Polytobacco Use Among a Nationally-Representative Sample of Black Adolescents

Abstract Introduction. Studies of the patterns of polytobacco use have increased. However, understanding the patterns of using multiple tobacco products among Black adolescents is minimal. This study identified the patterns of polytobacco use among U.S. Black adolescents. Methods. Latent class analysis (LCA) was used to identify patterns of adolescent polytobacco use among a representative sample of Black youth from the 2017 Youth Risk Behavior Survey (n=2,782). Ever and recent (past 30 day) use of cigarettes, electronic cigarettes, cigars, and dip or chewing tobacco were used as latent class indicators. Multinomial regression was conducted to identify the association if smoking adjusting for sex, age, grade, and marijuana use.Results. Most students were in the 9th grade (29%), e-cigarette users (21%) and were current marijuana users (25%). Three profiles of tobacco use were identified: Class 1: Non-smokers (81%), Class 2: E-cigarette Users (14%), and Class 3: Polytobacco Users (5%). Black adolescent Polytobacco users were the smallest class, but had the highest conditional probabilities of recent cigarette use, e-cigarette use, ever smoking cigars or chewing tobacco. Ever and current use of marijuana were associated with increased odds of being in the e-cigarette user versus non-smoker group, and current marijuana use was associated with increased odds of polytobacco use (aOR=24.61, CI=6.95-87.11). Conclusions. Findings suggests the need for targeted interventions for reducing tobacco use and examining the unique effects of polytobacco use on Black adolescents. Findings confirm a significant association of marijuana use with tobacco use.

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Polytobacco use among a nationally-representative sample of black high school students

BMC Public Health ◽

10.1186/s12889-021-10228-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tamika D. Gilreath ◽

Derek T. Dangerfield ◽

Francisco A. Montiel Ishino ◽

Ashley V. Hill ◽

Renee M. Johnson

Keyword(s):

High School Students ◽

Tobacco Use ◽

Representative Sample ◽

Latent Class ◽

Electronic Cigarettes ◽

Black Adolescents ◽

Marijuana Use ◽

Cigarette Use ◽

Chewing Tobacco ◽

Targeted Interventions

Abstract Background Studies of the patterns of polytobacco use have increased. However, understanding the patterns of using multiple tobacco products among Black adolescents is minimal. This study identified the patterns of polytobacco use among U.S. Black adolescents. Methods Latent class analysis (LCA) was used to identify patterns of adolescent polytobacco use among a representative sample of Black youth from the 2017 Youth Risk Behavior Survey (n = 2782). Ever and recent (past 30 day) use of cigarettes, electronic cigarettes, cigars, and dip or chewing tobacco were used as latent class indicators. Multinomial regression was conducted to identify the association if smoking adjusting for sex, age, grade, and marijuana use. Results Most students were in the 9th grade (29%), e-cigarette users (21%) and were current marijuana users (25%). Three profiles of tobacco use were identified: Class 1: Non-smokers (81%), Class 2: E-cigarette Users (14%), and Class 3: Polytobacco Users (5%). Black adolescent Polytobacco users were the smallest class, but had the highest conditional probabilities of recent cigarette use, e-cigarette use, ever smoking cigars or chewing tobacco. Ever and current use of marijuana were associated with increased odds of being in the e-cigarette user versus non-smoker group, and current marijuana use was associated with increased odds of polytobacco use (aOR = 24.61, CI = 6.95–87.11). Conclusions Findings suggests the need for targeted interventions for reducing tobacco use and examining the unique effects of polytobacco use on Black adolescents. Findings confirm a significant association of marijuana use with tobacco use.

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Polytobacco Use Among a Nationally-Representative Sample of Black High School Students

10.21203/rs.3.rs-44786/v1 ◽

2020 ◽

Author(s):

Tamika D. Gilreath ◽

Derek T. Dangerfield ◽

Francisco A. Montiel Ishino ◽

Ashley V. Hill ◽

Renee M. Johnson

Keyword(s):

High School Students ◽

Tobacco Use ◽

Representative Sample ◽

Latent Class ◽

Electronic Cigarettes ◽

Black Adolescents ◽

Marijuana Use ◽

Cigarette Use ◽

Chewing Tobacco ◽

Targeted Interventions

Abstract Introduction. Studies of the patterns of polytobacco use have increased. However, understanding the patterns of using multiple tobacco products among Black adolescents is minimal. This study identified the patterns of polytobacco use among U.S. Black adolescents. Methods. Latent class analysis (LCA) was used to identify patterns of adolescent polytobacco use among a representative sample of Black youth from the 2017 Youth Risk Behavior Survey (n = 2,782). Ever and recent (past 30 day) use of cigarettes, electronic cigarettes, cigars, and dip or chewing tobacco were used as latent class indicators. Multinomial regression was conducted to identify the association if smoking adjusting for age, grade, and marijuana use. Results. Most students were in the 9th grade (29%), e-cigarette users (21%) and were current marijuana users (25%). Three profiles of tobacco use were identified: Class 1: Non-smokers (81%), Class 2: E-cigarette Users (14%), and Class 3: Polytobacco Users (5%). Black adolescent Polytobacco users were the smallest class, but had the highest conditional probabilities of recent cigarette use, e-cigarette use, ever smoking cigars or chewing tobacco. Ever and current use of marijuana were associated with increased odds of being in the e-cigarette user versus non-smoker group, and current marijuana use was associated with increased odds of polytobacco use (aOR = 24.61, CI = 6.95–87.11). Conclusions. Findings suggests the need for targeted interventions for reducing tobacco use and examining the unique effects of polytobacco use on Black adolescents. Findings confirm a significant association of marijuana use with tobacco use.

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Invited Commentary: The Epidemiology of Electronic Cigarettes and Reproductive Health Begins

American Journal of Epidemiology ◽

10.1093/aje/kwaa066 ◽

2020 ◽

Author(s):

David A Savitz

Keyword(s):

Reproductive Health ◽

Tobacco Use ◽

Electronic Cigarettes ◽

Electronic Cigarette ◽

Cigarette Use ◽

Full Spectrum ◽

Extensive Documentation ◽

Exposure Profile ◽

Individual Decisions ◽

Complex Subject

Abstract Harlow et al. (Am J Epidemiol. 2020;000(00):000–000) are among the first to tackle the complex subject of electronic cigarette use and reproductive health, focused on fecundity but pertinent to the full spectrum of reproductive health concerns. Despite extensive documentation of the health harm from tobacco use and a shared exposure to nicotine, electronic cigarette (e-cigarette) users have a markedly different exposure profile. Because e-cigarettes might help to curtail or eliminate tobacco smoking, the health comparisons of interest for e-cigarettes should include cigarette smoking as well as no use of such products. These researchers confront significant methodological challenges in the study of reproductive health effects of e-cigarettes: addressing confounding with little information on the characteristics of e-cigarette users, a complex connection between e-cigarette and tobacco use, multiple and poorly understood exposure to e-cigarette vapors, and lack of a standard method for quantifying exposure. Evidence is urgently needed to inform regulation and individual decisions regarding the use of this potentially harmful product that might well entice new users of nicotine, some of whom progress to tobacco use, but that also has the potential to enable otherwise recalcitrant smokers to substitute a less harmful product.

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Tobacco Use Trajectories in Young Adults: Analyses of Predictors Across Systems Levels

Nicotine & Tobacco Research ◽

10.1093/ntr/ntaa048 ◽

2020 ◽

Vol 22 (11) ◽

pp. 2075-2084

Author(s):

Carla J Berg ◽

Regine Haardörfer ◽

Angela Lanier ◽

Donyale Childs ◽

Bruce Foster ◽

...

Keyword(s):

College Students ◽

Substance Use ◽

Young Adult ◽

Tobacco Use ◽

Urban Areas ◽

Marijuana Use ◽

Tobacco Product ◽

Multinomial Regression ◽

Adult College Students ◽

College Type

Abstract Introduction Research is needed to examine trajectories of tobacco use beyond cigarette smoking, particularly during emerging middle young adulthood, and to identify distinct multilevel influences of use trajectories. Aims and Methods We examined (1) tobacco use trajectories over a 2-year period among 2592 young adult college students in a longitudinal cohort study and (2) predictors of these trajectories using variables from a socioecological framework, including intrapersonal-level factors (eg, sociodemographics, psychosocial factors [eg, adverse childhood experiences, depressive symptoms, and attention-deficit hyperactivity disorder symptoms], early-onset substance use), interpersonal factors (eg, social support, parental substance use), and community-level factors (eg, college type, rural vs. urban). Results About 64.5% were female and 65.0% were white. From age 18 to 26, 27%–31% of participants reported past 30-day use of any tobacco product. We identified four trajectory classes: Abstainers/Dabblers who never or infrequently used (89.2%); Adult users who began using frequently around age 20 and continued thereafter (5.9%); College Smokers who began using before 19 but ceased use around 25 (2.5%); and Teenage users who used during their teenage years but ceased use by 22 (1.9%). Multinomial regression showed that, compared to Abstainers/Dabblers, significant predictors (p < .05) of being (1) Adult users included being male, earlier onset marijuana use, attending public universities or technical colleges (vs. private universities), and living in urban areas; (2) College users included being male, earlier onset marijuana use, and parental alcohol or marijuana use; and (3) Teenage users included only earlier onset marijuana use. Conclusion Distinct prevention and intervention efforts may be needed to address the trajectories identified. Implications Among young adult college students, the largest proportion of tobacco users demonstrate the risk of continued and/or progression of tobacco use beyond college. In addition, specific factors, particularly sex, earlier onset marijuana use, parental use of alcohol and marijuana, and contextual factors such as college setting (type of school, rural vs. urban) may influence tobacco use outcomes. As such, prevention and cessation intervention strategies are needed to address multilevel influences.

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Unstructured Socializing With Peers and Risk of Substance Use: Where Does the Risk Begin?

Journal of Drug Issues ◽

10.1177/0022042618774263 ◽

2018 ◽

Vol 48 (3) ◽

pp. 452-471 ◽

Cited By ~ 7

Author(s):

Ryan Charles Meldrum ◽

Anna Leimberg

Keyword(s):

Substance Use ◽

Tobacco Use ◽

Marijuana Use ◽

Cigarette Use ◽

Minimum Threshold ◽

Minimum Number ◽

Unstructured Socializing

Research finds that unstructured socializing with peers is positively associated with substance use, but important issues remain underexamined. Specifically, does the risk of substance use resulting from time spent engaged in unstructured socializing with peers begin immediately, or is a certain minimum threshold of time spent with peers required? To investigate this, data were collected on a statewide sample of adolescents from Florida. Results indicate the minimum required amount of time spent engaging in unstructured socializing with peers to pose a risk of alcohol or marijuana use is 3 to 5 hr per week. For tobacco use outcomes, the minimum number of hours required to pose a risk is higher, particularly for cigarette use, where risk begins at more than 20 hr per week. Supplementary analyses indicate that for alcohol and marijuana use there is a decelerating risk stemming from additional hours spent engaging in unstructured socializing with peers.

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Sex and Polytobacco Use among Spanish and Turkish University Students

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16245038 ◽

2019 ◽

Vol 16 (24) ◽

pp. 5038 ◽

Cited By ~ 3

Author(s):

Sílvia Font-Mayolas ◽

Mark J. M. Sullman ◽

Maria-Eugenia Gras

Keyword(s):

Young Adults ◽

University Students ◽

Tobacco Use ◽

Electronic Cigarettes ◽

Common Reason ◽

Future Research ◽

Cigarette Use ◽

Tobacco Products ◽

Concurrent Use ◽

Turkish University Students

Polytobacco use has become increasingly popular among young adults, particularly males, and can be defined as the concurrent use of regular cigarettes and other tobacco products (e.g., e-cigarettes). The present study investigated the use of legal smoking products (cigarettes, waterpipe and electronic cigarettes) among young adults (n = 355) in Spain and Turkey. The survey measured demographics, lifetime and past month tobacco use, waterpipe and e-cigarette use, whether waterpipes and e-cigarettes contained nicotine and reasons for using these substances. The majority of the Turkish (men = 80% and women = 63.9%) and Spanish sample (men = 61.4% and women = 69.3%) were polytobacco users. The most common reason for using e-cigarettes was “to experiment, to see what is like” (Turkish sample: men 66.7% and women 57.1; Spanish sample: men 72.7% and women 93.8%). The most common reason to use regular cigarettes was “to relax and relieve tension” (Turkish sample: men 88.9% and women 77.6%; Spanish sample: men 78.1% and women 76%), while for waterpipe users, the most common reason was “to experiment, to see what it is like” (Turkish sample: men 93.3% and women 80%; Spanish sample: men 78.9% and women 93.8%). The implications for prevention and future research are discussed.

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Flavored Electronic Cigarette Use and Smoking Among Youth

10.1542/9781610022743-flavored ◽

2017 ◽

pp. 68-75

Author(s):

Hongying Dai ◽

Jianqiang Hao

Keyword(s):

Tobacco Use ◽

Odds Ratio ◽

Logistic Regression Model ◽

Adjusted Odds Ratio ◽

Electronic Cigarettes ◽

The United States ◽

Intention To Quit ◽

Cigarette Use ◽

Current Smoking ◽

Control And Prevention

BACKGROUND AND OBJECTIVE Flavored electronic cigarettes (e-cigarettes) are not prohibited in the United States, and e-cigarette flavors proliferate on the market. This study sought to examine flavored e-cigarette use and its association with smoking among youth. METHODS Estimates of flavored e-cigarette use from the 2014 National Youth Tobacco Survey were investigated. A logistic regression model was used to assess whether flavored e-cigarette use was associated with (1) intention to initiate cigarette use among never-smoking youth (n = 16 471), (2) intention to quit tobacco use among current-smoking youth (n = 1338), and (3) perception of tobacco’s danger among all respondents (n = 21 491). RESULTS A total of 2017 respondents reported using e-cigarettes in the last 30 days, of whom 1228 (60.9%) reported using flavored e-cigarettes. Among never-smoking youth, 55.6% (288) of current e-cigarette users reported using flavored e-cigarettes. Among current smokers, 68.4% (495) of current e-cigarette users reported using flavored e-cigarettes. Compared with not using e-cigarettes in the past 30 days, using flavored e-cigarettes was associated with higher odds of intention to initiate cigarette use among never-smoking youth (adjusted odds ratio [aOR] = 5.7; P < .0001), lower odds of intention to quit tobacco use among current-smoking youth (aOR = 0.6; P = .006), and a lower prevalence of perception of tobacco’s danger among all respondents (aOR = 0.5; P < .0001). CONCLUSIONS Flavored e-cigarette use is associated with increased risks of smoking among youth. Comprehensive tobacco control and prevention strategies that address flavored e-cigarette products are critically needed to reduce tobacco use among youth.

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A Comparison of Dependence Across Different Types of Nicotine Containing Products and Coffee

10.20944/preprints201805.0382.v1 ◽

2018 ◽

Author(s):

Karl Fagerström

Keyword(s):

Representative Sample ◽

Electronic Cigarettes ◽

Coffee Consumption ◽

Cigarette Use ◽

Tobacco Products ◽

Nicotine Replacement ◽

Heavy Smoking ◽

Different Types ◽

Smoking Index

Introduction. Few studies have compared the dependence to different tobacco and nicotine products. Besides how dependence may vary between tobacco products there is even less known how it relates to other common drugs, e.g. caffeine. In this study degree of dependence was compared between snus, cigarettes, nicotine replacement (NR), electronic cigarettes and coffee. Methods. An internet panel was used to obtain a representative sample of 3001 Swedes. The responders were asked among other related things about their use of snus, NR, traditional cigarette or e-cigarette use and coffee consumption. The indicators of dependence used were: A. the Heavy Smoking Index, B. The proportions that used within 30 min after raising in the morning, C. rating the first use in the morning as the most important and D. Stating that it would be very hard to give up entirely. Results. Significantly fewer among coffee drinkers started use within 30 minutes of awakening compared with all other products. The first use of the day was found to be more important for snus users compared with other products. On HSI there was no difference between snus and cigarettes. Snus and cigarettes were rated as being more difficult to give up than NR and coffee. Conclusion. Dependence to traditional cigarettes and snus seem to be relatively similar while NR was rated lower and coffee lowest. Since the prevalence of caffeine use in all forms is so much more prevalent than nicotine use there might be more persons in the society heavily dependent on caffeine. Implication. Tobacco products are likely more dependence forming that NR products and coffee. The addiction to coffee or caffeine is seldom discussed in the society. But if there are more individuals heavily dependent on coffee than nicotine and some nicotine containing products like snus and even more so NR are not that much more harmful than coffee how problematic is the addiction?

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Discordance between perceived and actual tobacco product use prevalence among US youth: a comparative analysis of electronic and regular cigarettes

Tobacco Control ◽

10.1136/tobaccocontrol-2017-054113 ◽

2018 ◽

Vol 28 (2) ◽

pp. 212-219 ◽

Cited By ~ 1

Author(s):

Israel Terungwa Agaku ◽

Satomi Odani ◽

David Homa ◽

Brian Armour ◽

Rebecca Glover-Kudon

Keyword(s):

Tobacco Use ◽

Electronic Cigarettes ◽

Statistical Significance ◽

Tobacco Product ◽

Cigarette Use ◽

Cross Sectional ◽

Media Messages ◽

School Based ◽

Nationally Representative ◽

Actual Prevalence

ImportanceTwo components of social norms—descriptive (estimated prevalence) and injunctive (perceived acceptability)—can influence youth tobacco use.ObjectiveTo investigate electronic cigarettes (e-cigarette) and cigarette descriptive norms and measure the associations between overestimation of e-cigarette and cigarette prevalence and tobacco-related attitudes and behaviours.DesignCross-sectional.SettingSchool-based, using paper-and-pencil questionnaires.ParticipantsUS 6th-12th graders participating in the 2015 (n=17 711) and 2016 (n=20 675) National Youth Tobacco Survey.ExposureStudents estimated the percent of their grade-mates who they thought used e-cigarettes and cigarettes; the discordance between perceived versus grade-specific actual prevalence was used to categorise students as overestimating (1) neither product, (2) e-cigarettes only, (3) cigarettes only or (4) both products.OutcomesProduct-specific outcomes were curiosity and susceptibility (never users), as well as ever and current use (all students). Descriptive and multivariable logistic regression analyses were performed. Statistical significance was at P<0.05. Data were weighted to be nationally representative.ResultsMore students overestimated cigarette (74.0%) than e-cigarette prevalence (61.0%; P<0.05). However, the associations between e-cigarette-only overestimation and e-cigarette curiosity (adjusted OR (AOR)=3.29), susceptibility (AOR=2.59), ever use (AOR=5.86) and current use (AOR=8.15) were each significantly larger than the corresponding associations between cigarette-only overestimation and cigarette curiosity (AOR=1.50), susceptibility (AOR=1.54), ever use (AOR=2.04) and current use (AOR=2.52). Despite significant declines in actual e-cigarette use prevalence within each high school grade level during 2015–2016, perceived prevalence increased (11th and 12th grades) or remained unchanged (9th and 10th grades).ConclusionsFour of five US students overestimated peer e-cigarette or cigarette use. Counter-tobacco mass media messages can help denormalise tobacco use.

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Integrating Social Dynamics Into Modeling Cigarette and E-Cigarette Use

Health Education & Behavior ◽

10.1177/1090198119876242 ◽

2020 ◽

Vol 47 (2) ◽

pp. 191-201 ◽

Cited By ~ 3

Author(s):

Kar-Hai Chu ◽

Ariel Shensa ◽

Jason B. Colditz ◽

Jaime E. Sidani ◽

Beth L. Hoffman ◽

...

Keyword(s):

Public Health ◽

Cigarette Smoking ◽

Tobacco Use ◽

Real World ◽

Electronic Cigarettes ◽

Demographic Data ◽

Social Contagion ◽

Cigarette Use ◽

Health Campaigns ◽

Public Health Campaigns

Background. The use of electronic cigarettes (e-cigarette) offers potential to facilitate cigarette smoking cessation, yet potentially increases risk of cigarette smoking initiation. This relationship has been primarily modeled in mathematical ways that often do not represent real-world complexities, which could inform decisions regarding local prevention programs or policies. Aims. To develop a model of cigarette and e-cigarette use that combines current research on tobacco use and incorporates real-world geographic and demographic data. Method. We used a platform for developing agent-based models with demographic information representative of the population in Pennsylvania. We developed three models of cigarette and e-cigarette use. The primary outcome for each was the total number of users for cigarette, e-cigarette, and total nicotine. The first model applied current cigarette and e-cigarette data, the second tested the effect of implementing a program of e-cigarette education and policies, and the third considered a social contagion factor, where local schools functioned as a transmission vector. Results. The baseline and social contagion models found an overall decline in cigarette use but an increase in e-cigarette and total nicotine use. The education/policies model had declines in all categories. Sensitivity analysis suggested the importance of nuanced e-cigarette/cigarette interactions when modeling tobacco use. Discussion. Public health campaigns that focus on reducing youth e-cigarette usage can have a large effect. Social contagion should be strongly considered when studying e-cigarette spread. Conclusion. Targeted public health campaigns focused on reducing school prevalence of e-cigarette use may be particularly valuable.

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