Use ◽  
Tobacco Products ◽  
Product Use ◽  
Prior Use ◽  
Racial Ethnic

Abstract Introduction Understanding which noncigarette tobacco products precede smoking in youth across different racial/ethnic groups can inform policies that consider tobacco related health disparities. Methods We used nationally representative, longitudinal data from the Population Assessment of Tobacco and Health Study waves 1-4. The sample was a dynamic cohort of cigarette-naïve youth aged 12-17 years. Mixed effects models were used to assess noncigarette product [e-cigarette, cigar product, or other product] use with cigarette use over 1-year intervals. Results Of the 28,788 observations pooled across waves 1-4, respondents were 48.7% non-Hispanic white, 13.9% non-Hispanic black, and 23.1% Hispanic. Odds of cigarette initiation over 1-year follow up were higher among youth with prior use of e-cigarettes (OR, 2.76; 95% CI, 2.21-3.45), cigars (OR, 2.00; 95% CI, 1.42-2.80), or other products (OR, 1.66; 95% CI, 1.28-2.14) compared to never users. At the population level, 20.6% of cigarette initiation was attributable to e-cigarette use among white youth and 21.6% among Hispanic youth, while only 3.5% of cigarette initiation was attributable to e-cigarette use among black youth. In contrast, 9.1% of cigarette initiation for black youth was attributable to cigar use compared to only 3.9% for both white and Hispanic youth. Conclusions Prior use of e-cigarettes, cigars, and other noncigarette products were all associated with subsequent cigarette initiation. However, white and Hispanic youth were more likely to initiate cigarettes through e-cigarette use (vs. cigar or other product use), while black youth were more likely to initiate cigarettes through cigar use (vs. e-cigarette or other product use). Implications Our findings suggest that previous studies on effects of noncigarette tobacco products may overlook the critical role of cigar products as a pathway into cigarette smoking among US youth, particularly black youth. While our data support the importance of e-cigarette use as a pathway into smoking, regulatory actions aimed at addressing youth e-cigarette use alone may contribute to disparities in black vs. white tobacco use and further exacerbate inequities in tobacco-related disease. Thus, contemporary policy development and discourse about the effects of noncigarette tobacco products on cigarette initiation should consider cigar and other noncigarette products as well as e-cigarettes.

scholarly journals Polytobacco product use among current cigarette smokers in Hong Kong, China: results from population surveys (2015–17)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
S. L. Chau ◽  
M. P. Wang ◽  
Y. Wu ◽  
D. Y. T. Cheung ◽  
A. Kong ◽  
...  
Keyword(s):  
Control Policy ◽  
Tobacco Product ◽  
Cigarette Use ◽  
Related Factors ◽  
Cigarette Smokers ◽  
Tobacco Products ◽  
Product Use ◽  
Younger Age ◽  
Current Cigarette ◽  
Age And Sex

Abstract Background Polytobacco product use is increasingly popular, but little is known about the prevalence, trend, and factors of such use particularly in non-western countries. Method A representative sample of 1139 current cigarette smokers aged 15+ (84.1% male) were telephone interviewed in Tobacco Control Policy-related Surveys in 2015–2017. Information collected included poly-tobacco use (PTU), smoking and socio-demographic characteristics. Associations of current PTU with related factors were analyzed using logistic regression with adjustment for confounders. Prevalence was weighted by age and sex of current cigarette users in the general population. Results Eighty-four point one percent (95% CI 81.4–86.6%) were exclusive cigarette smokers. Fifteen point nine percent (13.4–18.6%) were current polytobacco product users, 12.3% (10.2–14.8%) used one tobacco product and 2.52% (1.59–3.97%) used two tobacco products in addition to cigarette. Cigarette use with cigar was more common (6.28%, 4.75–8.27%), and the least used product with cigarette was e-cigarette (1.05%, 0.44–2.50%). The changes in overall prevalence of PTU by number of products use varied in 3 years. Current PTU was associated with being male (AOR 2.01, 95% CI 1.12–3.61), younger age (AORs range from 1.34–4.65, P for trend < .001) and less ready to quit (2.08, 1.09–3.97). Conclusions Prevalence of PTU increased slowly by year, one tobacco product use with cigarette was more common. The most used tobacco product with cigarette was cigar. Being male, younger and less ready to quit were associated with current PTU.

Who Purchases Tobacco Online? Findings from Waves 1 and 4 of the Population Assessment of Tobacco and Health Study

2021 ◽  
Vol 7 (3) ◽  
pp. 155-169
Author(s):  
Jessica L. King ◽  
Julie W. Merten ◽  
Nicole E. Nicksic
Keyword(s):  
Black Youth ◽  
Health Study ◽  
Tobacco Products ◽  
Population Assessment ◽  
Factors Associated ◽  
The Us

Objectives: We examined the prevalence of and factors associated with usually purchasing tobacco online. Methods: We analyzed Waves 1 (2013-14) and 4 (2016-17) of the US Population Assessment of Tobacco and Health adult (18+) and youth (12-17) studies: 15,450 adults and 495 youth in 2013-14 and 15,037 adults and 465 youth in 2016-17. Z-tests compared the prevalence of usually purchasing tobacco online between waves and weighted multivariable regressions identified associations between purchasing online and sociodemographics. Results: The prevalence of usually purchasing tobacco online increased from 2.5% to 3.3% among adults (p < .05) and from 2.5% to 4.4% among youth (p < .05), generalizing to a US population of 2,000,000 adults and 35,000 youth. E-cigarettes and cigars and e-cigarettes and waterpipe tobacco were the most common products among adults and youth, respectively. Men, adults with greater education, adults with higher income, and non-Hispanic black youth had greater odds of purchasing tobacco online (p < .05). Conclusions: Usually purchasing tobacco online remains low, although ever purchasing was not assessed. Efforts should be made to expand Internet tobacco purchasing surveillance and extend and enforce restrictions broadly across tobacco products to reduce youth access.

scholarly journals Investigating gateway effects using the PATH study

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 264 ◽  
Author(s):  
Peter Lee ◽  
John Fry
Keyword(s):  
Cigarette Smoking ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Smoking Initiation ◽  
Continuous Variable ◽  
Sensitivity Analyses ◽  
Health Study ◽  
Cigarette Use ◽  
Tobacco Products ◽  
Residual Confounding

Background: A recent meta-analysis of nine cohort studies in youths reported that baseline ever e-cigarette use strongly predicted cigarette smoking initiation in the next 6-18 months, with an adjusted odds ratio of 3.62 (95% confidence interval 2.42-5.41).  A recent review of e-cigarettes agreed there was substantial evidence for this “gateway effect”.  However, the number of confounders considered in the studies was limited, so we investigated whether the effect might have resulted from inadequate adjustment, using Waves 1 and 2 of the Population Assessment of Tobacco and Health study. Methods: Our main analyses considered Wave 1 never cigarette smokers who, at Wave 2, had information available on smoking initiation.  We constructed a propensity score for ever e-cigarette use from Wave 1 variables, using this to predict ever cigarette smoking.  Sensitivity analyses accounted for use of other tobacco products, linked current e-cigarette use to subsequent current smoking, or used propensity scores for ever smoking or ever tobacco product use as predictors.  We also considered predictors using data from both waves to attempt to control for residual confounding from misclassified responses. Results: Adjustment for propensity dramatically reduced the unadjusted odds ratio (OR) of 5.70 (4.33-7.50) to 2.48 (1.85-3.31), 2.47 (1.79-3.42) or 1.85 (1.35-2.53), whether adjustment was made as quintiles, as a continuous variable or for the individual variables.  Additional adjustment for other tobacco products reduced this last OR to 1.59 (1.14-2.20).  Sensitivity analyses confirmed adjustment removed most of the gateway effect.  Control for residual confounding also reduced the association. Conclusions: We found that confounding is a major factor, explaining most of the observed gateway effect.  However, our analyses are limited by small numbers of new smokers considered and the possibility of over-adjustment if taking up e-cigarettes affects some predictor variables.  Further analyses are intended using Wave 3 data which should avoid these problems.

scholarly journals Pilot Ecological Momentary Assessment Study of Subjective and Contextual Factors Surrounding E-Cigarette and Combustible Tobacco Product Use among Young Adults

2021 ◽  
Vol 18 (21) ◽  
pp. 11005
Author(s):  
Deepa R. Camenga ◽  
Angela M. Haeny ◽  
Suchitra Krishnan-Sarin ◽  
Stephanie S. O’Malley ◽  
Krysten W. Bold
Keyword(s):  
Young Adults ◽  
Ecological Momentary Assessment ◽  
Contextual Factors ◽  
Tobacco Product ◽  
Cigarette Use ◽  
Tobacco Products ◽  
Product Use ◽  
Cigarette Dependence ◽  
Ecological Momentary ◽  
Momentary Assessment

Background: Dual use of e-cigarettes and combustible tobacco products is common in young adults. We aimed to explore how ratings of subjective and contextual factors differed between discrete episodes of e-cigarette use vs. combustible tobacco product smoking among a sample of young adults. Methods: Young adults (N = 29, ages 18–30) who used e-cigarettes and ≥1 combustible tobacco product at least once weekly completed a 1-week smartphone-based ecological momentary assessment (EMA). Twice daily random prompts assessed past-15-min use of tobacco products, ratings of subjective factors (e.g., negative affect, craving), and contextual factors related to activity, location, and companionship. A multivariable GEE model assessed whether subjective or contextual factors were associated with e-cigarette vs. combustible tobacco product episodes. Results: 184 tobacco use episodes were reported (39.7% e-cigarette, 60.3% combustible tobacco product). High baseline cigarette dependence, as measured by the Fagerström Test for Cigarette Dependence, was associated with lower odds of e-cigarette vs. combustible tobacco product episodes (aOR 0.01, 95% CI (0.002–0.08); p < 0.001). Neither between- or within-subjects negative affect or craving scores were associated with e-cigarette use. Activities of eating/drinking (aOR 0.20, 95% CI (0.08–0.49); p = 0.001) and being in the companionship of a person who smoked cigarettes (aOR 0.13, 95% CI (0.04–0.43); p = 0.001) were associated with lower odds of e-cigarette vs. combustible tobacco product use episodes. However, traveling (aOR 12.02, 95% CI (3.77–38.26); p ≤ 0.001) and being in a public space (aOR 2.76, 95% CI (1.10–6.96); p = 0.03) were associated with higher odds of e-cigarette than combustible tobacco product use episodes. Conclusions: This pilot data suggests that unique contextual factors may be associated with e-cigarette use, compared to combustible tobacco smoking in a sample of young adults who use both e-cigarettes and combustible tobacco products. Future research with larger samples is needed to better characterize varying contexts and cues for tobacco use among young adults who are dual users.

Who Is Using Alternative Tobacco Products and Why?

2018 ◽  
Author(s):  
Alexandra Loukas ◽  
Deepti Agarwal
Keyword(s):  
Developmental Trajectories ◽  
The United States ◽  
Future Research ◽  
Cigarette Use ◽  
Longitudinal Models ◽  
Tobacco Products ◽  
Factors Associated ◽  
Product Use ◽  
Patterns Of Use ◽  
Alternative Tobacco Products

There is a growing array of alternative tobacco and nicotine products, such as hookah, cigarillos, snus, and electronic nicotine delivery systems (e-cigarettes). Both e-cigarette and hookah use are now more prevalent than cigarette use among adolescents in the United States. Alternative products are appealing to adolescents and young adults because they are available in a variety of flavors, often cheaper than cigarettes, and perceived to be less harmful than cigarettes. Existing studies are beginning to provide important information on the prevalence, correlates, and patterns of alternative tobacco and nicotine product use. Longitudinal models that map developmental trajectories and transitions of tobacco and nicotine use are needed to examine factors associated with persistence, progression, or desistence of use and also with changes in patterns of use. Future research can draw on developmental traditions in other areas of substance use to describe the heterogeneity in product use across time.

scholarly journals Transitions in hookah (Waterpipe) smoking by U.S. sexual minority adults between 2013 and 2015: the population assessment of tobacco and health study wave 1 and wave 2

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mary Rezk-Hanna ◽  
Ian W. Holloway ◽  
Joy Toyama ◽  
Umme Shefa Warda ◽  
Lorree Catherine Berteau ◽  
...  
Keyword(s):  
Multinomial Logistic Regression ◽  
Health Study ◽  
Chi Square ◽  
Population Assessment ◽  
Logistic Regression Models ◽  
Global Epidemic ◽  
Product Use ◽  
Hookah Smoking ◽  
Nationally Representative ◽  
And Gender

Abstract Background Tobacco smoking using a hookah (i.e., waterpipe) is a global epidemic. While evidence suggests that sexual minorities (SM) have higher odds of hookah use compared to heterosexuals, little is known about their hookah use patterns and transitions. We sought to examine transitions between hookah smoking and use of other tobacco and electronic (e-) products among SM adults aged 18 years of age and older versus their heterosexual counterparts. Methods We analyzed nationally representative data of ever and current hookah smokers from Wave 1 (2013–2014; ever use n = 1014 SM and n = 9462 heterosexuals; current use n = 144 SM and n = 910 heterosexuals) and Wave 2 (2014–2015; ever use n = 901 SM and n = 8049 heterosexuals; current use n = 117 SM and n = 602 heterosexuals) of the Population Assessment of Tobacco and Health Study. Comparisons between groups and gender subgroups within SM identity groups were determined with Rao-Scott chi-square tests and multivariable survey-weighted multinomial logistic regression models were estimated for transition patterns and initiation of electronic product use in Wave 2. Results Ever and current hookah smoking among SM adults (ever use Wave 1: 29% and Wave 2: 31%; current use Wave 1: 4% and Wave 2: 3%) was higher than heterosexuals (ever use Wave 1: 16% and Wave 2: 16%; current use Wave 1: 1% and Wave 2: 1%; both p < 0.0001). Among SM adults who reported hookah use at Wave 1, 46% quit hookah use at Wave 2; 39% continued hookah use and did not transition to other products while 36% of heterosexual adults quit hookah use at Wave 2 and 36% continued hookah use and did not transition to other products. Compared with heterosexuals, SM adults reported higher use of hookah plus e-products (Wave 2 usage increased by 65 and 83%, respectively). Conclusions Compared to heterosexuals, in addition to higher rates of hookah smoking, higher percentages of SM adults transitioned to hookah plus e-product use between 2013 and 2015. Results have implications for stronger efforts to increase awareness of the harmful effects of hookah as well as vaping, specifically tailored among SM communities.

scholarly journals Cross-Sectional Associations of Smoking and E-cigarette Use with Self-Reported Diagnosed Hypertension: Findings from Wave 3 of the Population Assessment of Tobacco and Health Study

Toxics ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 52
Author(s):  
Connor R. Miller ◽  
Hangchuan Shi ◽  
Dongmei Li ◽  
Maciej L. Goniewicz
Keyword(s):  
Electronic Cigarettes ◽  
Epidemiologic Studies ◽  
Health Condition ◽  
Health Study ◽  
Cigarette Use ◽  
Health Consequences ◽  
Cross Sectional ◽  
Population Assessment ◽  
Current Smoking ◽  
Never Smokers

Following their introduction a decade ago, electronic cigarettes (e-cigarettes) have grown in popularity. Given their novelty, knowledge of the health consequences of e-cigarette use remains limited. Epidemiologic studies have not comprehensively explored associations between e-cigarette use and hypertension, a highly prevalent health condition and major contributor to cardiovascular disease burden. In this study, cross-sectional associations of cigarette smoking and e-cigarette use (vaping) with self-reported diagnosed hypertension were evaluated among 19,147 18–55 year old respondents in Wave 3 (2015–2016) of the Population Assessment of Tobacco and Health Study. Multivariable analyses first modeled smoking and vaping as separate 2-category variables, then as a 6-category composite variable accounting for former smoking. After adjusting for potential confounders, current vaping (aOR = 1.31; 95%CI: 1.05–1.63) and current smoking (aOR = 1.27; 95%CI: 1.10–1.47) were both associated with higher odds of hypertension. In analyses modeling smoking and vaping compositely, respondents who were concurrently smoking and vaping had the highest odds of hypertension (aOR = 1.77; 95%CI: 1.32–2.39 [referent: never smokers]). These results differ somewhat from prior epidemiologic studies of vaping and respiratory outcomes, which consistently report smaller point estimates for current vaping than for current smoking. Our findings reinforce the uncertainty surrounding long-term health consequences of vaping, as well as highlight important distinctions between respiratory and cardiovascular outcomes when considering the harm reduction potential of e-cigarettes.

scholarly journals Sex Difference in the Association between Electronic Cigarette Use and Subsequent Cigarette Smoking among U.S. Adolescents: Findings from the PATH Study Waves 1–4

2021 ◽  
Vol 18 (4) ◽  
pp. 1695
Author(s):  
Zongshuan Duan ◽  
Yu Wang ◽  
Jidong Huang
Keyword(s):  
Mental Health ◽  
Cigarette Smoking ◽  
Tobacco Use ◽  
Mental Health Problems ◽  
Cigarette Use ◽  
Tobacco Products ◽  
Estimation Equations ◽  
Nationally Representative ◽  
Prospective Association

E-cigarettes are the most-used tobacco products among U.S. adolescents. Emerging evidence suggests that adolescents using e-cigarettes are at elevated risk for initiating cigarette smoking. However, whether this risk may differ by sex remains unknown. This study analyzed data from Wave 1 to 4 of the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative longitudinal survey. Generalized estimation equations (GEE) were performed to estimate the associations between baseline e-cigarette use and subsequent cigarette smoking, controlling for sociodemographic characteristics, mental health conditions, and other tobacco use. Effect modifications by sex were examined. Multivariate analyses showed that, among baseline never cigarette smokers, past-30-day e-cigarette use at baseline waves was significantly associated with past-30-day cigarette smoking at follow-up waves (aOR = 3.90, 95% CI: 2.51–6.08). This association was significantly stronger for boys (aOR = 6.17, 95% CI: 2.43–15.68) than for girls (aOR = 1.10, 95% CI: 0.14–8.33). Additionally, using other tobacco products, older age, and having severe externalizing mental health problems at baseline were significantly associated with an increased likelihood of cigarette smoking at follow-up. The prospective association between e-cigarette use and cigarette smoking differs by sex among U.S. adolescents. Sex-specific tobacco control interventions may be warranted to curb the youth tobacco use epidemic.

Exploring Stakeholder and Parent Perspectives of a County Response to Adolescent Vaping and E-Cigarette Use

2021 ◽  
pp. 002204262199349
Author(s):  
Natasha Kurji ◽  
Thomas Koza ◽  
Amanda Sharp ◽  
Kathleen Moore
Keyword(s):  
United States ◽  
Substance Use ◽  
The United States ◽  
Classroom Observations ◽  
School Age ◽  
Parent Perspectives ◽  
Cigarette Use ◽  
Perceived Effectiveness ◽  
Tobacco Products ◽  
Hillsborough County

In the United States, regular cigarette use has steadily declined over the years; however, it has been met with an increase in vaping and e-cigarette use. In Tampa, Florida, this trend has been found especially prevalent among school-aged youth. To combat issues of substance use among youth and prevent criminalization for nonviolent crimes, school-age youth cited for use and possession of tobacco products in Hillsborough County were mandated to attend the Youth Tobacco Awareness Course (YTAC). The aim of this study was to investigate YTAC for its perceived effectiveness and usefulness in mitigating adolescent e-cigarette use. Classroom observations, parent focus groups, and program stakeholder interviews were conducted to comprehensively evaluate this program. Findings from this evaluation led to a deeper understanding of the barriers and facilitators to an effective course, the needs and perceptions of program stakeholders, as well as recommendations for improved future interventions.

scholarly journals Electronic cigarette use intensity measurement challenges and regulatory implications

2021 ◽  
pp. tobaccocontrol-2021-056483
Author(s):  
Eric Soule ◽  
Maansi Bansal-Travers ◽  
Rachel Grana ◽  
Scott McIntosh ◽  
Simani Price ◽  
...  
Keyword(s):  
Tobacco Use ◽  
User Behavior ◽  
Unintended Consequences ◽  
Electronic Cigarette ◽  
Cigarette Use ◽  
Tobacco Products ◽  
Intensity Measures ◽  
Nicotine Concentration ◽  
Regulatory Policies ◽  
Answering Questions

Assessing tobacco use intensity allows researchers to examine tobacco use in greater detail than assessing ever or current use only. Tobacco use intensity measures have been developed that are specific to tobacco products, such as asking smokers to report number of cigarettes smoked per day. However, consensus on electronic cigarette use intensity measures that can be used for survey research has yet to be established due to electronic cigarette product and user behavior heterogeneity. While some survey measures that attempt to assess electronic cigarette use intensity exist, such as examining number of ‘times’ using an electronic cigarette per day, number of puffs taken from an electronic cigarette per day, volume of electronic cigarette liquid consumed per day, or nicotine concentration of electronic cigarette liquid, most measures have limitations. Challenges in electronic cigarette measurement often stem from variations across electronic cigarette device and liquid characteristics as well as the difficulty that many electronic cigarette users have regarding answering questions about their electronic cigarette device, liquid, or behavior. The inability for researchers to measure electronic cigarette use intensity accurately has important implications such as failing to detect unintended consequences of regulatory policies. Development of electronic cigarette use intensity measures, though not without its challenges, can improve understanding of electronic cigarette use behaviors and associated health outcomes and inform development of regulatory policies.

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