Neighbourhood tobacco retail access and tobacco use susceptibility in young adolescents in urban India

BackgroundNeighbourhood tobacco retail access may influence adolescent tobacco use. In India, we examined the association between neighbourhood tobacco retail access and cognitive risks for tobacco use during early adolescence.MethodsIn 2019–2020, a population-based sample (n=1759) of adolescents aged 13–15 years was surveyed from 52 neighbourhoods in Mumbai and Kolkata. Neighbourhood tobacco retail access was measured as the frequency of visits to tobacco retailers, mapped tobacco retailer density and perceived tobacco retailer density. We estimated associations between neighbourhood tobacco retail access and cognitive risks for tobacco use (perceived ease of access to tobacco, perceived peer tobacco use and intention to use tobacco).ResultsThere was high neighbourhood tobacco retail access. Tobacco retailer density was higher in lower income neighbourhoods (p<0.001). Adolescent frequency of tobacco retailer visits was positively associated with cognitive tobacco use risks. Mapped tobacco retailer density was associated with perceived ease of access in Kolkata but not in Mumbai, and it was not associated with perceived peer tobacco use nor intention. Perceived tobacco retailer density was associated with perceived ease of access and perceived peer use, but not with intention. In Kolkata, higher perceived retailer density and frequency of tobacco retailer visits were negatively associated with perceived ease of access.ConclusionsEfforts to reduce neighbourhood tobacco retail access in India may reduce cognitive tobacco use risk factors in young adolescents. The frequency of tobacco retailer visits and perceived tobacco retailer density increased cognitive risks, though there were some exceptions in Kolkata that further research may explain.

Effects of a Brief Web-Based “Social Norms”-Intervention on Alcohol, Tobacco and Cannabis Use Among German University Students: Results of a Cluster-Controlled Trial Conducted at Eight Universities

Background and Aim: “Social norms” (SN)-interventions are aimed at changing existing misperceptions regarding peer substance use by providing feedback on actual norms, thereby affecting personal substance use. It is unknown whether SN-intervention effects previously demonstrated in US students can be replicated in German students. The aim of the INSIST-study was to examine the effects of a web-based SN-intervention on substance use.Design: Cluster-controlled trial.Setting: Eight Universities in Germany.Participants and Measurements: Students were recruited at four intervention vs. four delayed intervention control Universities. 4,463 students completed baseline, 1,255 students (59% female) completed both baseline and 5-months follow-up web-based surveys on personal and perceived peer substance use. Intervention participants received feedback contrasting personal and perceived peer use with previously assessed use and perceptions of same-sex, same-university peers. Intervention effects were assessed via multivariable mixed logistic regression models.Findings: Relative to controls, reception of SN-feedback was associated with higher odds for decreased alcohol use (OR: 1.91, 95% CI 1.42-2.56). This effect was most pronounced in students overestimating peer use at baseline and under or accurately estimating it at follow-up (OR: 6.28, 95% CI 2.00-19.8). The OR was 1.33 (95% CI 0.67-2.65) for decreased cannabis use in students at intervention Universities and was statistically significant at 1.70 (95% CI 1.13-2.55) when contrasting unchanged and decreased with increased use. Regarding tobacco use and episodes of drunkenness, no intervention effects were found.Conclusions: This study was the first cluster-controlled trial suggesting beneficial effects of web-based SN-intervention on alcohol and cannabis use in a large sample of German University students.Clinical Trial Registration: The trial registration number of the INSIST-study is DRKS00007635 at the “German Clinical Trials Register.”

Differences in JUUL Appeal Among Past and Current Youth JUUL Users

Introduction JUUL, a closed system e-cigarette with disposable pods, is popular among youth, with positive attributes of this product linked to current use by youth. However, many youth try JUUL and do not continue using; understanding differences in the appeal of this device between current users and those who chose not to continue use can inform regulation and prevention efforts. The aim of the current study is to compare JUUL appeal in youth among past users (i.e. used, but not in past month) and current users (i.e. used in past month). Methods A cross-sectional survey was conducted in four Connecticut high schools in Spring 2018. This survey assessed JUUL use and reasons for liking/disliking JUUL, including its’ pharmacological effects (e.g., nicotine “buzz”), product characteristics (e.g., flavors), peer influence, appeal compared to other e-cigarettes, and concealability. Logistic regressions were conducted to examine differences in liking/disliking JUUL by use status (past vs. current). Results Among JUUL users (N=1374; 43% of total sample), 30.4% were past users and 69.6% were current users. Compared to current users, past users were less likely to like JUUL for positive pharmacological effects (e.g. nicotine “buzz”), product characteristics (e.g. flavors), and peer use and more likely to dislike JUUL for the adverse pharmacological effects (e.g. headache), product characteristics (e.g. flavors), and for “other” reasons (open-ended response; e.g., perceived harm). Conclusions Findings suggest that altering JUUL appeal through regulating nicotine content and flavors may be key in policy aimed at shifting youth to become past JUUL users. Implications The current study investigates how current and past youth JUUL users differ in their report of the appeal of JUUL. Past users are less likely to report experiencing positive pharmacological effects and product characteristics of JUUL and are less likely to report appeal due to peer use. Understanding how appeal of JUUL may differ among past and current users can aid in our understanding of how to regulate these products so that they are less appealing to current youth users.

Perceptions and Misperceptions of Smartphone Use: Applying the Social Norms Approach

The social norms approach is an established technique to bring about behaviour change through challenging misperceptions of peer behaviour. This approach is limited by a reliance on self-report and a lack of interactivity with the target population. At the same time, excessive use of digital devices, known as digital addiction, has been recognized as an emergent issue. There is potential to apply the social norms approach to digital addiction and, in doing so, address some of the limitations of the social norms field. In this study, we trialled a social norms intervention with a sample of smartphone users (n = 94) recruited from the users of a commercial app designed to empower individuals to reduce their device usage. Our results indicate that most of the sample overestimated peer use of smartphone apps, demonstrating the existence of misperceptions relating to smartphone use. Such misperceptions are the basis for the social norms approach. We also document the discrepancy between self-report and smartphone usage data as recorded through data collected directly from the device. The potential for the application of the social norms approach and directions for future research are discussed.

Associations Between Peer Use, Costs and Benefits, Self-Efficacy, and Adolescent E-cigarette Use

Objective Prior research identified peer use as a salient risk factor of adolescent electronic cigarette (e-cigarette) use, but has not expanded on the mechanisms of this association. Methods Participants were 562 adolescents recruited from rural and suburban public high schools and an adolescent medicine clinic in the mid-Atlantic United States. Participants completed a packet of questionnaires that assessed demographics, substance use, expectations about the consequences of e-cigarette use, and perceptions of their own self-efficacy to resist using e-cigarettes. We estimated a series of mediation models using the MODEL INDIRECT command in MPLUS statistical software. In all models, significance of indirect effects from peer e-cigarette use to self-reported e-cigarette use were tested via two variables: (a) expected costs, (b) benefits of e-cigarette use, and (c) the perceived self-efficacy of the individual to refrain from e-cigarette use. Results Adolescents with more peers using e-cigarettes were more likely to have ever used an e-cigarette and perceived greater benefits and fewer costs, which was associated with a reduced self-efficacy to refrain from e-cigarette smoking (Model 1). Those with more peers using e-cigarettes were more likely to be currently using e-cigarettes themselves because they perceived greater benefits and fewer costs, which was associated with a reduced self-efficacy to refrain from e-cigarette smoking (Model 2). Conclusion Peer use, self-efficacy to resist use, and expectations of cost and benefits of e-cigarette use should be considered as possible targets when devising tailored interventions and policies to prevent or reduce negative health consequences of long-term e-cigarette use.

Determinants of waterpipe smoking among high school students in Jakarta, Indonesia

ObjectivesThe study aimed to examine factors associated with past 30 days waterpipe use among high school students in Jakarta, Indonesia.MethodsWe surveyed a multistage cluster random sample of 1,318 students of grade 10th and 11th from 14 schools in Jakarta. Multiple logistic regressions were employed to examine the association between past 30 days waterpipe use with sociodemographic characteristics, cigarettes smoking status, parental and peer use, availability and affordability.ResultsOf 1,318 participants, 3.3% of female and 8.4% of male currently smoked waterpipe. Multivariate analysis revealed that current waterpipe use was significantly associated with family use (AOR: 4.844, 95% CI: 1.225–19.151), friend use (AOR: 2.554, 95% CI: 1.424–4.582), and availability (AOR: 2.143, 95% CI: 1.127–4.076). Being current smokers were six times more likely (AOR: 6.055, 95% CI: 3.123–11.739) to use waterpipe in the past 30 days.ConclusionsThe finding suggests that smoking by a family member, friends, use of conventional cigarettes, and availability are significantly associated with increased probability of current waterpipe used among adolescents.

Use and social value in peer-to-peer prosumption communities

Purpose This paper aims to examine how prosumption manifests in an online community, Instructables.com, and its value for those who engage with it. The paper emphasizes its distinctiveness compared to similar phenomena, particularly co-creation. Design/methodology/approach This work uses a netnography-informed research approach, involving Instructables community observations, participation and 15 online interviews with members of the community. Findings Prosumption provides personal benefits including hedonic elements of enjoyment and fun, functional elements of monetary saving and self-sufficiency, and cognitive benefits such as problem solving and learning. Further, extra-personal benefits include community-, environment-, market-, family- and friends-oriented benefits. Research limitations/implications Personal and extra-personal prosumption benefits generate use and social value, progressing understanding of value through a type of prosumption that the authors term peer-to-peer. Practical implications An understanding of the differences among concepts can set expectations, responsibilities and opportunities for both firms and prosumers in an increasingly collaborative marketplace. Originality/value By critically analyzing the nature of value through a particular kind of prosumption, the paper makes three theoretical contributions. First, it transforms and broadens the scope of empirical research by clarifying critical distinctions between co-creation and prosumption and establishing them as higher-order concepts. Second, the paper determines the benefits, use and social value participants derive from particular forms of participation in the marketplace. Finally, the paper establishes a new concept, namely peer-to-peer prosumption, which the authors define as a type of prosumption that prioritizes collective, peer-to-peer use and social value over exchange value. The paper contributes to marketing literature on the ongoing evolution of consumer roles and participation in the marketplace, by furthering theorization in this field.

The role of school characteristics in pre-legalization cannabis use change among Canadian youth: implications for policy and harm reduction

Reducing youth cannabis use in Canada is a public health priority with schools of interest as a potential modifier of behavior and as a venue for prevention programming. This work aimed to provide a basis for future policy and programming by evaluating pre-legalization cannabis use change patterns in schools and the impact of school characteristics on these patterns. Average rates of cannabis use behavior change (initiation, escalation, reduction, cessation) were collected from 88 high schools located in Ontario and Alberta, Canada participating in the COMPASS prospective cohort study. There was little variability in cannabis use behaviors between schools with intra-class correlation coefficients lowest for cessation (0.02) and escalation (0.02) followed by initiation (0.03) and reduction (0.05). Modest differences were found based on school province, urbanicity and student-peer use. Cannabis ease of access rates had no significant effect. Fewer than half the schools reported offering school drug use prevention programs; these were not significantly associated with student cannabis use behaviors. In conclusion, current school-based cannabis prevention efforts do not appear sufficiently effective. Comprehensive implementation of universal prevention programs may reduce cannabis harms. Some factors (urbanicity, peer use rates) may indicate which schools to prioritize.

Comfortably Numb? Revisiting and Re-Specifying the Relationship Between Health Strain and Substance Use

Studies have found a positive linear relationship between health strain and substance use; however, they often omit potential confounders such as self-control, social bonds, and peer use. Furthermore, there are several reasons to believe the relationship is curvilinear according to Agnew’s general strain theory. Using data from the National Longitudinal Study of Adolescent to Adult Health, we examine whether the linear relationship persists after including confounders and we test the hypothesized curvilinear relationship. Results provide little support for the linear relationship; however, the hypothesized curvilinear relationship is supported in multiple alcohol and marijuana use models. In addition, there is little evidence that health strain is mediated by depressive symptoms. Policy implications, limitations, and directions for research are discussed.