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]
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.
- 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]
Three cigarette smoking behaviors influence lung cancer rates: how many people start, the amount they smoke, and the age they quit. California has reduced smoking faster than the rest of the US and trends in these 3 smoking behaviors should inform lung cancer trends. A newly published study examined trends in smoking behavior (initiation, intensity, and quitting) in California and the rest of US by regression models using the 1974-2014 National Health Interview Surveys (n=962,174).
· Among those aged 18- 35 years, California had much larger declines than the rest of the US in smoking initiation and intensity, and increased quitting.
· In 2012-14, among this age group, only 19% had ever smoked; smokers consumed only 6.3 cigarettes/day; and 46% of ever-smokers had quit by age 35.
· Each of these metrics was at least 24% better than in the rest of the US.
· There was no marked California effect on quitting or intensity among seniors. From 1986-2013, annual lung cancer mortality decreased more rapidly in California and by 2013 was 28% lower than in the rest of the US.
· California’s tobacco control efforts were associated with a major reduction in cigarette smoking among those under age 35 years.
The researchers concluded that these changes will further widen the lung cancer gap that already exists between California and the rest of the US.
Source: Pierce et al. (2018). Trends in lung cancer and cigarette smoking: California compared to the rest of the United States. Cancer Prevention Research, Oct 10. pii: canprevres.0341.2018. doi: 10.1158/1940-6207.CAPR-18-0341. [Epub ahead of print]