Psychosocial Factors Associated With Adolescent Electronic Cigarette and Cigarette Use

2017 ◽  
pp. 141-153
Author(s):  
Jessica L. Barrington-Trimis ◽  
Kiros Berhane ◽  
Jennifer B. Unger ◽  
Tess Boley Cruz ◽  
Jimi Huh ◽  
...  

BACKGROUND Use of electronic cigarettes (e-cigarettes) among adolescents has increased since their introduction into the US market in 2007. Little is known about the role of e-cigarette psychosocial factors on risk of e-cigarette or cigarette use in adolescence. METHODS Information on e-cigarette and cigarette psychosocial factors (use and attitudes about use in the home and among friends) was collected from 11th- and 12th-grade participants in the Southern California Children’s Health Study during the spring of 2014. RESULTS Of 2084 participants, 499 (24.0%) had used an e-cigarette, including 200 (9.6%) current users (past 30 days); 390 participants (18.7%) had smoked a combustible cigarette, and 119 (5.7%) were current cigarette smokers. Cigarette and e-cigarette use were correlated. Nevertheless, 40.5% (n = 81) of current e-cigarette users had never smoked a cigarette. Psychosocial factors (home use of each product, friends’ use of and positive attitudes toward e-cigarettes and cigarettes) and participant perception of the harm of e-cigarettes were strongly positively associated both with e-cigarette and cigarette use. Most youth who reported e-cigarette use had friends who used e-cigarettes, and almost half of current users reported that they did not believe there were health risks associated with e-cigarette use. CONCLUSIONS Longitudinal studies of adolescents are needed to determine whether the strong association of e-cigarette psychosocial factors with both e-cigarette and cigarette use will lead to increased cigarette use or dual use of cigarettes and e-cigarettes, or whether e-cigarettes will serve as a gateway to cigarette use.

2017 ◽  
pp. 101-110
Author(s):  
Jessica L. Barrington-Trimis ◽  
Robert Urman ◽  
Adam M. Leventhal ◽  
W. James Gauderman ◽  
Tess Boley Cruz ◽  
...  

BACKGROUND Use of electronic cigarettes (e-cigarettes) among adolescents has increased since their introduction into the US market in 2007. Little is known about the role of e-cigarette psychosocial factors on risk of e-cigarette or cigarette use in adolescence. METHODS Information on e-cigarette and cigarette psychosocial factors (use and attitudes about use in the home and among friends) was collected from 11th- and 12th-grade participants in the Southern California Children’s Health Study during the spring of 2014. RESULTS Of 2084 participants, 499 (24.0%) had used an e-cigarette, including 200 (9.6%) current users (past 30 days); 390 participants (18.7%) had smoked a combustible cigarette, and 119 (5.7%) were current cigarette smokers. Cigarette and e-cigarette use were correlated. Nevertheless, 40.5% (n = 81) of current e-cigarette users had never smoked a cigarette. Psychosocial factors (home use of each product, friends’ use of and positive attitudes toward e-cigarettes and cigarettes) and participant perception of the harm of e-cigarettes were strongly positively associated both with e-cigarette and cigarette use. Most youth who reported e-cigarette use had friends who used e-cigarettes, and almost half of current users reported that they did not believe there were health risks associated with e-cigarette use. CONCLUSIONS Longitudinal studies of adolescents are needed to determine whether the strong association of e-cigarette psychosocial factors with both e-cigarette and cigarette use will lead to increased cigarette use or dual use of cigarettes and e-cigarettes, or whether e-cigarettes will serve as a gateway to cigarette use.


Toxics ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 52
Author(s):  
Connor R. Miller ◽  
Hangchuan Shi ◽  
Dongmei Li ◽  
Maciej L. Goniewicz

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.


2017 ◽  
Vol 137 (6) ◽  
pp. 322-325 ◽  
Author(s):  
Jia Pu ◽  
Xiao Zhang

Objective: US adolescents are exposed to high levels of advertisements for electronic cigarettes (e-cigarettes). This study aimed to examine the associations between exposure to e-cigarette advertisements and perception, interest, and use of e-cigarettes among US middle school and high school students. Methods: Data from the 2014 cross-sectional National Youth Tobacco Survey were used. Logistic regressions were conducted to model four outcomes, including perception of reduced harmfulness compared to regular cigarettes, perception of reduced addictiveness, intention to use, and current use of e-cigarettes. Main predictors were exposure to e-cigarette advertisements via four sources, including Internet, newspaper/magazines, retail stores, and TV. Results: When all the four sources of e-cigarette advertisements exposure were evaluated jointly, exposure via the Internet was associated with elevated likelihood of reporting all four outcomes related to e-cigarettes, while exposure via retail stores was associated with higher likelihood of current e-cigarette use and perception of reduced harmfulness of e-cigarettes compared to regular cigarettes ( p < .05). However, exposure via newspaper/magazines and TV was associated with lower likelihood of perceiving e-cigarettes to be less harmful or addictive ( p < .05). Conclusion: Exposure to e-cigarette advertisements via the Internet and retail stores may play a significant role in adolescents’ use and perception of e-cigarettes. The results call for more research on the influence of different sources of advertising exposure on e-cigarette use to help public health programmes curtail the fast growing use of e-cigarette products among youth.


2018 ◽  
Vol 14 (2) ◽  
pp. 83-87
Author(s):  
Rachael Taylor ◽  
David Sidloff ◽  
Robert D. Sayers ◽  
Matthew J. Bown ◽  
Athanasios Saratzis

Introduction: Smoking is one of the most important risk factors for cardiovascular disease (CVD). Electronic cigarettes (e-cigarettes) are becoming increasingly popular. However, little is known regarding their patterns of use in patients with established CVD.Aims: We aimed to assess the perceptions and patterns of use of e-cigarettes in patients presenting to a vascular clinic.Methods: We performed a qualitative study to identify perceptions and beliefs about e-cigarettes. Semi-structured interviews of consecutive patients consenting to participate were performed over five-months. Individuals were recruited from a vascular surgery outpatient clinic. Initial interviews were based on a questionnaire. Further structured interviews were conducted with patients currently using e-cigarettes, which were transcribed and analysed to assess perceptions and patterns of use.Results/Findings: Four overarching themes emerged: attraction to e-cigarettes as a harm reduction/smoking cessation strategy; uncertainty regarding the risks of e-cigarettes; use of various types of smoking cessation strategies; dual use and often complete relapse to tobacco products.Conclusions: Patients with established CVD view e-cigarettes as a means of smoking cessation; however, many relapse to tobacco products or use both simultaneously. Further research is necessary regarding the role of e-cigarettes in smoking cessation in this high-risk group.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Jack Baichao Ding ◽  
Kevin Hu

Recent data suggests that the prevalence of smoking in schizophrenia remains high. While reports suggest that smoking increases the risk of developing schizophrenia, the potential causative role of smoking in this relationship needs further investigation. Smokers with schizophrenia are more likely to have more intense positive symptoms and lower cognitive function, but diminished intensity of extrapyramidal side effects than nonsmoking patients with schizophrenia. They were also more likely to exhibit aggressive behaviour compared to nonsmokers, which could suggest higher levels of baseline aggression. The significant cost associated with regular tobacco expenditure can detract from investment in key domains. Large-scale trials have shown that pharmacotherapy for smoking cessation is effective and does not worsen the risk of developing neuropsychiatric symptoms compared to placebo. Electronic cigarette use among schizophrenia patients is high, and there is emerging evidence supportive of its efficacy. Future improvements include large-scale trials assessing the utility, efficacy, and safety of electronic cigarettes in schizophrenia patients.


2018 ◽  
Vol 21 (10) ◽  
pp. 1331-1338 ◽  
Author(s):  
Linda Johnson ◽  
Yinjiao Ma ◽  
Sherri L Fisher ◽  
Alex T Ramsey ◽  
Li-Shiun Chen ◽  
...  

Abstract Introduction We examined past-12-month quit attempts and smoking cessation from 2006 to 2016 while accounting for demographic shifts in the US population. In addition, we sought to understand whether the current use of electronic cigarettes was associated with a change in past-12-month quit attempts and successful smoking cessation at the population level. Methods We analyzed data from 25- to 44-year-olds from the National Health Interview Survey (NHIS) from 2006 to 2016 (N = 26,354) and the Tobacco Use Supplement to the Current Population Survey (TUS-CPS) in 2006–2007, 2010–2011, and 2014–2015 (N = 33,627). Data on e-cigarette use were available in the 2014–2016 NHIS and 2014–2015 TUS-CPS surveys. Results Past-12-month quit attempts and smoking cessation increased in recent years compared with 2006. Current e-cigarette use was associated with higher quit attempts (adjusted odds ratio [aOR] = 2.29, 95% confidence interval [CI] = 1.87 to 2.81, p < .001) and greater smoking cessation (aOR = 1.64, 95% CI = 1.21 to 2.21, p = .001) in the NHIS. Multivariable logistic regression of the TUS-CPS data showed that current e-cigarette use was similarly significantly associated with increased past-12-month quit attempts and smoking cessation. Significant interactions were found for smoking frequency (everyday and some-day smoking) and current e-cigarette use for both outcomes (p < .0001) with the strongest positive effects seen in everyday smokers. Conclusions Compared with 2006, past-12-month quit attempts and smoking cessation increased among adults aged 25–44 in recent years. Current e-cigarette use was associated with increased past-12-month quit attempts and successful smoking cessation among established smokers. These findings are relevant to future tobacco policy decisions. Implications E-cigarettes were introduced into the US market over the past decade. During this period, past-12-month quit attempts and smoking cessation have increased among US adults aged 25–44. These trends are inconsistent with the hypothesis that e-cigarette use is delaying quit attempts and leading to decreased smoking cessation. In contrast, current e-cigarette use was associated with significantly higher past-12-month quit attempts and past-12-month cessation. These findings suggest that e-cigarette use contributes to a reduction in combustible cigarette use among established smokers.


2020 ◽  
Author(s):  
Arielle Selya

Abstract Background: Electronic cigarettes (“e-cigarettes”) have altered tobacco use trends, and their impacts are controversial. Given their lower risk relative to conventional cigarettes, e-cigarettes have potential for harm reduction. This study presents a simulation-based analysis of an e-cigarette harm reduction policy set in the US. Methods: A system dynamics simulation model was constructed, with separate aging chains representing different stages of use for both cigarette smokers and e-cigarette users. These structures interact with a policy module to close the gap between actual (simulated) and goal numbers of cigarette smokers, chosen to reduce the tobacco-attributable death rate to that due to all accidents in the general population. The policy is two-fold, removing existing flavor bans and providing an informational campaign promoting e-cigarettes as a lower-risk alternative. Realistic practical implementation challenges are modeled in the policy sector, including time delays, political resistance, and budgetary limitations. Effects of e-cigarettes on conventional smoking occurs through three mechanisms: 1) diversion from ever initiating conventional smoking; 2) reducing progression to established smoking; and 3) increasing smoking cessation. An important unintended effect was included, which increases the tobacco-related mortality accordingly with an increase in nicotine users due to e-cigarettes. Results: The base-case model replicated the historical exponential decline in smoking and the exponential increase in e-cigarette use since 2010. The ideal-case policy was able to reduce conventional smoking to the goal level approximately 40 years after implementation. Implementation obstacles (time delays, political resistance, and budgetary constraints) delayed and weakened the effect of the policy by up to 95% in the worst case, relative to the ideal-case scenario; however, these discrepancies substantially decreased over time in dampened oscillations as negative feedback loops stabilize the system after the one-time “shock” introduced by policy changes. Conclusions: Current findings demonstrate that the promotion of e-cigarettes as a harm-reduction policy is a viable strategy, given current knowledge of e-cigarettes’ effects on conventional smoking. Given the strong effects of implementation challenges on policy effectiveness in the short term, accurately modeling such obstacles is essential in policy design. Ongoing research is needed with forthcoming data on e-cigarette use prevalence and possible effects on cigarette smoking.


2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S62-S63
Author(s):  
Ryan Suk ◽  
Heetae Suk ◽  
Kalyani Sonawane ◽  
Ashish Deshmukh

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.


2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Jorge Espinoza-Derout ◽  
Xuesi M Shao ◽  
Jocelyn Molina-Mancio ◽  
Kamrul M Hasan ◽  
Norma Mtume ◽  
...  

Abstract Electronic nicotine delivery systems or electronic cigarettes (e-cigarettes) are becoming exceptionally popular in the world as an alternative to conventional nicotine cigarettes, both in smokers and people who have never smoked. Nicotine can induce lipolysis in adipose tissue, leading to increased serum free fatty acids (FFA). Increased levels of FFA are one of the key elements in inducing a pro-inflammatory response and lead to ectopic lipid accumulation, lipotoxicity, mitochondrial dysfunction and metabolic disease. Our laboratory has shown that chronic e-cigarette exposure induces cardiac dysfunction, atherosclerosis and hepatic steatosis in the ApoE knockout (KO) model associated with increased levels of serum FFA. In this study, we investigated the role of adipose tissue in the metabolic changes associated with e-cigarette exposure. ApoE KO mice were exposed to saline, e-cigarette without nicotine [e-cigarette (0%)] and e-cigarette with 2.4% nicotine [e-cigarette (2.4%)] aerosol for 12 weeks. Western blot analyses from adipose tissue showed that mice treated with e-cigarette (2.4%) had decrease levels of SIRT1 when compared to mice treated with saline or e-cigarette (0%). Transcriptomic analysis of the differentially expressed genes shows a differential transcriptional response to e-cigarette (2.4%) in adipose tissue in comparison with e-cigarette (0%) or saline. The RNA-seq examination using ingenuity pathway analysis (IPA) software, revealed dysregulation of fibrosis, agranulocyte and granulocyte adhesion and diapedesis pathways in e-cigarette (2.4%) -exposed adipose tissue. Overall, we found an inflammatory phenotype associated with decreased levels of SIRT1 in adipose tissue of mice treated with e-cigarette (2.4%). Understanding the consequences of e-cigarette use on metabolic disease is directly relevant to the development of policies related to e-cigarette use.


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