Did You Know: Youth Exiting Foster Care Are At High Risk For Smoking

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Among the struggles faced by youth currently in or recently exiting foster care, tobacco use remains a low priority for practitioners and researchers, alike. A recently published study aimed to determine the prevalence of lifetime and current combustible and non-combustible tobacco use among youth exiting foster care, and report on the prevalence of nicotine dependence, motivation to quit, and preferred methods of tobacco cessation. Youth aged 18-24 who were transitioning from foster care (N = 154) completed a survey of tobacco product use.

 

Findings included:

  • Most participants (76%) reported lifetime use of combustible cigarettes, while almost half (42%) were current combustible cigarette smokers.
  • Current use of electronic cigarettes was comparable to general population rates.
  • Many participants (76%) reported interest in quitting and willingness to try through patches/gum (56%) and technology-based (61%) approaches.

 

The researchers concluded that youth exiting foster care are at high risk for smoking and other tobacco product use, as well as dependence, yet are rarely screened for use or advised to quit.

 

Source: Braciszewski et al. (2019). Combustible Cigarette Smoking and Alternative Tobacco Use in a Sample of Youth Transitioning from Foster Care. Children and Youth Services Review, 96:231-236.

Less Than Half of Teachers Know What a JUUL Looks Like

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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? African American And Low SES Children With Asthma Have More Exposure To Passive Tobacco Smoke

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A newly published study examined the risk of asthma in children exposed to passive tobacco smoke. Researchers analyzed National Health and Nutrition Examination Survey (NHANES) data collected from 2003 to 2014 (n = 8064).

Findings included:

  • The proportion of children living with household smokers decreased from 24.9% in the 2003-2004 cycle to 11.4% in the 2013-2014 cycle.
  • Highly exposed asthmatic children were primarily Non-Hispanic Black and whose family incomes were below poverty guidelines.
  • Overall results reveal passive smoke exposure level among children ages 3-11 in the US decreased over the study period.
  • Nevertheless, higher exposure to passive smoke is still associated with higher odds of childhood asthma.

 

The researchers concluded that targeted smoking cessation interventions in clinical practices are needed to reduce tobacco smoke exposure and related asthma risk in children, particularly in low-income and minority groups.

 

Source: Zhang et al. (2018). Decreasing trend in passive tobacco smoke exposure and association with asthma in U.S. children. Environmental Research, May 31;166:35-41. doi: 10.1016/j.envres.2018.05.022. [Epub ahead of print]

Alternative Tobacco Product Use, Ownership of Tobacco Promotional Items, and Easy Access to Cigarettes Linked to Increased Smoking Susceptibility Among Youth

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A newly published study examined perceptions and behaviors associated with smoking susceptibility among adolescents in the current tobacco landscape. Participants were 8th and 10th grade never-smokers of conventional cigarettes from Monitoring the Future surveys (2014-2016).

 

Findings included:

  • Among never-smokers of conventional cigarettes, 17% were susceptible to smoking, 6% were past 30-day alternative tobacco product users, and 4% owned tobacco promotional items.
  • Alternative tobacco product use, ownership of tobacco promotional items, and easy access to cigarettes were associated with increased likelihood of smoking susceptibility.
  • Perceived great influence by antismoking ads and higher perceived addictiveness of conventional cigarette smoking were associated with lower odds of smoking susceptibility.

 

The researchers concluded that alternative tobacco product use, ownership of tobacco promotional items, easy access to cigarettes, low influence by antismoking ads, and low perceptions of the addictiveness of conventional cigarettes are significant and actionable risk factors for smoking susceptibility among adolescents.

Source: Owotomo & Maslowsky (2018). Adolescent Smoking Susceptibility in the Current Tobacco Context: 2014-2016. American Journal of Health Behavior, May 1;42(3):102-113. doi: 10.5993/AJHB.42.3.10.

Did You Know? Study Shows that Tobacco 21 Policies are Effective in Reducing Smoking Among 18-20 Year Olds

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States and municipalities are increasingly restricting tobacco sales to those under age-21, in an effort to reduce youth and young adult smoking. A recently published study examined the effectiveness of such policies. Researchers analyzed 2011 – 2016 data from the Behavioral Risk Factor Surveillance System’s Selected Metropolitan/Micropolitan Area Risk Trends dataset.

 

Findings included:

·         Current smoking rates fell from 16.5 percent in 2011 to 8.9 percent in 2016 among 18-20 year-olds in these data.

·         A tobacco-21 policy covering one’s entire metropolitan and micropolitan statistical areas (MMSA) yields an approximately 3.1 percentage point reduction in 18 to 20 year-olds’ likelihoods of smoking.

·         Accounting for partial policy exposure – tobacco-21 laws implemented in some but not all jurisdictions within an MMSA implies that the average exposed 18 to 20 year-old experienced a 1.2 percentage point drop in their likelihood of being a smoker.

 

The researchers concluded that local tobacco-21 policies yield a substantive reduction in smoking among 18 to 20 year-olds living in metropolitan and micropolitan statistical areas. This finding provides empirical support for efforts to raise the tobacco purchasing age to 21 as a means to reduce young adult smoking. Moreover, it suggests that state laws preempting local tobacco-21 policies may impede public health.

 

Source: Friedman & Wu (2019). Do Local Tobacco-21 Laws Reduce Smoking among 18 to 20 Year-Olds? Nicotine & Tobacco Research, Jul 26. pii: ntz123. doi: 10.1093/ntr/ntz123. [Epub ahead of print]

LOOP Leaders In the Field Focus On Menthol, Flavors & Vaping

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unnamed (11)Dr. Valerie Yerger in Santa Clara County
Dr. Yerger was invited to present at Hooked: Reverse the Vaping Epidemic 2019 Summit in Santa Clara County on Friday, September 13th hosted by Santa Clara County Public Health Department, Tobacco Use Prevention Education, and First Five Santa Clara County. Her presentation on “Menthol, Flavors, and Vaping: Advocates Working Together to Kick These Poisons Out of Our Communities” focused on the tobacco industry’s influence in communities of color. The summit also included a keynote delivered by April Rosseler, Chief of California Tobacco Control Program with the California Department of Public Health. In addition, there was a Tobacco 101 presentation with Bonnie Helpern-Felsher, a youth experience panel, and a discussion of potential solutions with Superintendent Mary-Ann Dewan, Commissioner Leticia Pelayo, and Former Supervisor Ken Yeager.
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Carol McGruder in Fresno
Carol McGruder, Director of AMPLIFY, along with other members of the California Tobacco Control Program-funded coordinating centers (Rod Lew with the Asian American Pacific Islander Coordinating Center, Rosendo Iniguez with the Hispanic Latino Coordinating Center, Amanda Walner with LGBTQ Coordinating Center, and Wendy Kaplan with American Indian Native American Coordinating Center) held a press conference in Fresno on Tuesday, September 17th addressing the vaping epidemic. This was a timely issue as there was a vaping-related death confirmed in Tulare County.

Would you like one of the LOOP team members or trainers to present on a specific topic in your county or city? Email us at theloop@ucsf.edu.

Did You Know? Cigarette Use Patterns Over Time Differ for White and Hispanic White Youth

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A newly published study examined whether adolescent cigarette and e-cigarette use patterns over time differ by ethnicity. Data were pooled from three cohort studies of adolescents in California and Connecticut.

 

Findings included:

·         Among non-Hispanic White (NHW) participants, ever e-cigarette or cigarette users at baseline (vs. never users) had significantly higher odds of past 30-day use tobacco use pattern at follow-up.

·         Among Hispanic White (HW) participants, compared with never users, exclusive e-cigarette users at baseline had increased odds of continued e-cigarette use but not of transition to exclusive cigarette use at follow-up and HW exclusive cigarette users at baseline had greater odds of continued cigarette use but not of transition to exclusive e-cigarette use at follow-up.

 

Findings that NHW youth report more transitional use patterns and HW youth report more stable use patterns suggest a potential for differential impacts of e-cigarettes, by ethnicity, in increasing subsequent transition to or cessation from cigarette smoking.

 

Source: Barrington-Trimis et al. (2019). Ethnic Differences in Patterns of Cigarette and E-Cigarette Use Over Time Among Adolescents. The Journal of Adolescent Health, Jun 24. pii: S1054-139X(19)30199-5. doi: 10.1016/j.jadohealth.2019.04.002. [Epub ahead of print]

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

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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? Sexual Minority Youth at Greater Risk of Alcohol, Tobacco and Marijuana Use

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A recently published study examined substance use disparities among sexual minority youth. The current subsample of 348,175 students participated in the Youth Risk Behavior Surveillance System (YRBSS) study from years 2005 to 2015.

 

Findings included:

·         Female lesbian and bisexual youth were at risk of initiating substance use at younger ages and, among lifetime users, were more likely to persist in their tobacco and marijuana use over time, relative to sexually active female heterosexual youth.

·         Among lifetime users, male youth with partners of both sexes were at greater risk of persistent use of alcohol, tobacco, and marijuana over time and earlier ages of first use.

 

Source: Talley et al. (2019). Sexual Minority Youth at Risk of Early and Persistent Alcohol, Tobacco, and Marijuana Use. Archives of Sexual Behavior, Jan 2. doi: 10.1007/s10508-018-1275-7. [Epub ahead of print]