A recently published study examined the relationships between flavored tobacco use and single, dual, and poly tobacco product use, among adolescents. Data were obtained from the 2017 National Youth Tobacco Survey. Participants were 2,329 adolescent past 30-day tobacco users.
· Approximately half of all adolescent tobacco users (49%) reported use of more than one product.
· The majority of adolescent tobacco users reported using flavors (73%).
· Flavored tobacco use was significantly correlated with a greater risk of dual and poly tobacco use, relative to single product use.
· Similarly, flavored tobacco use was significantly correlated with a greater risk of poly tobacco use, relative to dual tobacco use.
The researchers concluded that there is a positive relationship between flavored tobacco use and multiple tobacco product use. Recommendations included stronger regulations of flavored tobacco products and the need to emphasize flavored tobacco use in prevention and education programs.
Source: Mantey et al. (2018). Flavored tobacco use is associated with dual and poly tobacco use among adolescents. Addictive Behaviors, Dec 27;92:84-88. doi: 10.1016/j.addbeh.2018.12.028. [Epub ahead of print]
Water pipe with smoke
A newly published study assessed the contribution of substance use and stress/traumatic events to hookah use among African American college students (n = 1,402).
· Lifetime hookah use was 25%, with 34% of lifetime users having done so in the past 30 days.
· Compared to nonusers, hookah users had significantly higher use rates of alcohol, marijuana, other tobacco, and other drugs.
· Hookah use was more likely among those with cumulative stress, yet less likely among older students.
The researchers concluded that prevention messages may need to be tailored for African American college students and particularly target younger students, substance users, and those with cumulative stress.
Source: Cunningham-Williams et al. (2018). Stress, stressors, and substance use: Differential risk for hookah use among African American college students. Journal of Ethnicity in Substance Abuse, Oct 22:1-22. doi: 10.1080/15332640.2018.1511492. [Epub ahead of print]
Young adults have high smoking rates and low utilization of evidence-based smoking cessation strategies. A recently published study investigated smoking cessation intentions, strategy use, and socioeconomic predictors of strategy use among young adult smokers (age 18-24) and compared patterns to those of older adults (age 25-64).
· Young adults planned to quit on a longer time frame, expressed lower interest in quitting, and were more confident they would be successful, compared to older adults.
· Young adults were significantly less likely to use pharmacotherapy.
· Both groups reported using product substitution, primarily with e-cigarettes, more than any evidence-based cessation strategy.
· Socioeconomic predictors of cessation strategy use did not differ between age groups.
The researchers concluded that more research on why young adult smokers underutilize evidence-based cessation support is needed, as are innovative efforts to increase intentions to quit and utilization of cessation assistance.
Source: Watkins et al. (2018). Cold Turkey and Hot Vapes? A national study of young adult cigarette cessation strategies. Nicotine & Tobacco Research, Dec 26. doi: 10.1093/ntr/nty270. [Epub ahead of print]
On February 22, 2019, Godfrey Ramos of The LOOP presented for Madera County’s youth coalition, Students Working Against Tobacco (SWAT) Team. His presentation entitled, “Flava In Ya Ear: Integrating Hip-Hop Culture Into Your Advocacy”, focused on how to use the 5 Elements of Hip-Hop Culture (Emceeing, DJing, Breakdancing, Graffiti Art, and Knowledge) as a way to mobilize youth, as well the community, around tobacco control efforts.
Godfrey also presented at the 20th Annual Leaders in Life (LIL) Conference in Bakersfield on March 14, 2019. According to the LIL website, students are “educated and enlightened on issues that are important to them so that they can make healthy and informed decisions regarding drug and alcohol abuse, future career exploration, and youth advocacy; and they are motivated to help others make positive decisions.” This was Godfrey’s third consecutive year presenting at the conference.
Godfrey’s presentation has continued to gain buzz and interest because of the way it resonates with youth and young adults. He has been invited to present at the SOL Project’s 2019 SOLdiers Spring Summit in Sacramento this Saturday, April 13th!
If you would like to request assistance from Godfrey or another LOOP Tailored Assistance Trainer for your needs, contact us atTheLOOP@ucsf.edu!
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).
- 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]
Restricting youth access to tobacco is a central feature of US tobacco regulatory policy, but impact of local tobacco retail licensing (TRL) regulation on cigarette smoking rates remains uncertain. A newly published study examined the effects of TRL on other tobacco product use and use as adolescents reach the age to legally purchase tobacco products. Prevalences of ever and past 30-day cigarette, electronic cigarette (e-cigarette), cigar, and hookah use were assessed in a survey of a cohort of 1553 11th- and 12th-grade adolescents. An American Lung Association (2014) youth access grade was assigned to each of 14 political jurisdictions in which participants lived on the basis of the strength of the local TRL ordinance.
· At baseline, participants living in 4 jurisdictions with “A” grades (ie, with most restrictive ordinances) had lower odds of ever cigarette use and past 30-day use than participants in 10 D- to F-grade jurisdictions.
· At follow-up at legal age of purchase, lower odds of cigarette use initiation occurred in jurisdictions with stronger TRL policy.
· Lower odds of e-cigarette initiation at follow-up and of initiation with past 30-day use were also associated with better regulation.
The researchers concluded that strong local TRL ordinance may lower rates of cigarette and e-cigarette use among youth and young adults.
Source: Astor et al. (2019). Tobacco Retail Licensing and Youth Product Use. Pediatrics, Jan 7. pii: e20173536. doi: 10.1542/peds.2017-3536. [Epub ahead of print]
Certain racial and ethnic minorities have lower utilization of tobacco cessation services, such as Helpline counseling and cessation medications. The goal of the California Medicaid (Medi-Cal) Incentives to Quit Smoking Program was to facilitate successful cessation by promoting modest financial and cessation medication-related incentives to increase engagement with the California Smokers’ Helpline counseling services. A newly published study examined differences in the response to incentives and outreach on engagement with Helpline services among racial/ethnic groups within the Medi-Cal population.
- African Americans and English-speaking Hispanics/Latinos had higher engagement with the financial incentive ($20) compared to whites.
- Spanish-speaking Hispanics/Latinos had lower initial engagement with the financial incentive but higher engagement with Medi-Cal’s all-household mailing.
- Although African Americans and English-speaking Hispanics/Latinos had similar rates of completing counseling and receiving nicotine replacement therapy as whites, Spanish-speaking Hispanics/Latinos had higher rates compared to whites.
The researchers concluded that the promotion of modest financial and cessation medication incentives through multiple outreach channels increased callers’ engagement with the Helpline and appeared to promote ethnic and linguistic equity with respect to the receipt of counseling and nicotine replacement therapy. Targeted community-based outreach may resonate particularly for African Americans, and language-concordant Medi-Cal insurance plan mailings may have reached newly covered Spanish-speaking Hispanics/Latinos.
Source: Vijayaraghavan et al. (2018). Racial/Ethnic Differences in the Response to Incentives for Quitline Engagement. American Journal of Preventive Medicine, Dec;55(6S2):S186-S195. doi: 10.1016/j.amepre.2018.07.018.
A newly published study whether self-reported and geographically estimated tobacco retailer exposures differ by participant or neighborhood characteristics among urban and rural adolescents. The data for this study were part of a cohort study of 1220 adolescent males residing in urban and rural (Appalachian) regions in Ohio. The baseline survey asked participants how often they visited stores that typically sell tobacco in the past week (self-reported exposures). The number of tobacco retailers between home and school was determined using ArcGIS software (potential exposures).
· Adolescents who were non-Hispanic black or other racial/ethnic minority, had used tobacco in the past, and lived in rural areas had higher self-reported exposures.
· Urban adolescents, non-Hispanic black or other racial/ethnic minority, and those living in neighborhoods with a higher percentage of poverty had more potential exposures to tobacco retailers in their path between home and school.
The researchers concluded that rural adolescents had more self-reported marketing exposures than urban adolescents. However, urban adolescents had more potential tobacco exposures between home and school. Thus, point of sale marketing limitations might be a more effective policy intervention in rural areas whereas limits on tobacco retailers might be more effective for urban areas.
Source: Burgoon et al. (2019). Exposures to the tobacco retail environment among adolescent boys in urban and rural environments. American Journal of Drug and Alcohol Abuse, Jan 2:1-10. doi: 10.1080/00952990.2018.1549562. [Epub ahead of print]
Little is known about why bisexual people use tobacco at higher rates than any other sexual identity group. Non-binary sexualities, such as bisexuality, exist within the socially constructed borderland between homosexuality and heterosexuality. A newly published study examined everyday smoking contexts and practices of bisexual individuals. Participants (n = 17; ages 18-26, California) identified as bisexual, pansexual, and/or queer.
· Survey smoking patterns and situational predictors were similar to other young adults’.
· However, interviews revealed unique roles of tobacco use in participants’ navigation of differently sexualized spaces in everyday life: 1) stepping away from uncomfortable situations related to bisexual identity; 2) facilitating belonging to LGBTQ+ community; and 3) recovering from bisexual identity perception management.
Source: McQuoid et al (2019). Tobacco use in the sexual borderlands: The smoking contexts and practices of bisexual young adults. Health & Place, Jan 10. pii: S1353-8292(18)30669-5. doi: 10.1016/j.healthplace.2018.12.010. [Epub ahead of print]
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).
· 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]