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  • 1
    In: Nicotine & Tobacco Research, Oxford University Press (OUP), Vol. 23, No. 6 ( 2021-05-24), p. 900-908
    Abstract: Understanding which non-cigarette tobacco products precede smoking in youth across different racial/ethnic groups can inform policies that consider tobacco-related health disparities. Methods We used nationally representative, longitudinal data from the Population Assessment of Tobacco and Health Study waves 1–4. The sample was a dynamic cohort of cigarette-naïve youth aged 12–17 years. Mixed-effects models were used to assess non-cigarette product (e-cigarette, cigar product, or other product) use with cigarette use over 1-year intervals. Results Of the 28 788 observations pooled across waves 1–4, respondents were 48.7% non-Hispanic white, 13.9% non-Hispanic black, and 23.1% Hispanic. Odds of cigarette initiation over 1-year follow-up were higher among youth with prior use of e-cigarettes (odds ratio [OR], 2.76; 95% confidence interval [CI] , 2.21–3.45), cigars (OR, 2.00; 95% CI, 1.42–2.80), or other products (OR, 1.66; 95% CI, 1.28–2.14) compared to never users. At the population level, 20.6% of cigarette initiation was attributable to e-cigarette use among white youth and 21.6% among Hispanic youth, while only 3.5% of cigarette initiation was attributable to e-cigarette use among black youth. In contrast, 9.1% of cigarette initiation for black youth was attributable to cigar use compared to only 3.9% for both white and Hispanic youth. Conclusions Prior use of e-cigarettes, cigars, and other non-cigarette products were all associated with subsequent cigarette initiation. However, white and Hispanic youth were more likely to initiate cigarettes through e-cigarette use (vs. cigar or other product use), while black youth were more likely to initiate cigarettes through cigar use (vs. e-cigarette or other product use). Implications Our findings suggest that previous studies on effects of non-cigarette tobacco products may overlook the critical role of cigar products as a pathway into cigarette smoking among US youth, particularly black youth. While our data support the importance of e-cigarette use as a pathway into smoking, regulatory actions aimed at addressing youth e-cigarette use alone may contribute to disparities in black versus white tobacco use and further exacerbate inequities in tobacco-related disease. Thus, contemporary policy development and discourse about the effects of non-cigarette tobacco products on cigarette initiation should consider cigar and other non-cigarette products as well as e-cigarettes.
    Type of Medium: Online Resource
    ISSN: 1469-994X
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2020202-7
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  • 2
    In: Preventive Medicine, Elsevier BV, Vol. 148 ( 2021-07), p. 106545-
    Type of Medium: Online Resource
    ISSN: 0091-7435
    RVK:
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 1471564-8
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  • 3
    In: Nicotine & Tobacco Research, Oxford University Press (OUP), Vol. 24, No. 3 ( 2022-02-14), p. 416-420
    Abstract: Previous studies suggest that young adults who vape nicotine experience difficulty when answering survey items assessing the quantity of vaping. The current study asked young adults who vape to provide suggestions for improving the scientific measurement of vaping. Aims and Methods We conducted semi-structured qualitative interviews with 62 young adults who vape in Los Angeles, California between June 2018 and June 2019. We analyzed participants' responses to the following question: “What do you think is the best way for us to understand how much people vape?” using thematic content analysis. Results We identified two major themes: (1) challenges stemming from differences between the way researchers query about vaping and how individuals self-monitor vaping frequency, and (2) insights for future measurement of vaping. Participants reported that challenges of accurately quantifying vaping were due to inherently hard-to-answer questions (eg, puffs per day), lack of awareness of or not actively monitoring consumption of vaping products, or because vaping behaviors vary considerably between and within individuals over time, making “on-average” questions challenging. Participants discussed ideas for improving survey measures that could accurately assess vaping quantity, including querying about the type of device used, and frequency of replenishment of nicotine solutions. Conclusions Existing vaping behavior survey measures may not accurately capture the quantity of vaping as they differ from how (or if) participants track their own vaping consumption patterns. While continued research is needed to optimally refine survey measures on vaping consumption, future measures may better align with vapers' self-monitoring by including questions on device-type and replenishment frequency. Implications The present study provides insights regarding the variability that exists between vaping quantity measurements utilized by researchers and individuals who consume e-cigarettes. The qualitative data analyzed for this study support previous reports of difficulties faced by vapers when asked questions by researchers related to their vaping behavior. Furthermore, the present findings suggest the direction for the future development of accurate measurements of vaping frequency.
    Type of Medium: Online Resource
    ISSN: 1469-994X
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2020202-7
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  • 4
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2023
    In:  Nicotine and Tobacco Research Vol. 25, No. 6 ( 2023-05-22), p. 1116-1124
    In: Nicotine and Tobacco Research, Oxford University Press (OUP), Vol. 25, No. 6 ( 2023-05-22), p. 1116-1124
    Abstract: Understanding the reasons young adults use e-cigarettes (ie, vape)—and whether these motivations vary across groups—is essential for informing tobacco regulatory efforts. Aims and Methods An online panel of young adults who vape (n = 230; age = 18–30 years) completed a maximum difference discrete choice task for 15 reasons for vaping. Over 9 choice sets, participants were presented a subset of 5 reasons and selected the most and least important. Hierarchical bayesian analysis estimated the relative importance of each reason. Latent class analysis (LCA) identified groups with similarly ranked reasons for use. Multinomial regression evaluated the association between sample characteristics and class membership. Results Overall, relaxation had the highest probability of being the most important reason for use (14.8%), followed by harm reduction (13.2%), and flavors (10.3%). LCA identified five distinct classes, based on top reasons for use: 1. cessation (cigarette cessation [20.2%]; n = 80); 2. dependence (relaxation [20.5%] and unable to quit [19.2%]; n = 21); 3. relaxation (relaxation [20.6%] ; n = 66); 4. socializing (socializing [22.2%]; n = 27); and 5. variable (boredom [10.5%] and acceptability [10.2%]; n = 36). Participants who were older, smoked cigarettes, or vaped more frequently were more likely to belong to the cessation class while those who were younger or more e-cigarette dependent were more likely to belong to the dependence class. Conclusions Perceived reasons why young adults vape are highly heterogeneous and dependent on the type of user. Tobacco regulatory efforts targeting distinct types of vapers are needed to minimize the adverse public health impact of vaping without compromising appeal for smoking cessation. Implications E-cigarette use remains high among young adults, with flavors, cost, and harm reduction (vs. combustible cigarettes) among the mostly commonly reported reasons for use. Yet, little is known about how relatively important these reasons are to the individual. Leveraging a maximum difference task, young adults’ reasons for use were evaluated on a common interval scale and groups sharing similar reasons identified. Smoking cessation, dependence, relaxation, socialization, and boredom were respectively the most important reasons for use among five classes of vapers. E-cigarette regulatory policies should consider the distinct reasons for use as to not compromise their appeal for smoking cessation.
    Type of Medium: Online Resource
    ISSN: 1469-994X
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2020202-7
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  • 5
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2021
    In:  Nicotine & Tobacco Research Vol. 23, No. 5 ( 2021-05-04), p. 829-835
    In: Nicotine & Tobacco Research, Oxford University Press (OUP), Vol. 23, No. 5 ( 2021-05-04), p. 829-835
    Abstract: The rapidly evolving landscape of vaping devices has complicated analyses of use patterns among youth and young adults. The current study describes the prevalence of use, substances vaped, and purchasing behaviors across five different vaping device categories. Aims and Methods Participants (n = 2505; mean age = 19.2, SD = 0.46) from a cohort in the Los Angeles area completed web-based surveys from June 2018 to October 2019. For each of four device type categories depicted via digital images (any pod-style vape, cigalike, box-mod, vape pen) and for JUUL specifically, participants reported ever and past 30-day use, substance vaped (mostly nicotine, nicotine and tetrahydrocannabinol [THC], mostly THC, neither), ownership of device (yes/no), where they obtained that device (eg, purchased themselves, from a friend), and if purchased, purchase location (eg, vape shop, online). Results Overall, 44.9% reported ever use, and 26.2% reported past 30-day use of at least one of the devices. The prevalence of past 30-day use was highest for pod-style vapes (any pod = 17.0%; JUUL = 15.1%). Among respondents who reported ever owning any device (n = 643 [25.7%]), 59.9% reported purchasing the device themselves, despite not being of legal purchasing age (15.4% of total sample); across all device types, products were most often purchased in vape shops or online. Conclusions Across all devices, the prevalence of self-purchase of vaping devices among underage young adults in the Los Angeles area was high, and most were purchased from a vape shop or online. Tobacco control policies to prevent underage purchase of tobacco products—particularly among never smokers—are needed. Implications A high proportion of underage young adults reported owning their own vaping device and having purchased it themselves from a vape shop or online. Stronger tobacco control policies and better enforcement efforts are needed to successfully prevent underage purchase of tobacco products.
    Type of Medium: Online Resource
    ISSN: 1469-994X
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2020202-7
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  • 6
    Online Resource
    Online Resource
    American Medical Association (AMA) ; 2020
    In:  JAMA Network Open Vol. 3, No. 10 ( 2020-10-06), p. e2019181-
    In: JAMA Network Open, American Medical Association (AMA), Vol. 3, No. 10 ( 2020-10-06), p. e2019181-
    Type of Medium: Online Resource
    ISSN: 2574-3805
    Language: English
    Publisher: American Medical Association (AMA)
    Publication Date: 2020
    detail.hit.zdb_id: 2931249-8
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  • 7
    In: BMC Public Health, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: While rates of e-cigarette use (‘vaping’) continue to potentiate concern, there is limited data on common symptoms of e-cigarette dependence among young adults who vape. This study sought to critically explore how young adults experience, manifest, and conceptualize vaping dependence symptoms in their everyday lives. Methods Between June 2018 and 2019, in-depth qualitative interviews were conducted with 62 young adults who use e-cigarettes (aged 18–25) and live in Southern California. We explored participants’ product preferences, daily e-cigarette use patterns, vaping history, withdrawal experiences, and quit attempts or periods of cessation. We used a thematic analysis approach to interpret the transcripts. Results Young adults discussed nine dimensions of vaping dependence that were organized into two categories: 1) general nicotine dependence symptoms, and 2) unique dependence symptoms related to vaping. Nicotine dependence symptoms included cravings and urgency to use, increased use to achieve desired effects, and unsuccessful quit attempts and withdrawal. Symptoms unique to vaping dependence included greater nicotine consumption due to accessibility and lack of restrictions, habitual vaping, inability to track vaping frequency, immediate gratification and comfort, social acceptability and norms, and awareness of vaping dependency. Conclusions In addition to nicotine dependence symptoms that have been characterized for other tobacco products, young adult e-cigarette users described unique symptoms of vaping dependence that necessitate the need for more refined measures. All dimensions of vaping dependence should be considered in discussions of policies as well as treatment and education efforts intended to protect young people from e-cigarette dependence.
    Type of Medium: Online Resource
    ISSN: 1471-2458
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2041338-5
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  • 8
    In: Drug and Alcohol Dependence, Elsevier BV, Vol. 217 ( 2020-12), p. 108298-
    Type of Medium: Online Resource
    ISSN: 0376-8716
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 2004927-4
    SSG: 15,3
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  • 9
    In: Drug and Alcohol Dependence, Elsevier BV, Vol. 216 ( 2020-11), p. 108258-
    Type of Medium: Online Resource
    ISSN: 0376-8716
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 2004927-4
    SSG: 15,3
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  • 10
    In: Psychopharmacology, Springer Science and Business Media LLC
    Abstract: Specific cannabis products may differentially increase risk of initiating non-cannabis illicit drug use during adolescence. Objective To determine whether ever- and poly-use of smoked, vaporized, edible, concentrate, or blunt cannabis products are associated with subsequent initiation of non-cannabis illicit drug use. Methods High school students from Los Angeles completed in-classroom surveys. The analytic sample ( N  = 2163; 53.9% female; 43.5% Hispanic/Latino; baseline  M age = 17.1 years) included students who reported never using illicit drugs at baseline (spring, 11th grade) and provided data at follow-up (fall and spring, 12th grade). Logistic regression models assessed associations between use of smoked, vaporized, edible, concentrate, and blunt cannabis at baseline (yes/no for each product) and any non-cannabis illicit drug use initiation—including cocaine, methamphetamine, psychedelics, ecstasy, heroin, prescription opioids, or benzodiazepines—at follow-up. Results Among those who never used non-cannabis illicit drugs at baseline, ever cannabis use varied by cannabis product (smoked = 25.8%, edible = 17.5%, vaporized = 8.4%, concentrates = 3.9%, and blunts = 18.2%) and patterns of use (single product use = 8.2% and poly-product use = 21.8%). After adjustment for baseline covariates, odds of illicit drug use at follow-up were largest for baseline ever users of concentrates (aOR [95% CI] = 5.74[3.16–10.43] ), followed by vaporized (aOR [95% CI] = 3.11 [2.41–4.01] ), edibles (aOR [95% CI] = 3.43 [2.32–5.08] ), blunts (aOR [95% CI] = 2.66[1.60–4.41] ), and smoked (aOR [95% CI] = 2.57 [1.64–4.02] ) cannabis. Ever use of a single product (aOR [95% CI] = 2.34 [1.26–4.34] ) or 2 + products (aOR [95% CI] = 3.82 [2.73–5.35] ) were also associated with greater odds of illicit drug initiation. Conclusions For each of five different cannabis products, cannabis use was associated with greater odds of subsequent illicit drug use initiation, especially for cannabis concentrate and poly-product use.
    Type of Medium: Online Resource
    ISSN: 0033-3158 , 1432-2072
    RVK:
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2066933-1
    SSG: 15,3
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