Tobacco Use Status and Temptation to Try E-Cigarettes among a Sample of Appalachian Youth.
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ABSTRACT:
SUBMITTER: Mattingly DT
PROVIDER: S-EPMC8267625 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Appalachian youth tobacco use rates exceed the national average. Additional inquiry is needed to better understand youth product perceptions and use patterns. This study examined tobacco harm perceptions and their relationship with tobacco use among Appalachian youth. From 2014 to 2016, a survey of Appalachian middle and high school students (N = 1,136) was conducted. Tobacco harm perceptions were assessed by tobacco use status, categorized as never user, cigarette only user, smokeless only user, e-cigarette only user, or polytobacco user. Descriptive characteristics were compared by tobacco use status and harm perceptions. Adjusted multivariable logistic regression models assessed the relationship between tobacco use status and harm perceptions. Over one-third of participants were tobacco users (34.6%; 4.7% cigarette only users, 3.3% smokeless only users, 5.6% e-cigarette only users, and 21.0% polytobacco users). Approximately half agreed that e-cigarettes cause health problems (54.4%), and 64.7% agreed that e-cigarettes are addictive. Most participants (83.4-92.3%) agreed that smoking and smokeless tobacco cause health problems and are addictive. Tobacco users more often disagreed that tobacco products cause health problems than did never users. Compared to never users, e-cigarette only users were more likely to disagree that smoking (AOR: 2.99, 95% CI: 1.30-6.90) and e-cigarettes cause health problems (AOR: 2.79, 95% CI: 1.64-4.75) and that e-cigarettes cause addiction (AOR: 2.48, 95% CI: 1.48-4.16). Most youth were aware of health dangers associated with smoking, but perceptions were split on whether e-cigarettes were associated with health problems or addiction. The findings indicate the need for additional youth tobacco use prevention efforts.
| S-EPMC7190762 | biostudies-literature
Project description:E-cigarettes are the most popular tobacco product among youth. Although harm perceptions have been linked to youth e-cigarette use, little research focuses on vulnerable populations, such as Appalachian youth. This study examines associations between e-cigarette harm perceptions and tobacco use among a sample of Appalachian youth. Using data from the 2014-2016 Youth Appalachian Tobacco Study (n=1074), distributions of six e-cigarette harm perceptions by tobacco use (never, ever non-e-cigarette, ever e-cigarette) were examined, and multivariable multinomial logistic regression was used. Nearly one-fourth (23.4%) of the sample were ever e-cigarette users. More e-cigarette users were male (53.4%) and in high school (57.0%). Fewer e-cigarette users strongly agreed that e-cigarettes cause health problems (15.1%), breathing problems (20.3%), and oral health problems (18.7%) and that e-cigarettes are addictive (25.1%), compared to never and non-e-cigarette users. More e-cigarette users strongly agreed (32.3%) that e-cigarettes are healthier alternatives to cigarettes compared to never (24.1%) and non-e-cigarette (25.7%) users. Regression models indicate that e-cigarette users had greater odds of strongly disagreeing with e-cigarettes being harmful or addictive, compared to never users. E-cigarette users had approximately six-fold odds of strongly disagreeing with e-cigarettes causing health problems (OR=6.12; 95% CI: 3.16-11.90) and two times greater odds of disagreeing with e-cigarettes being addictive (OR=2.09; 95% CI: 1.07-4.08) compared to never users. Appalachian youth ever e-cigarette users perceive e-cigarettes as less harmful and less addictive compared to never users. Better informing youth, especially youth tobacco users, of the harms associated with e-cigarettes is vital.
| S-EPMC8411871 | biostudies-literature
Project description:INTRODUCTION:Youth tobacco use rates in Appalachia exceed the US national average, and e-cigarette use has increased. Thus, further research is needed to understand how these youth receive and share product information. METHODS:Middle and high school students in rural Appalachia were surveyed (N=1103). The primary outcome, tobacco use, was categorized as: never users, cigarette-only users, smokeless-only users, e-cigarette-only users, and polytobacco users. Associations between receiving or sharing conventional tobacco-related or e-cigarette-related information via specific communication channels and tobacco use were assessed. RESULTS:Participants who received tobacco information from friends and family (FF) (OR=1.87; 95% CI: 1.35-2.57), public displays (PUB) (OR=1.49; 95% CI: 1.09-2.05), and digital media (DIG) (OR=1.95; 95% CI: 1.41-2.70) and e-cigarette information via the same communication channels, FF (OR=2.65; 95% CI: 1.93-3.65), PUB (OR=1.62; 95% CI: 1.17-2.26), and DIG (OR=2.24; 95% CI: 1.61-3.12), had greater odds of being polytobacco users, compared to never users. Participants who received e-cigarette-related information from FF (OR=2.42; 95% CI: 1.42-4.13) and PUB (OR=2.13; 95% CI: 1.25-3.65) had greater odds of being e-cigarette-only users compared to never users. Participants who shared e-cigarette-related information with FF had greater odds of being e-cigarette-only users (OR=3.16; 95% CI: 1.80-5.58) and polytobacco users (OR=4.48; 95% CI: 3.16-6.35) compared to never users. CONCLUSIONS:Receiving and sharing tobacco-related and e-cigarette-related information via multiple communication channels is associated with e-cigarette and polytobacco use among Appalachian youth. Several channels may need to be utilized in health campaigns to influence youth.
| S-EPMC7291911 | biostudies-literature
Project description:IntroductionPatterns of youth tobacco use, including use of multiple products, have likely shifted as e-cigarettes have grown in popularity. However, there is limited understanding of dual and poly tobacco use and the associated disparities, especially among Appalachian youth.MethodsWe analyzed Youth Appalachian Tobacco Study data (n=1116) to estimate prevalence of current (past-30 day) cigarette, e-cigarette, and smokeless tobacco use by gender, race/ethnicity, age, school type, state, smartphone use, and number of household tobacco users. We created a pattern of tobacco use variable (i.e. never, former, single, dual, poly) based on all possible combinations of the included products. Using multivariable multinomial logistic regression (outcome reference: never use), we evaluated associations between sociodemographic characteristics and patterns of tobacco use.ResultsFormer (16.2%) was the most common tobacco use group, followed by single (10.8%), dual (4.5%), and poly (2.4%) use. Dual and poly use were more prevalent among males, Whites/Caucasians, older participants, and participants living in households with tobacco users. Kentucky residents (vs New York) had higher odds of dual use (OR=5.15; 95% CI: 1.72-15.44), and youth who used smartphones for ≥20hours/week (vs <20 hours/week) had greater odds of poly use (OR=3.02; 95% CI: 1.34-6.80).ConclusionsDifferences in single, dual, and poly tobacco use were evidenced by sociodemographic characteristics. Additional inquiry should further examine these disparities so that tobacco prevention interventions can be appropriately tailored.
| S-EPMC7549506 | biostudies-literature
Project description:Given that Appalachian youth tobacco use rates are higher than the US national average, it is important to understand whether sex differences shape associations between receiving and sharing product information and using tobacco. Middle and high school students in rural Appalachia (n=1038) were surveyed about tobacco-related perceptions and behaviors, including ways youth receive and share conventional tobacco-related and e-cigarette-related information. Youth were characterized as tobacco users (i.e. ever or current users of cigarettes, smokeless tobacco, or e-cigarettes) or never users. Descriptive characteristics were compared by tobacco use and sex. Adjusted logistic regression models evaluated associations between communication channels and tobacco use. Models were stratified by sex to examine effect modification. Approximately one-third of Appalachian youth (33.8%) were tobacco users and use varied by sex (males: 54.4%; females: 45.6%). Male (OR=1.75; 95% CI: 1.18-2.60) and female (OR=2.30; 95% CI: 1.53-3.47) youth who received e-cigarette-related information through friends and family (FF) had higher odds of tobacco use. Additionally, females who received e-cigarette-related information through public displays and digital media had nearly two-fold increased odds of tobacco use. Although sharing conventional tobacco-related and e-cigarette-related information through FF was associated with increased odds of tobacco use among both sexes, these relationships were stronger among females. Although specific communication channels were associated with tobacco use, associations involving receiving and sharing e-cigarette information were more pronounced in female tobacco users. Consideration of sex differences in how youth receive and share tobacco-related information may benefit tobacco prevention interventions.
| S-EPMC7899165 | biostudies-literature
Project description:IntroductionSexual minority individuals experience elevated risk for smoking and violence due to a combination of general and unique identity-based risk factors. This study examined associations among sexual minority status, school-based violence, and tobacco use, among youth.MethodsData for this secondary data analysis consisted of Chicago-specific data from the 2019 Youth Risk Behavior Surveillance System (n=1562). Current use (≥1 day during the previous 30 days) of any tobacco product (cigarettes, e-cigarettes, smokeless tobacco, and cigars) and school-based violence (avoided school because they felt unsafe, were threatened/injured with a weapon, were in a physical fight, and were bullied) were estimated by sexual orientation (heterosexual vs gay, lesbian, bisexual, and unsure). A chi-squared test was used to investigate associations among the variables. Path analysis was employed to examine possible mediation effects of school-based violence.ResultsThirty percent of sexual minority youth and 11.5% of heterosexual youth reported current tobacco use (χ2=55.91; p<0.001). Nearly one-third (31.8%) of youth reported school-based violence, with a higher rate (41.2%) reported by sexual minority youth compared to heterosexual youth (28.1%; χ2=19.48; p<0.001). Path analysis confirmed these associations, controlling for sex, age, and race/ethnicity. The model showed that sexual minority status increased odds of current tobacco use by a factor of 1.8 (95% CI: 1.3-2.6) via its relationship with school-based violence, explaining 33.8% of the total association between sexual minority status and tobacco use.ConclusionsTobacco use was higher among sexual minority youth. School-based violence partially mediated the association between sexual minority status and tobacco use. Findings highlight the need for tobacco prevention and treatment efforts for sexual minority youth and school-based interventions to reduce exposure to violence.
| S-EPMC9753573 | biostudies-literature
Project description:INTRODUCTION:Approximately 9 million American adults use two or more tobacco products regularly, referred to as dual or poly tobacco users. In Alaska, where tobacco is not native, approximately 20% of the population smokes cigarettes, and among smokers, 10% use two or more tobacco products. Previous research suggests that dual tobacco product use may be especially high among Alaska Native people. The current study examined cultural and demographic characteristics associated with dual tobacco use. METHODS:Alaska Native adults reporting daily smoking and identified with high blood pressure or cholesterol were recruited in the Norton Sound region of Alaska between 2015-2019 as part of a treatment trial targeting cardiovascular disease risk factors. Participants reported their tribal group, level of identification with their Alaska Native heritage, speaking of their tribal language, basic demographic characteristics, and past 30-day use of tobacco products in addition to smoking cigarettes. RESULTS:Participants (n=299) were 48.5% female and identified as Yup'ik (31.1%), Inupiat (60.5%), and other or multiple tribal group(s) (8.4%). Most participants (85.3%) strongly identified with their Alaska Native heritage. Past 30-day dual tobacco use was reported by 10.0%, specifically 9.0% chew/snuff, 1.3% e-cigarettes, and 0.7% Iq'mik. Multivariate regression models indicated that dual tobacco use was more likely among men (OR=3.35; 95% CI: 1.30-8.64), younger participants (OR range: 10.97-12.35; 95% CI: 2.33-57.86), those identifying as Yup'ik (OR=2.86; 95% CI: 1.13-7.19), and those who identified very little or not at all with their Alaska Native heritage (OR=2.98; 95% CI: 1.14-7.77). CONCLUSIONS:Young men identifying as Yup'ik were more likely to use dual forms of tobacco. Stronger identification with one's Alaska Native heritage was associated with lower risk of dual tobacco use. The findings highlight cultural and demographic factors for further consideration and attention in tobacco cessation treatment interventions.
| S-EPMC7309271 | biostudies-literature
Project description:BACKGROUND:While e-cigarette use is increasing, reasons to use e-cigarettes are poorly summarized in the literature. The objective of this study was to organize reasons to use e-cigarette items into factors and determine associations between these factors and e-cigarette user characteristics. METHODS:Data were drawn from youth (12-17) and adults (18+) in Wave 1 (2013-2014) of the Population Assessment of Tobacco and Health (PATH) study. Exploratory factor analysis was conducted on 13 reasons to use survey items from experimental and established adult e-cigarette users and past 30?day youth e-cigarette users to determine two factors - "alternative to cigarettes" and "larger social environment". Weighted linear regression models tested the associations between e-cigarette user group and sociodemographics and reasons to use factors among youth and adults. RESULTS:Adult current established e-cigarette users were associated with both alternative to cigarettes (??=?0.128, p?<?.001) and larger social environment (??=?0.063, p?<?.001) factors, while former established e-cigarette users were associated with alternative to cigarettes (??=?0.064, p?<?.001). Several adult sociodemographic characteristics were associated with one but not the other factor, or both but in opposite directions. Youth that used e-cigarettes earlier today were also associated with both reasons to use factors (??=?0.127-0.130, p?<?.01, each); however, youth using any other day in the past 30?days was not associated with either factor. CONCLUSIONS:Reasons to use are associated with patterns of e-cigarette use among youth and adults. These factors could support a comprehensive approach to addressing rising e-cigarette use among youth and adults and target certain user populations.
| S-EPMC6594857 | biostudies-literature
Project description:Tobacco companies have distributed free samples of tobacco products in the past. While prior studies have found a relationship between various marketing strategies and tobacco use, no study has assessed the prevalence of free sample receipt or the relationship between receipt and subsequent tobacco use. We analyze three waves of Population Assessment of Tobacco and Health (PATH) Study data to provide the first nationally representative prevalence estimates of free tobacco product receipt among US youth and adults in 2014 to 2016. This analysis also examines the relationship between free tobacco product receipt and ever, past 30-day, and new tobacco use one year later. The prevalence of free sample receipt in the US population in 2014-2016 was 0.8% for any tobacco product but 1.6% for ENDS/e-liquid in adults, and 0.5% for any tobacco product but 1.05% for ENDS/e-liquid in youth. Free sample receipt was higher among vulnerable subgroups. Receipt of free tobacco product samples was associated with tobacco use status using cross-sectional data in youth and adults, as well as one year later in youth. Receipt of a free ENDS or e-liquid sample was associated with any tobacco and ENDS use status using cross-sectional data in youth and adults. After these data were collected, the US Food and Drug Administration broadened the ban on distributing free samples to include all tobacco products except smokeless tobacco in adult-only facilities. Our findings support limiting free samples to further prevent youth access to tobacco products.
| S-EPMC10542903 | biostudies-literature
Project description:In this paper, an empirical review of 64 teen tobacco use cessation studies is provided. Examined include program contents, delivery modalities, number of contacts, and expected quit rates. In addition, means of recruitment and retention of smokers in programming are discussed. Also, promising contemporary methods of teen smoking cessation are examined, including use of pharmacologic adjuncts, electronic technology, and cigarette price increases (and no smoking policy). Conclusions are made regarding implications for developing and implementing teen tobacco use cessation programs.
| S-EPMC2644896 | biostudies-literature