Alcohol, cigarette, e-cigarette and marijuana use among adolescents and young adults with chronic kidney disease in North America.
Ontology highlight
ABSTRACT: Purpose
This study aimed to describe substance use (SU) among adolescents and young adults (AYA) with chronic kidney disease, compare these findings with the general population, and identify associated risk factors.Methods
708 AYA participants contributing 2475 person-visits from the Chronic Kidney Disease in Children Study were used to estimate prevalence rates of past year and 30-day alcohol, cigarette, e-cigarette and marijuana use, and were compared with national surveys. Repeated measures logistic regression estimated the association between SU and participant characteristics.Results
There was nearly no SU among those 12 to 14 years, but use increased with age, and past year alcohol use was about 80% for those greater than or equal to 22 years. Rates of use among males were constant or increased with age, while rates of use among females were lower after age 22 compared to ages 18 to 22. Associated risk factors included non-Black and non-Hispanic identity, older age, and worse disease severity. Participants were less likely to use substances compared to the general population, especially those 14-18 years.Conclusions
SU was less common in AYA with chronic kidney disease than the general population, but differences were attenuated among those greater than or equal to 18 years. Ages 12-14 appear to be the ideal time for prevention efforts. As the landscape of e-cigarette and marijuana policies change, these results underscore the need to understand how similar high-risk populations engage in SU.
SUBMITTER: Molino AR
PROVIDER: S-EPMC8327403 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundWe investigated the putative associations of alcohol, cigarette, e-cigarette, and marijuana use with kidney function and proteinuria among adolescents and young adults (AYA) with pediatric-onset chronic kidney disease (CKD) enrolled in the Chronic Kidney Disease in Children (CKiD) study.MethodsParticipants responded to questions about past year and 30-day substance use. Associations between each substance and kidney function, proteinuria, nephrotic range proteinuria, and high blood pressure were separately estimated using repeated measures regression models, adjusting for sociodemographic characteristics. Models controlled for covariates at the present visit (contemporaneous) and additionally controlled for disease severity at the year prior to reporting substance use (lagged).ResultsA total of 441 participants ≥16 years contributed 1,245 person-visits with 39% reporting alcohol and 16%, 17%, and 15% reporting cigarette, e-cigarette, and marijuana use, respectively, over the previous year. In adjusted lagged models, past year and 30-day cigarette use were significantly associated with higher levels of proteinuria (+18.6%, 95%CI: +2.8%, +36.9%; and +20.0%, 95%CI: +0.7%, +43.1%, respectively). Inferences were similar when controlling for secondhand smoke exposure.ConclusionsIn a cohort of AYA with pediatric kidney diseases, substance use was non-trivial, and cigarette use was associated with higher proteinuria, although the prevalence of use was low. Occasional alcohol, e-cigarette, and marijuana use were not associated with proteinuria, disease progression, or elevated blood pressure. Pediatric nephrologists as specialty care providers are well-positioned to discuss substance use and should encourage tobacco prevention/treatment efforts among AYA at high risk for use in order to preserve kidney function and promote well-being.
| S-EPMC8938986 | biostudies-literature
Project description:BACKGROUND AND OBJECTIVES:Although the prevalence of e-cigarette use among adolescents and young adults has caught up to or eclipsed that of combustible cigarette use, there is relatively little known about (a) the link between e-cigarettes and other substances and (b) the reasons underlying this increase in e-cigarette use. To address this gap in knowledge, the current study examined associations between e-cigarette use and other substances and identified motives for e-cigarette use among young adults. METHODS:Participants included an ethnically diverse sample of African American, White, and Hispanic young adults (N?=?662; 61% female) who were participating in an ongoing survey-based longitudinal study of health and risky behaviors. RESULTS:Hispanic, White, and male young adults reported significantly greater past year e-cigarette use compared to their African American and female counterparts. Bivariate correlations showed that use of e-cigarettes was positively associated with use of combustible cigarettes, alcohol, marijuana, cocaine, amphetamines, inhalants, hallucinogens, ecstasy, and misuse of over-the-counter and prescription medications. Furthermore, e-cigarette users reported a higher prevalence of substance use relative to those who did not use e-cigarettes. The taste of e-cigarettes was identified as an important motive for use. CONCLUSIONS AND SIGNIFICANCE:Although the potential harm associated with e-cigarettes remains largely unknown, e-cigarettes appear to be a risk marker for the use of substances that are known to pose substantial health problems. Health care providers should screen for e-cigarette use, and youth substance use prevention programs should target the reduction of e-cigarette use with particular attention to addressing their taste appeal. (Am J Addict 2017;26:343-348).
| S-EPMC5426966 | biostudies-literature
Project description:BACKGROUND:Medical marijuana legalization is associated with a higher prevalence of marijuana use which may affect cigarette use and nicotine dependence in co-users. In the present study, we examined relationships between statewide legalization of medical marijuana and prevalence of cigarette and marijuana co-use and nicotine dependence in co-using adolescents and adults. METHODS:Data were analyzed from the 2013 National Survey on Drug Use and Health. We compared cigarette and marijuana co-use in the past 30days across age categories (12-64 years) by statewide medical marijuana legalization. Logistic regression models were used to estimate the odds of having nicotine dependence among current cigarette smokers who also reported past 30-day marijuana use and "ever but not current" marijuana use (vs. "never" use) adjusting for covariates including statewide legalization of medical marijuana. RESULTS:Overall, 5.1% of the sample reported past 30-day cigarette and marijuana co-use and a higher proportion of co-users resided in states where medical marijuana was legal compared to illegal (5.8% vs. 4.8%; p=0.0011). Co-use was associated with greater odds of having nicotine dependence compared to cigarette-only use across age categories. Odds were highest and up to 3-times higher in adolescents aged 12-17 years (OR=3.54; 95%CI: 1.81-6.92) and adults aged 50-64 years (OR=3.08; CI: 1.45-6.55). CONCLUSION:Marijuana policy could inadvertently affect cigarette and marijuana co-use and pose challenges to tobacco cessation.
| S-EPMC4983542 | biostudies-literature
Project description:Importance:Use of electronic cigarettes (often called e-cigarettes) has increased considerably among young people in the past 5 years. Use of e-cigarettes has been associated with higher rates of marijuana use, which is associated with several adverse health outcomes in youth. Objective:To characterize and quantify the association between e-cigarette and marijuana use among youth using a meta-analysis. Data Sources:PubMed, Embase, and Web of Science & ProQuest Dissertations and Theses were searched from inception to October 2018. A gray-literature search was also conducted on conference abstracts, government reports, and other sources. Study Selection:Included studies compared rates of marijuana use among youth aged 10 to 24 years who had used e-cigarettes vs those who had not used e-cigarettes. Two reviewers independently assessed studies for inclusion; disagreements were discussed with a third reviewer and resolved by consensus. Data Extraction and Synthesis:Data were extracted by 2 independent reviewers following Meta-analyses of Observational Studies in Epidemiology (MOOSE) reporting guidelines and pooled using a random-effects analysis. The Newcastle-Ottawa Scale was used to assess data quality and validity of individual studies. Main Outcomes and Measures:Adjusted odds ratios (AORs) of self-reported past or current marijuana use by youth with vs without past or current e-cigarette use. Results:Twenty-one of 835 initially identified studies (2.5%) met selection criteria. The meta-analysis included 3 longitudinal and 18 cross-sectional studies that included 128?227 participants. Odds of marijuana use were higher in youth who had an e-cigarette use history vs those who did not (AOR, 3.47 [95% CI, 2.63-4.59]; I2, 94%). Odds of marijuana use were significantly increased in youth who used e-cigarettes in both longitudinal studies (3 studies; AOR, 2.43 [95% CI, 1.51-3.90]; I2, 74%) and cross-sectional studies (18 studies; AOR, 3.70 [95% CI, 2.76-4.96]; I2, 94%). Odds of using marijuana in youth with e-cigarette use were higher in adolescents aged 12 to 17 years (AOR, 4.29 [95% CI, 3.14-5.87]; I2, 94%) than young adults aged 18 to 24 years (AOR, 2.30 [95% CI, 1.40-3.79]; I2, 91%). Conclusions and Relevance:This meta-analysis found a significant increase in the odds of past or current and subsequent marijuana use in adolescents and young adults who used e-cigarettes. These findings highlight the importance of addressing the rapid increases in e-cigarette use among youths as a means to help limit marijuana use in this population.
| S-EPMC6692686 | biostudies-literature
Project description:The majority of young adults who use alcohol and marijuana sometimes use the two substances simultaneously. Understanding why young adults engage in simultaneous alcohol and marijuana (SAM) use may inform interventions and help offset negative consequences. To date, research has not yet examined motives for SAM use. The current study tested a 26-item measure of motives for SAM use in a community sample of young adults to identify the factor structure and to evaluate associations of subscales of SAM motives with alcohol and marijuana motives and substance use. Young adults from the Seattle metropolitan area (N=286; 58% female, 67% White/Caucasian) were asked about their motives for using alcohol, marijuana, and SAM as well as their use of alcohol and marijuana and related consequences in the past month. Exploratory factor analysis with promax rotation identified four factors to characterize motives for SAM use: (1) conformity (8 items, ?=0.87, e.g., "to fit in with a group I like," "pressure from others"), (2) positive effects (6 items, ?=0.88, e.g., "cross-faded effects are better," "to get a better high") (3) calm/coping (3 items, ?=0.77, e.g., "to calm me down," "to cope with anxiety"), and (4) social (5 items, ?=0.78, e.g., "because it is customary on special occasions," "as a way to celebrate"). Results revealed that alcohol, marijuana, and SAM motives were moderately correlated. Even after controlling for alcohol or marijuana motives, SAM motives were associated with SAM use and marijuana use/consequences (but not alcohol use/consequences).
| S-EPMC5614866 | biostudies-literature
Project description:OBJECTIVE:The current study examines the prevalence, stability, and correlates of simultaneous alcohol and marijuana (SAM) use among underage US young adults, a population at high risk for participating in this behavior. METHOD:Analyses used data from 1719 respondents (46.8% men) who participated in the nationally representative 12th-grade Monitoring the Future study and provided responses to SAM use items at longitudinal follow-up at modal ages 19/20 between 2007 and 2016. Prevalence estimates and covariate associations with SAM use were estimated. RESULTS:SAM use prevalence at modal age 19/20 was 22.5%. Multivariable models indicated that odds of age 19/20 SAM use were significantly (p?<?.05) higher for men (vs. women) and for respondents who started alcohol use by age 18 (vs. those who delayed uptake until after high school). Odds of SAM use were especially high for individuals attending college full-time and not living with parents. Among those who reported SAM use at modal age 18, 56.2% continued to report SAM use at modal age 19/20. Among those who did not report SAM use at modal age 18, only 14.2% reported SAM use at modal age 19/20. CONCLUSIONS:SAM use among young adults aged 19/20 in the US is relatively common, but especially so for those who began such use by age 18, highlighting the early onset and stability of this behavior. Among underage drinkers, SAM risk varies by sex, race/ethnicity, college status, and living arrangements.
| S-EPMC6447064 | biostudies-literature
Project description:Association between drinking and smoking has remained controversial since the association between two studies were influenced by various confounding. Thus, our study aimed to explore the causal effect of alcohol consumption and cigarette smoking using alcohol flushing as an instrument variable, which is free from confounders. We analyzed cross-sectional survey data from 2500 Korean young adults (1600 men and 900 women). Alcohol flushing was strongly associated with log transformed alcohol consumption (F = 272). In men, alcohol non-flushers were 1.41 times (95% CI 1.28-1.55) more likely to smoke 100 cigarettes in their lifetime in logistic regression analysis. Alcohol non-flushers were also 1.3 times (95% CI 1.21-1.40) more likely to become daily smokers and 1.39 times (95% CI 1.27-1.51) more likely to be current smokers than alcohol flushers. However, in an IV analysis, no causal relationships between alcohol consumption and smoking status were found. Alcohol consumption, on the other hand, was causally associated with lowering nicotine dependence and former smoking in men. Alcohol consumption determined by alcohol flushing status does not appear to be causally linked to the smoking behavior of young adults. The relationship between alcohol consumption and nicotine dependence and smoking cessation needs further study.
| S-EPMC8583641 | biostudies-literature
Project description:INTRODUCTION:Although epidemiologic studies suggest low levels of cigarette use among African American adolescents relative to White U.S. adolescents, it is not known whether this may be due to racial differences in the relative contribution of genes and environment to cigarette use initiation and progression to regular use. METHODS:Using data from White (n=2665) and African American (n=809) twins and full siblings sampled in the National Longitudinal Study of Adolescents, we fitted age-, sex- and race-specific variance decomposition models to estimate the magnitude of genetic and environmental effects on cigarette use initiation and cigarette use quantity in Whites and African Americans across adolescence and adulthood. We employ a causal-contingent-common pathway model to estimate the amount of variance explained in quantity of cigarettes smoked contingent on cigarette use initiation. RESULTS:African Americans had lower cigarette use prevalence from adolescence through adulthood, and used cigarettes less heavily than Whites. Race-specific causal-contingent-common pathway models indicate that racial differences in genetic and environmental contributions to cigarette use initiation and cigarette use quantities are not present in adolescence but appear in young adulthood. Additive genetic factors were an important risk factor for cigarette use initiation for White but not African American young adults and adults. CONCLUSIONS:Genetic and environmental contributions for cigarette use are similar by race in adolescence. In adulthood, genes have a stronger influence for cigarette use among White adolescents while the influence of the environment is minimal. For African Americans, both genetic and environmental influences are important in young adulthood and adulthood.
| S-EPMC4983522 | biostudies-literature
Project description:OBJECTIVE:Research on substance use motives typically examines each substance separately. However, simultaneous alcohol and marijuana (SAM) use-that is, using alcohol and marijuana at the same time so that their effects overlap-is common among young adults. This study examines day-to-day fluctuations in motives for using alcohol and/ or marijuana among young adult substance users as predictors of alcohol, marijuana, and SAM use across days. METHOD:Data were from a community sample of young adults who reported SAM use in the past month (analytic sample: N = 399, mean [SD] age = 21.63 [2.17]; 50.9% women). Participants reported alcohol, marijuana, and SAM use, and also motives "for alcohol and/or marijuana use" for 14 consecutive days. RESULTS:Multilevel models showed that elevated enhancement motives were associated with heavy episodic drinking, drinking more, and more hours high from marijuana. Elevated social motives were associated with heavy episodic drinking and drinking more, and also with fewer hours high. Elevated conformity motives were associated with drinking more. SAM use was more likely: on alcohol days and on marijuana days with elevated enhancement and conformity motives, on alcohol days with elevated coping motives, and on marijuana days with elevated social motives. CONCLUSIONS:SAM use on a given day was primarily associated with enhancement and conformity motives. Social motives were more strongly linked to alcohol use, and to some extent coping motives were linked to marijuana use in this young adult sample. Further examination of situation-specific motives and contexts of use is needed to inform development of real-time interventions for SAM use and consequences.
| S-EPMC6739644 | biostudies-literature
Project description:Objective: Driving while impaired by alcohol or drugs increases the risk of motor vehicle fatalities, the leading cause of death among young adults. The current study documented the prevalence of driving after alcohol and marijuana use in the past 2 weeks as well as the prevalence of riding with a driver who had used each substance during that time frame. We tested whether young adults who lived with family members (i.e., their parents or their children) were less likely to engage in these behaviors. Methods: Participants aged 18-25 who resided in nonmetropolitan areas in the United States (N?=?1,131; 55% female, Mage = 22.6) completed an online survey. Multivariate logistic regressions examined alcohol- and marijuana-related driving and riding behaviors adjusting for demographic factors. Interactions tested whether associations varied by gender. Results: In the 2 weeks prior to the survey, 17% of participants drove after drinking alcohol and 21% had ridden with a driver who had been drinking. The prevalence of driving after marijuana use was 11%, and 16% of the sample had ridden with a driver who had been using marijuana. Participants who lived with their parents were less likely to ride with a driver who had been using alcohol or marijuana (adjusted odds ratios [AORs]?=?0.71 and 0.55, respectively). Living with parents was also associated negatively with driving after both substances, but these associations were no longer significant when controlling for substance use frequency and driving frequency. Surprisingly, the odds of driving after marijuana use were over 2 times larger for young adults who lived with their children. For women, but not men, residing with children decreased the odds of driving and riding after alcohol use. Conclusions: Living with parents protects against riding after substance use among young adults. Prevention programs should target young adults who live independently or those transitioning away from the parental home. Furthermore, given the higher rates of driving after marijuana use among young adult parents, this group should be educated about the risks associated with this behavior.
| S-EPMC6827710 | biostudies-literature