Changes in knowledge, perceptions and use of JUUL among a cohort of young adults

ObjectiveE-cigarettes have gained popularity, most recently with pod-style devices, such as JUUL. We examined changes in JUUL awareness, use, perceptions, nicotine content knowledge, number of days a pod lasts and exposure to JUUL retail advertising over a 6-month period in a cohort of young adults.MethodsIn spring and fall 2018, 1836 young adults completed online surveys on tobacco use, including JUUL perceptions and use behaviours. Demographics, tobacco use and JUUL advertising exposure in spring 2018 were examined as predictors of current JUUL use in fall 2018.ResultsEver and current JUUL use doubled in 6 months (5.9% vs 12.7%, p<0.001; 1.6% vs 3.4%, p<0.001). The number of days a JUUL pod lasts significantly changed (p=0.049). Although there was an increase in those reporting JUUL has as much or more nicotine than a pack of cigarettes, 58% are ‘not sure’ of JUUL’s nicotine content. Exposure to JUUL’s advertising significantly increased (31.8% to 46.4%; p<0.001). In multivariable models, those perceiving JUUL as or more harmful than cigarettes, and former and never cigarette smokers had significantly lower odds of current JUUL use at 6 months compared with their respective counterparts (p<0.0001). Those reporting exposure to JUUL’s advertising had significantly increased odds of current JUUL use 6 months later (p<0.03).ConclusionsFindings demonstrate changes in knowledge of JUUL’s nicotine content, perceptions and use over a short period of time, suggesting frequent measurement is necessary. Additionally, efforts are needed to regulate retail advertising and ensure consumer education about product risks as they are associated with current use.

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Heat-not-burn Tobacco Products and the Increased Risk for Poly-tobacco Use

American Journal of Health Behavior ◽

10.5993/ajhb.45.1.16 ◽

2021 ◽

Vol 45 (1) ◽

pp. 195-204

Author(s):

Pallav Pokhrel ◽

Thaddeus A. Herzog ◽

Crissy T. Kawamoto ◽

Pebbles Fagan

Keyword(s):

Smoking Cessation ◽

Young Adults ◽

Tobacco Use ◽

Tobacco Product ◽

Dual Use ◽

Cigarette Smokers ◽

Product Use ◽

Increased Risk ◽

Current Cigarette

Objectives: In this study, we tested the use of ecigarette, cigarette, and dual use of both as predictors of heat-not-burn (HNB) tobacco product use onset among young adults, and examined common predictors of smoking cessation as predictors of HNB product use. Methods: We collected data from 2229 young adults [mean age = 21.1 (SD = 2.1); 55% women] in Hawaii, at 2 time-points 6 months apart. Results: Current cigarette-only use was the strongest concurrent predictor of HNB product use, followed by dual use, and ecigarette-only use. Among HNB product never users at Wave 1, dual and ecigarette-only use at Wave 1 significantly predicted HNB product use onset at Wave 2. Among cigarette smokers who had never used an HNB product at Wave 1, current use of ecigarette for help with smoking cessation predicted increased odds of HNB product use at 6-month follow-up. Conclusions: Although promoted as a safer alternative for exclusive cigarette smokers, HNB products may increase the risk of dual or poly-tobacco product use among young adults, including current exclusive e-cigarette users. Surveillance of HNB product use as a modified risk tobacco product may need to consider the effects of HNB products on poly-tobacco use among young people.

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Tobacco Advertisement Liking, Vulnerability Factors, and Tobacco Use Among Young Adults

Nicotine & Tobacco Research ◽

10.1093/ntr/nty220 ◽

2018 ◽

Vol 21 (3) ◽

pp. 300-308 ◽

Cited By ~ 6

Author(s):

Brianna A Lienemann ◽

Shyanika W Rose ◽

Jennifer B Unger ◽

Helen I Meissner ◽

M Justin Byron ◽

...

Keyword(s):

Young Adults ◽

Educational Attainment ◽

Tobacco Use ◽

Smokeless Tobacco ◽

The United States ◽

Vulnerability Factors ◽

Poverty Level ◽

Advertising Exposure ◽

Marketing Messages ◽

Lower Educational Attainment

Abstract Introduction Young adulthood (aged 18–24) is a crucial period in the development of long-term tobacco use patterns. Tobacco advertising and promotion lead to the initiation and continuation of smoking among young adults. We examined whether vulnerability factors moderated the association between tobacco advertisement liking and tobacco use in the United States. Methods Analyses were conducted among 9109 US young adults in the nationally representative Population Assessment of Tobacco and Health (PATH) Study wave 1 (2013–14). Participants viewed 20 randomly selected sets of tobacco advertisements (five each for cigarettes, e-cigarettes, cigars, and smokeless tobacco) and indicated whether they liked each ad. The outcome variables were past 30-day cigarette, e-cigarette, cigar, and smokeless tobacco use. Covariates included tobacco advertisement liking, age, sex, race or ethnicity, sexual orientation, education, poverty level, military service, and internalizing and externalizing mental health symptoms. Results Liking tobacco advertisements was associated with tobacco use, and this association was particularly strong among those with lower educational attainment (cigarettes, cigars) and living below the poverty level (e-cigarettes, smokeless tobacco). Conclusions The association between tobacco advertisement liking and tobacco use was stronger among young adults with lower educational attainment and those living below the poverty level. Policies that restrict advertising exposure and promote counter-marketing messages in this population could reduce their risk. Implications This study shows that liking tobacco advertisements is associated with current tobacco use among young adults, with stronger associations for vulnerable young adults (ie, lower education levels and living below the poverty level). Findings suggest a need for counter-marketing messages, policies that restrict advertising exposure, and educational interventions such as health and media literacy interventions to address the negative influences of tobacco advertisements, especially among young adults with a high school education or less and those living below the poverty level.

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‘Ice’ flavoured e-cigarette use among young adults

Tobacco Control ◽

10.1136/tobaccocontrol-2020-056416 ◽

2021 ◽

pp. tobaccocontrol-2020-056416

Author(s):

Adam Leventhal ◽

Hongying Dai ◽

Jessica Barrington-Trimis ◽

Steve Sussman

Keyword(s):

Young Adults ◽

Los Angeles ◽

Tobacco Use ◽

Cross Sectional Study ◽

Cigarette Use ◽

Cross Sectional ◽

Web Based ◽

The Past ◽

Frequency Of Use ◽

Exposure Variable

Background‘Ice’ e-cigarette flavours—marketed as a combination of fruity/sweet and cooling flavours (eg, ‘blueberry ice’ or ‘melon ice’)—recently entered the US market. The prevalence and correlates of ice flavoured e-cigarette use in young adults are unknown.MethodsThis cross-sectional study of a Los Angeles, California, USA, cohort analysed data from the past 30-day e-cigarette (current) users (n=344; M (SD)=21.2 (0.4) years old) who completed web-based surveys from May–August 2020. The exposure variable was self-reported e-cigarette flavour used most often in the past month (menthol/mint, fruit/sweet or ice). Outcomes included self-reported combustible tobacco use, vaping dependence symptoms, frequency of use and device type used.ResultsAmong current e-cigarette users, 48.8% reported using ice flavours most often, 33.7% predominately used fruit/sweet and 17.4% used menthol/mint. Using primarily ice-flavour was associated with reporting more past-30-day vaping days (vs menthol/mint: b=4.4, 95% CI (1 to 7.7); vs fruit/sweet: b=3.6, 95% CI (0.8 to 6.4)) and more episodes per vaping day versus fruit/sweet users (b=2.4, 95% CI (0.5 to 4.3)). Ice-flavour users were less likely than menthol/mint users to use JUUL/cartridge-based rechargeable (OR=0.1, 95% CI (0.03 to 0.45)) and more likely than sweet/fruit users to use disposable non-cartridge (OR=3.9, 95% CI (2.1 to 7.4)) devices than refillable/rechargeable tank/pen or other devices. Ice users had greater odds of past 30-day combustible tobacco use versus menthol/mint users (OR=2.7, 95% CI (1.3 to 5.7)) and vaping dependence symptoms than versus sweet/fruit users (OR=2.6, 95% CI (1.5 to 4.4)).ConclusionYoung adult use of ice flavoured e-cigarettes may be common and positively associated with combustible tobacco use, nicotine vaping frequency and dependence and use of disposable e-cigarette devices. Further study of the prevalence, determinants and health effects of ice flavoured e-cigarette use is warranted.

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The effect of 13 weeks of running training followed by 9 d of detraining on postprandial lipaemia

British Journal Of Nutrition ◽

10.1017/s0007114598001779 ◽

1998 ◽

Vol 80 (1) ◽

pp. 57-66 ◽

Cited By ~ 51

Author(s):

Sara L. Herd ◽

Adrianne E. Hardman ◽

Leslie H. Boobis ◽

Caroline J. Cairns

Keyword(s):

Young Adults ◽

Training Session ◽

Acute Effect ◽

Single Session ◽

High Fat ◽

Postprandial Lipaemia ◽

Blood Samples ◽

Running Training ◽

Short Period ◽

Fat Meal

The present study examined the influence of training, followed by a short period of detraining, on postprandial lipaemia. Fourteen normolipidaemic, recreationally active young adults aged 18–31 years participated, in two self-selected groups: three men and five women (BMI 21·7–27·6 kg/m2) completed 13 weeks of running training, after which they refrained from exercise for 9 d; three men and three women (BMI 21·5–25·6 kg/m2) maintained their usual lifestyle. Oral fat tolerance tests were conducted at baseline and again 15 h, 60 h and 9 d after the runners' last training session. Blood samples were drawn after an overnight fast and at intervals for 6 h after consumption of a high-fat meal (1·2 g fat, 1·4 g carbohydrate, 70·6 kJ energy/kg body mass). Heparin was then administered (100 IU/kg) and a further blood sample was drawn for measurement of plasma lipoprotein lipase (EC3.1.1.34; LPL) activity. Endurance fitness improved in runners, relative to controls (maximal O2uptake +3·2 (SE 1·1) ml/kg per minv.− 1·3 (SE 1·2) ml/kg per min; P < 0·05). In the absence of the acute effect of exercise, i.e. 60 h after the last training session, there was no effect of training on either postprandial lipaemia or on post-heparin LPL activity. However, changes during 9 d of detraining in both these variables differed significantly between groups; after 2 d without exercise (60 h test), the runners' lipaemic response was 37% higher than it was the morning after their last training session (15 h test; runnersv.controlsP< 0·05), with a reciprocal decrease in post-heparin LPL activity (P< 0·01). These findings suggest that improved fitness does not necessarily confer an effect on postprandial lipaemia above that attributable to a single session of exercise.

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The influence of cannabis motives on alcohol, cannabis, and tobacco use among treatment-seeking cigarette smokers

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2014.11.013 ◽

2015 ◽

Vol 146 ◽

pp. 81-88 ◽

Cited By ~ 11

Author(s):

Dawn W. Foster ◽

Nicholas P. Allan ◽

Michael J. Zvolensky ◽

Norman B. Schmidt

Keyword(s):

Tobacco Use ◽

Treatment Seeking ◽

Cigarette Smokers

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The Effect of Branding to Promote Healthy Behavior: Reducing Tobacco Use among Youth and Young Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph14121517 ◽

2017 ◽

Vol 14 (12) ◽

pp. 1517 ◽

Cited By ~ 22

Author(s):

Donna Vallone ◽

Marisa Greenberg ◽

Haijun Xiao ◽

Morgane Bennett ◽

Jennifer Cantrell ◽

...

Keyword(s):

Young Adults ◽

Tobacco Use ◽

Healthy Behavior ◽

Youth And Young Adults

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Waterpipe tobacco use in college and non-college young adults in the USA

Family Practice ◽

10.1093/fampra/cmy037 ◽

2018 ◽

Vol 36 (2) ◽

pp. 103-109 ◽

Cited By ~ 5

Author(s):

Jaime E Sidani ◽

Ariel Shensa ◽

Jonathan Yabes ◽

Carl Fertman ◽

Brian A Primack

Keyword(s):

Young Adults ◽

Tobacco Use ◽

The Usa

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Effect of a hypothetical modified risk tobacco product claim on heated tobacco product use intention and perceptions in young adults

Tobacco Control ◽

10.1136/tobaccocontrol-2021-056479 ◽

2021 ◽

pp. tobaccocontrol-2021-056479

Author(s):

Julia C Chen-Sankey ◽

Afton Kechter ◽

Jessica Barrington-Trimis ◽

Rob McConnell ◽

Evan A Krueger ◽

...

Keyword(s):

Young Adults ◽

Tobacco Product ◽

Cigarette Use ◽

Dual Use ◽

Cigarette Smokers ◽

Web Based ◽

Experimental Effect ◽

Current Cigarette ◽

Product Claim ◽

Related Harm

IntroductionModified risk tobacco product (MRTP) claims for heated tobacco products (HTPs) that convey reduced exposure compared with conventional cigarettes may promote product initiation and transition among young people. We assessed the effects of a hypothetical MRTP claim for HTPs on young adults’ intention and perceptions of using HTPs and whether these effects differed by their current cigarette and e-cigarette use.MethodsWe embedded a randomised between-subjects experiment into a web-based survey administered among a cohort of 2354 Southern California young adults (aged 20–23) in 2020. Participants viewed depictions of HTPs with an MRTP claim (n=1190) or no claim (n=1164). HTP use intention and HTP-related harm and use perceptions relative to cigarettes and e-cigarettes were assessed.ResultsOverall, participants who viewed versus did not view the claim did not differ in HTP use intention (28.5% vs 28.7%) but were more likely to perceive HTPs as less harmful than cigarettes (11.4% vs 7.0%; p<0.001). The experimental effect on HTP use intention did not differ among past 30-day cigarette smokers versus non-smokers (interaction adjusted OR (AOR)=0.78, 95% CI 0.36 to 1.76) but differed among past 30-day e-cigarette users versus non-users (interaction AOR=1.67, 95% CI 1.02 to 2.68).DiscussionThe hypothetical MRTP claim may lower young adults’ HTP harm perceptions compared with cigarettes but may not change HTP use intention overall or differentially for cigarette smokers. The larger effect on HTP use intention among e-cigarette users than non-users raises the question of whether MRTP claims may promote HTP use or HTP and e-cigarette dual use among young e-cigarette users.

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The Progression of the Tobacco Epidemic in India on the National and Regional Levels, 1998-2016

10.21203/rs.3.rs-117370/v1 ◽

2020 ◽

Author(s):

Rufi Shaikh ◽

Fanny Janssen ◽

Tobias Vogt

Keyword(s):

Tobacco Use ◽

Smokeless Tobacco ◽

Family Health ◽

Developed Countries ◽

Tobacco Consumption ◽

Comprehensive Overview ◽

Middle Income ◽

The North ◽

Short Period ◽

Tobacco Epidemic

Abstract Background: According to the smoking epidemic framework, societies undergo successive stages in which the prevalence of tobacco use first increases, and then declines. This pattern was has been extensively documented for developed countries, but evidence that it has occurred in low- and middle-income countries remains fragmented. We assessed the progression of the tobacco epidemic in India on the national and regional levels by gender, including trends in the consumption of smokeless tobacco, to provide a comprehensive overview of tobacco use in India and its states.Methods: We use information on current tobacco consumption among Indians aged 15-49 from three rounds of the National Family Health Survey (NFHS) (1998-99, 2005-06, 2015-16) to estimate the age-standardized smoking and smokeless tobacco prevalence across India and its states.Results: Age-standardized tobacco consumption prevalence in India increased between 1998-99 and 2005-06, and declined from 2005-06 to 2015-2016, simultaneously for men and women. There are substantial spatial differences in the progression of the tobacco epidemic in India. In the north-eastern states in particular, tobacco consumption prevalence remains higher than the national average, and is still increasing. Conclusions: Our results suggest that India and the majority of its states experienced a ‘compressed tobacco epidemic’ in which the prevalence of tobacco consumption increased and decreased simultaneously for women and men over a comparatively short period of time. Despite the overall progress in reducing tobacco use India has made, further lowering tobacco consumption remains a public health priority, as the prevalence of smoking and/or smokeless tobacco use remains high in a number of states. We therefore conclude that tobacco regulations should be expanded with the aim of reducing the overall health burden associated with tobacco consumption across India.

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Sensory attributes of e-cigarette flavours and nicotine as mediators of interproduct differences in appeal among young adults

Tobacco Control ◽

10.1136/tobaccocontrol-2019-055172 ◽

2019 ◽

pp. tobaccocontrol-2019-055172 ◽

Cited By ~ 1

Author(s):

Adam Leventhal ◽

Junhan Cho ◽

Jessica Barrington-Trimis ◽

Raina Pang ◽

Sara Schiff ◽

...

Keyword(s):

Young Adults ◽

Interaction Effects ◽

Sensory Attributes ◽

Electronic Cigarette ◽

Free Products ◽

Nicotine Content ◽

Visual Analogue Scales ◽

Subject Design ◽

Aversive Taste ◽

Analogue Scales

ObjectiveTo estimate the extent to which specific sensory attributes, for example, smoothness, mediate differences in electronic cigarette (e-cigarette) appeal between products in non-tobacco versus tobacco flavours and varying nicotine content in young adults.MethodE-cigarette users (n=100; aged 18–34 years) administered standardised two-puff e-cigarette doses of different products varying in a flavour (fruit, menthol, tobacco) × nicotine (nicotine-containing (6 mg/mL freebase), nicotine-free) within-subject design. Participants rated sensory attributes (sweetness, bitterness, smoothness and harshness) and appeal on 100-unit visual analogue scales after administering each product. Sensory ratings were tested as simultaneous mediators of flavour, nicotine and flavour × nicotine effects on appeal.ResultsAppeal preferences for fruit versus tobacco flavours were mediated by sweetness-enhancing (βindirect=0.092), smoothness-enhancing (βindirect=0.045) and bitterness-reducing (βindirect=0.072) effects of fruit flavours. Appeal preferences for menthol versus tobacco flavours were mediated by menthol’s smoothness-enhancing (βindirect=0.039) and bitterness-reducing (βindirect=0.034) effects. Lower appeal of nicotine-containing versus nicotine-free products was mediated by nicotine’s sweetness-reducing (βindirect=–0.036), smoothness-reducing (βindirect=–0.156) and bitterness-increasing (βindirect=0.045) effects. Flavour × nicotine interaction effects on appeal were explained by menthol-related suppression of nicotine’s bitterness-enhancing and sweetness-reducing mediation pathways and fruit-related suppression of nicotine’s bitterness-enhancing mediation pathway. Harshness did not mediate appeal after adjusting for other sensory attributes.ConclusionBitterness and smoothness may be cross-cutting mediators of interproduct variation in the effects of types of non-tobacco flavours and nicotine on e-cigarette appeal in young adults. Sweetness may also mediate appeal-enhancing effects of fruit and appeal-reducing effects of nicotine. Non-tobacco flavours may suppress appeal-reducing effects of nicotine in e-cigarettes through attenuation of nicotine’s aversive taste attributes.

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