Did You Know: Arrest During Emerging Adulthood Can Impact Smoking Behavior of African Americans

unnamed-12
A newly published study examined how arrest during emerging adulthood altered smoking behavior during subsequent years and whether there were differential effects by race/ethnicity and gender. Researchers analyzed 15 waves of data from the National Longitudinal Survey of Youth 1997.
Findings included:
  • For both genders, arrested black men and women had the most distinct smoking transitions (both increases and decreases) as compared with their non-arrested counterparts.
  • Among men, particularly black males, arrest in early adulthood was associated with the men transitioning to both increased and decreased smoking.
  • Patterns in smoking transitions for women were less clear, suggesting that women’s smoking may be influenced by factors not in the models.
  • Women had a low probability of starting to smoke or increasing smoking if they were never arrested between 18 and 21 years of age.

The researchers conclude that transitioning into increased smoking offers some support for labeling theory processes. Other findings suggest that arrest may lead to some men reducing or quitting smoking. Early adulthood arrest may serve to “shock the system” and contribute to males altering their prior smoking behavior. Because criminal justice policymakers tend to focus on issues like ex-offender unemployment, public health officials can provide guidance regarding the effect of justice system involvement on smoking, particularly given the adverse health outcomes of using cigarettes.

Source: Hassett-Walker & Shadden (2020). Examining Arrest and Cigarette Smoking in Emerging Adulthood. Tobacco Use Insights, 13: 1179173X20904350.

Did You Know: Less Than Half of Teachers and Parents Know What a JUUL Looks Like

unnamed-5

Electronic cigarette use, including JUUL, has risen to epidemic levels among high school and middle school students in the United States. Schools serve as a key environment for prevention and intervention efforts to address e-cigarette use, yet little is known about the awareness of and response to e-cigarettes in schools. A newly published study of middle and high school teachers and administrators (n = 1,420) measured JUUL awareness, e-cigarette policies, and barriers to enforcement in schools.

 

Findings included:

  • While two thirds of respondents had heard of a product called JUUL (68%), less than half accurately identified a photo of a JUUL as a vaping device/e-cigarette (47%).
  • Awareness of JUUL (81%) was higher among high school teachers (83%) than among middle school teachers (78%).
  • A large majority of respondents reported that their school had an e-cigarette policy (83%), but less than half of the sample worked in a school with a policy that specifically included JUUL (43%).
  • Those working in a school with an e-cigarette policy in place noted that e-cigarettes’ discreet appearance (66%) and difficulties in identifying origin of vapor or scent (46%) made the policy difficult to enforce.

 

The researchers concluded that efforts to increase middle and high school staff awareness of the ever-evolving e-cigarette market are essential to help prevent youth use.

 

Source: Schillo et al. (2019). JUUL in School: Teacher and Administrator Awareness and Policies of E-Cigarettes and JUUL in U.S. Middle and High Schools. Health Promotion Practice, Sept 18. [Epub ahead of print]

 

Did You Know? Flavors Like Menthol/Mint, Fruit and Candy Appeal to Young Tobacco Users

flavorsunnamed-5

A recently published study examined youth preference for flavored tobacco products.

Findings included:

  • Prevalence of flavored tobacco product use was highest among youth, followed by young adults and adult 25+.
  • Within each age group, flavored use was greatest among hookah, e-cigarette and snus users.
  • Overall, menthol/mint, fruit and candy/sweet were the most prevalent flavor types at first and past 30-day use across age groups.
  • For past 30-day use, all flavor types except menthol/mint exhibited an inverse age gradient, with more prevalent use among youth and young adults, followed by adults 25+.
  • Prevalence of menthol/mint use was high (over 50% youth, young adults; 76% adults 25+).
  • Brand-categorized and self-reported flavor use measures among adults 18+ were moderately to substantially concordant across most products.

 

The researchers concluded that these findings can inform tobacco flavor regulations to address flavor appeal especially among youth.

 

Source: Rose et al. (2019). Flavour types used by youth and adult tobacco users in wave 2 of the Population Assessment of Tobacco and Health (PATH) Study 2014-2015. Tobacco Control, Sep 21. [Epub ahead of print]

Less Than Half of Teachers Know What a JUUL Looks Like

juul

Electronic cigarette use, including JUUL, has risen to epidemic levels among high school and middle school students in the United States. Schools serve as a key environment for prevention and intervention efforts to address e-cigarette use, yet little is known about the awareness of and response to e-cigarettes in schools. A newly published study of middle and high school teachers and administrators (n = 1,420) measured JUUL awareness, e-cigarette policies, and barriers to enforcement in schools.

 

Findings included:

  • While two thirds of respondents had heard of a product called JUUL (68%), less than half accurately identified a photo of a JUUL as a vaping device/e-cigarette (47%).
  • Awareness of JUUL (81%) was higher among high school teachers (83%) than among middle school teachers (78%).
  • A large majority of respondents reported that their school had an e-cigarette policy (83%), but less than half of the sample worked in a school with a policy that specifically included JUUL (43%).
  • Those working in a school with an e-cigarette policy in place noted that e-cigarettes’ discreet appearance (66%) and difficulties in identifying origin of vapor or scent (46%) made the policy difficult to enforce.

 

The researchers concluded that efforts to increase middle and high school staff awareness of the ever-evolving e-cigarette market are essential to help prevent youth use.

 

Source: Schillo et al. (2019). JUUL in School: Teacher and Administrator Awareness and Policies of E-Cigarettes and JUUL in U.S. Middle and High Schools. Health Promotion Practice, Sept 18. [Epub ahead of print]

56% of Adolescent Electronic Nicotine Delivery Systems Users Also Use Other Tobacco Products

e-cig

A newly published study examined how adolescents use electronic nicotine delivery systems (ENDS), and compared youth who are only use ENDS and polytobacco users (ENDS and at least one other tobacco product). Researchers surveyed a nationally representative sample of 3,517 13-25-year olds.

Findings included:

·         4.5% of adolescents and 10% of young adults reported past 30-day ENDS use.

·         ENDS users were 38.8% female and 70.6% white.

·         Over half (55.9%) were polytobacco ENDS users.

·         The most common patterns of polytobacco ENDS use were ENDS and cigarettes (11.5%), ENDS and cigars (7.7%), and ENDS, cigars, and waterpipe (5.2%).

·         Those who perceived ENDS to be less harmful than cigarettes were more likely to be exclusive ENDS users than those who perceived ENDS to be as or more harmful than cigarettes.

·         There were no differences between ENDS groups on age, race, sex, parental education, sexual orientation, or ENDS use frequency.

The researchers concluded that the Food and Drug Administration is responsible for communicating product risk to consumers and should consider common patterns of use and relative risk perceptions in its ENDS public education efforts.

Source: King et al. (2018). Polytobacco Use Among a Nationally Representative Sample of Adolescent and Young Adult E-Cigarette Users. The Journal of Adolescent Health, Aug 13. pii: S1054-139X(18)30186-1. doi: 10.1016/j.jadohealth.2018.04.010. [Epub ahead of print]

Did You Know? That Following a Campus-Wide Tobacco Ban, Combustible Cigarette Use Declined, but E-Cigarette Use Increased?

unnamed (3)
A newly published study examined changes in prevalence of e-cigarette use and perceptions of the harmfulness of e-cigarette and combustible cigarettes following a campus-wide tobacco ban. Undergraduate students completed surveys of tobacco use and perceived product harmfulness. Four samples were collected: in 2013 prior to the ban (n = 792) and in fall 2014 (n = 310), 2015 (n = 208), and 2016 (n = 417).
Findings included:
  • E-cigarette use increased in the years following the ban while combustible cigarette use decreased from 2013 to 2016.
  • Men were more likely than women to use both products.
  • Students’ perceptions of the harmfulness of combustible and electronic cigarettes remained stable in the years following the ban.
Source: Leavens et al. (2019). Electronic cigarette and combustible cigarette use following a campus-wide ban: Prevalence of use and harm perceptions. Journal of American College Health, Jan 25:1-4. doi: 10.1080/07448481.2018.1551803. [Epub ahead of print]

Youth Hookah Use Strongly Associated With Co-Use of Flavored Tobacco Products

unnamed (2)

A recently published study examined three social dimensions of youth hookah smoking: frequency, places smoked, and descriptive social norms. Researchers analyzed data from the 2016 National Youth Tobacco Survey of US sixth- to 12th-graders (n = 20,675).

 Findings included:

·         Overall, 10.5% reported smoking hookah ≥1 time in their lifetime. Of these, 65.8% were former, 26.3% were current occasional, and 7.9% were current frequent smokers.

·         Overall, 59.3% of students overestimated hookah smoking prevalence in their grade.

·         Current frequent smoking was most strongly predicted by living with a hookah smoker, speaking a second language other than English, and co-use of mentholated cigarettes or other flavored non-cigarette tobacco products.

·         The top 3 places hookah was smoked were a friend’s house (47.7%), the respondent’s own house (31.8%), and another family member’s house (20.8%).

 

The researchers concluded that because the home environment was the most common place for youth hookah smoking, home-tailored interventions that encourage voluntary smoke-free rules and warn about the dangers of social smoking could help denormalize hookah smoking.

 

Source: Agaku et al. (2018). Social aspects of hookah smoking among US youth. Pediatrics, July 2, [Epub ahead of print]

Did You Know? Youth Believe that Ads for Flavored E-Liquids Target Them

e liquid

The e-cigarette industry argues that flavors are not meant to appeal to youth, yet no study has asked youth what age group they think ads for flavored e-liquids are targeting. A newly published study asked youth which age group they thought ads for flavored e-liquids targeted. A random sample of 255 youth from across California viewed eight ads, presented in randomized order, for fruit-, dessert-, alcohol-, and coffee-flavored e-liquids and indicated the age group they thought the ads targeted: younger, same age, a little older, or much older than them.

 

Findings included:

  • Most participants (94%) indicated the cupcake man flavor ad targeted an audience of people younger than they.
  • Over half felt ads for smoothy (68%), cherry (64%), vanilla cupcake (58%), and caramel cappuccino (50%) targeted their age and for no flavor ad did most feel the primary target age group was much older.
  • Youth believe ads for flavored e-liquids target individuals about their age, not older adults.

 

The researchers concluded that findings support the need to regulate flavored e-liquids and associated ads to reduce youth appeal, which ultimately could reduce youth use of e-cigarettes.

 

Source: McKelvey et al. (2018). Youth say ads for flavored e-liquids are for them. Addictive Behaviors, Aug 29. pii: S0306-4603(18)30957-2. doi: 10.1016/j.addbeh.2018.08.029. [Epub ahead of print]

A Study Examines Perceived Positive And Negative Traits Of Adolescent E-Cigarette Users

unnamed (14)
A newly published study examined the relationship between adolescents’ positive opinions of e-cigarette users and willingness to use e-cigarettes. Participants were 578 U.S. adolescents (ages 14 to 20) recruited from ten California schools. An online survey assessed their attitudes toward and opinions of adolescents who use e-cigarettes in 2015-2016.
Findings included:
  • The majority (61%) of participants had negative overall opinions toward adolescent e-cigarette users.
  • Few participants ascribed positive traits (i.e., sexy, cool, clean, smart, and healthy) to e-cigarette users.
  • Participants who were willing to try or had used e-cigarettes endorsed positive traits more than those unwilling to try and never-users.
  • Participants sometimes endorsed negative traits (i.e., unattractive, trashy, immature, disgusting, and inconsiderate) to describe e-cigarette users.
  • Unwilling and never-users viewed negative traits as more descriptive of e-cigarette users than willing or ever-users.
Adolescents generally had somewhat negative opinions of other adolescents who use e-cigarettes. Building on adolescents’ negativity toward adolescent e-cigarette users may be a productive direction for prevention efforts, and clinicians can play an important role by keeping apprised of the products their adolescent patients are using and providing information on health effects to support negative opinions or dissuade formation of more positive ones.
Source: McKelvey et al. (2018). Adolescents have unfavorable opinions of adolescents who use e-cigarettes. PloS One, Nov 7;13(11):e0206352. doi: 10.1371/journal.pone.0206352. eCollection 2018.
unnamed (15).jpg
Top Reason for E-Cigarette Use Among Young Adults: “They come in flavors I like”
A newly published study examined whether strong local policies may reduce e-cigarette initiation rates by influencing the appeal of these products. Online questionnaires were completed by Southern California Children’s Health Study participants in 2015-2016 (mean age?=?18.9?years).

Findings included:

  • The top reason for e-cigarette use was “They come in flavors I like” (57%).
  • Using e-cigarettes to quit smoking was uncommon (13%).
  • Participants in jurisdictions with weaker tobacco retail licensing ordinances were more likely to report use of e-cigarettes because they are less harmful than cigarettes (50% vs. 36%), more acceptable to non-tobacco users (38% vs. 25%), and because they can use e-cigarettes in places where smoking is prohibited (31% vs. 18%).
The study authors recommend targeted policy that conveys the adverse impact of e-cigarettes, and restricts use in public places may reduce e-cigarette use among adolescents and young adults.
Source: Hong et al. (2018). The impact of local regulation on reasons for electronic cigarette use among Southern California young adults. Addictive Behaviors, Nov 16. pii: S0306-4603(18)31329-7. doi: 10.1016/j.addbeh.2018.11.020. [Epub ahead of print]