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Exposure to adverse childhood experiences and early initiation of electronic vapor product use among middle school students in Nevada.

ABSTRACT: Introduction:The use of electronic vapor products (EVPs) among youth has increased significantly in recent years, yet little is known about factors associated with initiation of EVPs during early adolescence. The purpose of this study was to explore the relationship between chronic exposure to adverse childhood experiences (ACEs) and early initiation of EVPs in a representative sample of middle school students. Methods:5,464 students from 113 middle schools (grades 6-8) completed the Nevada Youth Risk Behavior Survey (YRBS) in the spring of 2017. Six abuse and household dysfunction measures were used to calculate a cumulative ACE score (range 0-6). Initiation of EVPs (e-cigarettes, e-cigars, e-pipes, vape pipes, vaping pens, e-hookahs, and hookah pens) before age 11 was considered early initiation. Weighted logistic regression was used to assess the relationship between cumulative ACE exposure and early initiation of EVPs after controlling for sex, age, race/ethnicity, rurality, free or reduced lunch status, and military family involvement. Results:Nearly 1 in 5 middle school students (18.6%) reported using EVPs, 6.7% had used EVPs during the past 30 days, and 5.1% started using EVPs before age 11. After controlling for sociodemographics, a strong graded relationship between cumulative ACE exposure and early initiation of EVPs was observed: 1 ACE (AOR = 1.60; 95% CI = 0.99-2.59), 2 ACEs (AOR = 2.29; 95% CI = 1.33-3.93), and 3-6 ACEs (AOR = 3.43, 95% CI = 2.20-5.36) compared to no ACEs. Conclusions:Screening for ACEs in school-based settings may be a feasible approach for identifying students who may be at-risk for early initiation of EVPs.

SUBMITTER: Williams L

PROVIDER: S-EPMC7244918 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Exposure to adverse childhood experiences and early initiation of electronic vapor product use among middle school students in Nevada.

Williams Lauren L Clements-Nolle Kristen K Lensch Taylor T Yang Wei W

Addictive behaviors reports 20200219

<h4>Introduction</h4>The use of electronic vapor products (EVPs) among youth has increased significantly in recent years, yet little is known about factors associated with initiation of EVPs during early adolescence. The purpose of this study was to explore the relationship between chronic exposure to adverse childhood experiences (ACEs) and early initiation of EVPs in a representative sample of middle school students.<h4>Methods</h4>5,464 students from 113 middle schools (grades 6-8) completed ...[more]

PMID: 32467855

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Project description:BackgroundNearly one-half of Americans have been exposed to at least one adverse childhood experience (ACE) before turning 18, contributing to a broad array of problems spanning physical health, mental and behavioral health, and psychosocial functioning.MethodsThis was a cross-sectional, survey research study, using 2018 data from a state adolescent health surveillance system, i.e., Maryland Youth Risk Behavior Survey/Youth Tobacco Survey. The population-based sample of Maryland high school students (n = 41,091) is representative at the state and county levels. The outcome variables included five binary measures of ACEs (i.e., food insecurity, parental substance use/gambling, parental mental illness, family member in jail/prison, and caregiver verbal abuse), and number of ACEs. The main exposure variable, area-level socioeconomic disadvantage, was assessed at the county level using a continuous measure of the area deprivation index (ADI). Additional covariates included: rural county status, age, race/ethnicity, sex, and sexual or gender minority (SGM) status. We used mixed-effect multivariate logistic regression to estimate the odds of ACEs in association with socioeconomic deprivation. Models were adjusted for all covariates.ResultsCounty-level ADI was associated with 3 of the 5 ACES [i.e., food insecurity (OR = 1.10, 95% CI: 1.07-1.13), parental substance use/gambling (OR = 1.05, 95% CI: 1.02-1.07), and incarceration of a family member (OR = 1.14, 95% CI: 1.09-1.19)]; and with having at least one ACE (i.e., OR = 1.08, 95% CI: 1.05-1.10). Odds of reporting at least one ACE were higher among girls, older adolescents (i.e., aged 16 and ≥ 17 relative to those aged ≤ 14 years), and among SGM, Black, and Latinx students (all ORs > 1.20).ConclusionsACEs greatly increase risk for adolescent risk behaviors. We observed an increased likelihood of adversity among youth in more deprived counties and among Black, Latinx, or SGM youth, suggesting that social and structural factors play a role in determining the adversity that youth face. Therefore, efforts to address structural factors (e.g., food access, family financial support, imprisonment as a sanction for criminal behavior) could be a critical strategy for primary prevention of ACEs and promoting adolescent health.

Project description:AimsTo identify prototypical developmental patterns of tobacco product and cannabis use and co-use initiation during adolescence, and determine risk factors for and consequences of these initiation patterns.DesignProspective repeated-measures cohort with eight semi-annual assessments during high school. Multiple-event process survival mixture modeling identified latent initiation classes with distinct patterns of variation in timing of use initiation of tobacco products and cannabis. We then estimated: (1) associations of baseline risk factors with membership in initiation classes and (2) differences between initiation classes in frequency of cannabis and tobacco product use at the final assessment.SettingTen high schools in the Los Angeles, CA, USA metropolitan area, 2013-17.ParticipantsStudents [1031 (45.4%) males; mean (standard deviation) age at baseline = 14.6 (0.39) years] who had never used any tobacco products or cannabis at baseline 9th grade assessment (n = 2272).MeasurementsSelf-report measures of electronic cigarette (e-cigarette), combustible cigarette, hookah, cigar/cigarillos and cannabis use were collected at each assessment.FindingsFour distinct tobacco and cannabis use initiation classes were identified: (1) early and high-risk cannabis and polytobacco initiators (n = 116; 5.1%); (2) early cannabis and polytobacco initiators (n = 172; 7.6%); (3) late cannabis and e-cigarette initiators (n = 431; 19.0%); and (4) abstainers (n = 1553; 68.4%). At baseline, older age for the early and high-risk cannabis and polytobacco initiators [odds ratio (OR) = 1.22, 95% confidence interval (CI) = 1.10, 1.35, P < 0.001], peer cannabis use (OR = 1.60, 95% CI = 1.23, 2.08, P < 0.001) and delinquent behavior (OR = 1.30, 95% CI = 1.08, 1.55, P = 0.004) were associated with membership in the three initiation classes (versus abstainers). Membership in the early and high-risk cannabis and polytobacco initiators class (versus three other classes) was significantly associated with increased past 30-day frequency and daily intensity of use at the final assessment (P-values < 0.001).ConclusionsOlder age, peer cannabis use and delinquent behavior appear to be risk factors for the initiation of tobacco/cannabis product use among high school students in the Los Angeles metropolitan region. Early and higher-risk polyproduct use initiation appears to be associated with greater escalation of past 30-day and daily tobacco and cannabis use at the end of the high school.

Project description:Background Schools play an important role in providing access to physical activity opportunities for children. There are common economic and gender disparities in physical activity and health-related fitness among children, which may inform a school’s programming needs. The purpose of this study is to gain a better understanding about gender, school-level socioeconomic status, and children’s cardiorespiratory fitness. Methods This observational study used 2017–2018 school year data from schools in the Dallas Metropolitan area participating in the Healthy Zone School (HZS) program. Three data sources were integrated: 1) FitnessGram® data, 2) school-level data from the Texas Education Agency, and 3) HZS survey data. Being in the Healthy Fitness Zone (HFZ) for aerobic capacity was the dependent variable, and gender and the percentage of economically disadvantaged students (at the school-level) were key independent variables. Mixed-effects logistic regression models examined associations between dependent and independent variables. Final models were adjusted for age and type of aerobic test. Results There were 67 schools and 15,052 students included in the analysis. When testing main effects, girls had lower odds for being in the HFZ for aerobic capacity than boys (OR?=?0.54, CI?=?0.47–0.62). Additionally, having a greater percentage of students who were economically disadvantaged was associated with lower odds for being in the HFZ for aerobic capacity (0.98, CI?=?0.98–0.99). There was a significant interaction between gender and the percentage of economically disadvantaged students. Results indicated girls had even lower odds (than boys) for being in the HFZ in schools with 90% economically disadvantaged students (OR?=?0.44, CI?=?0.35–0.55) versus in schools with 15% economically disadvantage students (OR?=?0.62, CI?=?0.51–0.76). Conclusions Results suggest girls in Healthy Zone Schools have lower odds to meet aerobic capacity fitness standards than boys. Additionally, boys and girls in schools serving a greater percentage of economically disadvantaged students have lower odds to meet aerobic capacity fitness standards. Last, girls have even lower odds of meeting HFZ standard when attending a school serving a greater percentage of economically disadvantaged students. Thus, schools need to provide more programs for girls targeting aerobic physical activity. This is especially important for schools serving a high percentage of low-income students.

Dataset Information

Exposure to adverse childhood experiences and early initiation of electronic vapor product use among middle school students in Nevada.

Publications

Exposure to adverse childhood experiences and early initiation of electronic vapor product use among middle school students in Nevada.

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