Objective:
Blunt smoking presents unique public health concerns relative to other methods of marijuana use, including greater exposure to toxins and carcinogens as well as increased risk for cannabis ...use disorder. This study examines correlates of self-reported daily blunt use among a nationally representative sample of adult blunt users in the United States.
Method:
We pooled and analyzed 5 years of cross-sectional data from n = 10,826 adult blunt smokers in the United States using the National Survey on Drug Use and Health (2014-2018). Multiple logistic regression analysis examined correlates of daily blunt use among non-Hispanic White, non-Hispanic African American, and Hispanic/Latino adult blunt users in the United States. Next, multiple logistic regression analyses stratified by race/ethnicity were conducted. This study examined: (a) socio-demographic (age, sex, and income); (b) behavioral (alcohol, tobacco, and illicit drug use); (c) intrapersonal (depression); and (d) regulatory (marijuana laws) factors.
Results:
African Americans had the greatest prevalence of daily blunt use (24.2%), relative to Whites (9.1%) and Hispanic/Latinos (13.9%) (p < .001). African Americans aged 26-34 years old (adjusted odds ratio Adj OR: 1.37) and living in medical marijuana states (Adj OR: 1.28) were more likely to be daily blunt users; these factors were not associated with daily blunt use in the full sample or in stratified models of Whites or Hispanic/Latinos. Alcohol use was negatively associated with daily blunt use among Whites and Hispanic/Latinos but not African Americans.
Conclusions:
Socio-demographic, behavioral, and regulatory factors appear differently associated with daily blunt use across racial/ethnic groups.
Public Health Significance
This study is among the first to examine daily blunt use among adults using a nationally representative sample. Findings highlight racial/ethnic differences in correlates of daily blunt use. This research provides sociocultural context in our understanding of daily blunt use and, thus, assists in the efforts to improve health equity.
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CEKLJ, FFLJ, NUK, ODKLJ, PEFLJ, UPUK
Introduction
There is an established link between tobacco use and adverse oral health outcomes. However, there is a paucity of research exploring the effect of various tobacco products on clinically ...diagnosed adverse oral health outcomes.
Methods
Data were pooled from three cycles of the National Health and Nutrition Examination Survey: 2009–2010; 2011–2012; and 2013–2014 (n = 11,453). Multivariable logistic regressions examined the associations between periodontitis and dental caries with the type of tobacco product used (combustible, non‐combustible or both).
Results
Overall, 42.3% of the study sample had any periodontitis, 7.8% had severe periodontitis and 21.7% had dental caries. There was a higher prevalence of periodontitis and caries among combustible tobacco users than non‐combustible tobacco use; 62.1% of combustible tobacco smokers had any periodontitis, 17.1% had severe periodontitis, while 39.4% of adults with dental caries were dual users. Compared to non‐smokers, combustible tobacco use increased the odds of any periodontitis (adjusted odds ratio aOR 2.81, 95% confidence interval CI 2.28, 3.45) and severe periodontitis (aOR 2.62, 95% CI 1.90, 3.61). Compared to non‐smokers, both combustible tobacco (aOR 2.11, 95% CI 1.61, 2.76) and non‐combustible tobacco use (aOR 2.09, 95% CI 1.19, 3.66) increased the odds of dental caries.
Discussion and Conclusions
In this study of US adults, combustible tobacco use was associated with periodontitis and dental caries, while non‐combustible tobacco use was associated with dental caries. In addition to conducting extensive oral health screening among all smokers, oral health‐care providers should counsel smokers on the need for smoking cessation.
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BFBNIB, DOBA, FSPLJ, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UILJ, UKNU, UL, UM, UPUK
We quantified the linear trend in combustible tobacco smoking among adolescents in the United States from 2014 to 2020, then compared these trends across racial and ethnic category. We also tested ...the effect of e-cigarette use on these trends for all youth and across racial and ethnic categories.
We pooled and analyzed seven years of National Youth Tobacco Survey (NYTS) data for n=124,151 middle and high school students from 2014 to 2020. Weighted logistic regression analyses calculated the annual change in combustible tobacco smoking (i.e., cigarettes, cigars, and hookah) from 2014 to 2020. Stratified analyses examined linear trends for non-Hispanic White (NHW), NH-Black (NHB), Hispanic/Latino, and NH-Other (NHO) youth. All models controlled for sex, grade level, and past 30-day e-cigarette use.
Combustible tobacco smoking from 2014 to 2020 dropped by more than 50% for NHW youth, more than 40% for Latino and NHO youth, compared to just 16% among NHB youth. From 2014 to 2020, odds of combustible tobacco smoking declined by 21.5% per year for NHWs, which was significantly greater than Hispanic/Latinos (17% per year; p=0.025), NHOs (15.4% per year; p=0.01), and NHBs (5.1% per year; p<0.001), adjusting for sex, grade, and e-cigarette use. Trends and disparities in trends by race and ethnicity were observed independent of e-cigarette use.
Combustible tobacco smoking declined for all youth but at significantly different rates across races and ethnicity. Notably, declines in combustible tobacco smoking are lagging among NHB youth. Interventions are critically needed to address this disparity.
A direct, evidence-based intervention to reduce combustible tobacco smoking among NHB youth is critically needed. Such tobacco control initiatives should follow the Best Practices for Comprehensive Tobacco Control Framework, incorporating sustainable funding for school-based intervention, public health education, and adult cessation.
This study aims to examine the relationship between self-reported history of concussion and risk factors for completed suicide among middle school students.
We analyzed state-level data from the 2017 ...YRBS. The study sample was n = 19,254 middle school students in 7 States: Delaware, Florida, Hawaii, Kentucky, Nevada, Rhode Island, and Virginia. We conducted multi-level, multivariate logistic regression models to assess the relationship between self-reported concussions and suicidal ideations, planned suicide attempt, and past suicide attempt.
Approximately 17.8% of the sample self-reported a history of concussion. Self-reported history of concussion was significantly associated with greater odds for history of suicidal ideation (Adj OR: 1.31), planned suicide attempt (Adj OR: 1.36), and past suicide attempt (Adj OR: 1.67).
This is the first study to examine the relationship between self-reported concussion and risk factor for completed suicide among middle school students. Research findings mirror similar study done among high school students and young adults. Findings suggest the need to expand prevention programs, intervention strategies and education campaigns to include middle school students.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Abstract
Introduction
Recent literature has demonstrated individuals may be using electronic cigarettes (e-cigarettes) as a method of weight loss and/or management. Furthermore, e-cigarette companies ...are developing and patenting technologies related to e-cigarettes and weight loss. This study aims to determine the association between intentions to lose weight and e-cigarette use behaviors among a nationally representative sample of high school students.
Methods
Data were obtained from the 2015 Youth Risk Behavior Surveillance survey. Participants were 12 847 students in grades 9–12 in the United States. Multivariate multinomial logistic regression models assessed the association between past 30-day e-cigarette use and weight loss intentions among 9–12 grade students. Subsample analyses were conducted, stratified by sex. Covariates included perceived weight, sex, race/ethnicity, grade, and past 30-day tobacco use.
Results
Overall, 23.7% of the sample used e-cigarettes in the past 30 days. E-cigarette use was associated with 1.38 (95% CI = 1.07% to 1.78%) greater risk of intentions to lose weight among the full sample, controlling for covariates. Among girls, e-cigarette use was associated with 1.44 (95% CI = 1.05% to 1.97%) greater risk of intentions to lose weight, controlling for covariates. Among boys, e-cigarette use was associated with 1.40 (95% CI = 1.04% to 1.88%) greater odds of intentions to gain weight, controlling for covariates.
Conclusion
Findings show a significant association between e-cigarette use and intentions to lose weight among high school students, among the full sample. Interestingly, e-cigarette use was statistically associated with intentions to gain weight among boys. Longitudinal study is needed to further examine this relationship.
Implications and Contribution
This is the one of the first studies reporting on e-cigarette use and weight loss intentions among adolescents, both highly prevalent among this population. These findings are an important development in the study of e-cigarette use given the established link between conventional cigarette smoking and weight loss and/or management.
•Menthol was associated with heavier and more frequent cigarette smoking.•Menthol was associated with lower intentions to quit smoking.•Menthol was associated with greater odds of nicotine ...dependence.
Use of menthol cigarettes is linked to sustained cigarette smoking adults. However, the relationship between menthol and smoking profile has not been thoroughly explored in adolescent cigarette smokers. This study examines the relationship between use of menthol cigarette and smoking frequency (i.e., days per month), quantity (i.e., cigarettes per day), quit intentions, and nicotine dependence (i.e., craving tobacco; use within 30 min of waking).
We pooled four years (2017–2020) of cross-sectional data from the National Youth Tobacco Survey. Participants were 2699 adolescent, past 30-day cigarette smokers. Multinomial logistic regression models examined the relationship between menthol and cigarette smoking frequency and quantity. Logistic regressions examined the relationship between menthol and intentions to quit smoking and nicotine dependence. Models controlled for socio-demographics and other tobacco use.
Menthol cigarette smokers had greater risk of smoking 20–30 days per month relative to 1–5 days per month (RRR: 1.90; 95% CI: 1.41 – 2.54) and greater risk of smoking 11+ cigarettes per day relative to 1 or less cigarettes per day (RRR: 1.35; 95% CI: 1.01 – 1.80), adjusting for covariates. Menthol cigarette smokers had lower odds of intentions to quit smoking (Adj OR: 0.70; 95% CI: 0.58 – 0.84) but great odds of craving tobacco (OR: 1.47; 95% CI: 1.20 – 1.81) and using tobacco within 30 minutes of waking (OR: 1.63; 95% CI: 1.29 – 2.05), adjusting for covariates
Findings suggest the relationship between menthol and cigarette smoking profile (i.e., frequency, quantity, quit intentions) is different for youth than that of adults. This study adds adolescent-specific evidence to existing research that suggests menthol reinforces sustained cigarette smoking among youth.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Secondhand smoke exposure during adolescence is linked to increased risk for cigarette smoking susceptibility and initiation. Non-urban youth may encounter a disproportionate number social and ...environmental risk factors for secondhand smoke exposure. Research is needed to explore geographic disparities in secondhand smoke exposure.
Four years of National Youth Tobacco Survey (2015-2018) data were pooled. Participants were 69 249 middle and high school students. Multivariable logistic regression examined the relationship between geographic region and secondhand smoke exposure (1) at home and (2) in a vehicle. A multivariable, multinomial logistic regression examined the relationship between geographic region and number of sources of secondhand smoke exposure (ie, 0, 1 source, 2 sources). Covariates included sex, race/ethnicity, grade level, past 30-day tobacco use, and living with a tobacco user.
From 2015 to 2018, ~28.4% of middle and high school students reported secondhand smoke exposure either at home, in a vehicle, or both. Non-urban youth had greater odds of reporting secondhand smoke exposure at home (Adj OR: 1.26; 95% CI: 1.15 to 1.38) and in a vehicle (Adj OR: 1.50; 95% CI: 1.35 to 1.65), compared with urban youth. Similarly, non-urban youth had greater odds of reporting secondhand smoke exposure via one source (RRR: 1.21; 95% CI: 1.11 to 1.31) and two sources (RRR: 1.61; 95% CI: 1.42 to 1.82), relative to no exposure, than urban youth.
Secondhand smoke exposure at home and/or in a vehicle varies across geographic region. Targeted interventions should be developed and implemented to reduce secondhand smoke exposure among at-risk youth.
Findings showcase the need to address secondhand smoke exposure in non-urban areas and how it impacts adolescents. Public health interventions and regulatory policies aimed at improving social norms and expanding health infrastructure in rural communities should be designed and implemented in order to prevent and reduce secondhand smoke exposure among non-urban youth.
•Approximately 1 in 5 never blunt smokers initiated during the transition from youth to young adulthood.•More than half (56.8%) of current blunt smokers continued using at each follow-up ...observation.•Risk for blunt initiation was greater among Hispanic (72%) and NH-Black (115%), relative to NH-White.•Alcohol use was common predictor of transitioning from never to current blunt use each race/ethnic category.
To characterize and compare transitions in blunt smoking behaviors among a diverse cohort of youth and young adults observed between Spring 2019 and Fall 2021.
We analyzed n = 14,152 observations (i.e., completed surveys) provided by n = 2,610 youth and young adults over six (6) waves from Spring 2019 to Fall 2021 via the Texas Adolescent Tobacco and Marketing Surveillance (TATAMS) system. Participants were recruited in age-cohorts, reflecting 16.5 years (0.5), 18.5 years (0.6), and 20.1 years (0.8) of age at baseline. We applied a three-state Markov model to estimate blunt initiation (never → ever), onset (never → current), continuation (ever → current), and discontinuation (current → ever). First, we compared transitions in blunt smoking by race/ethnicity, with non-Hispanic (NH) Whites as the referent. Second, we stratified the Markov models by race/ethnicity to identify common and unique predictors of blunt transitions, including sex, age, alcohol use, depression, anxiety, and tobacco cigar smoking.
At baseline, 73% of participants had never smoked blunts, 15.3% had ever smoked blunts s, and 11.7% currently smoked blunts. NHB (HR: 2.15; 95% CI: 1.21–3.84) and Hispanic (HR: 1.72; 95% CI: 1.08–2.72) participants had significantly greater risk of blunt smoking initiation, relative to NHWs. Similarly, NHBs had great risk for continuation (HR: 1.65; 95% CI: 1.16–2.34) and lower risk of discontinuation (HR: 0.57; 95% CI: 0.42–0.77), relative to NHWs. Alcohol use predicted greater risk for onset among NHW (HR: 5.22; 95% CI: 1.40–19.45), NHB (HR: 3.14; 95% CI: 1.32–7.46), and Hispanic (HR: 2.99; 95% CI: 1.80–4.97) participants.
Blunt smoking initiation was most common among NHB and Hispanic youth and young adults while risk for sustained blunt smoking was higher in NHB youth and young adults. Research and interventions should investigate the link between alcohol use and elevated blunt smoking among young people.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Nicotine exposure among adolescent e-cigarette users remains a public health concern. JUUL, a popular e-cigarette brand among youth, is particularly alarming given the high nicotine delivery ...(59 mg/mL). This study compares e-cigarette use frequency and symptoms of nicotine dependence among adolescent JUUL and non-JUUL users.
We analyzed data from the 2020 National Youth Tobacco Survey. Participants were n = 1713 U.S. middle and high school students who reported past 30-day e-cigarette use. We compared adolescent e-cigarette users who reported JUUL use to those who did not. Outcomes were: (1) symptoms of nicotine dependence (i.e. nicotine cravings; use within 30 min of waking); (2) past 30-day e-cigarette use frequency, categorized as 1–5 days, 6–19 days, and 20–30 days. Covariates were sex, race/ethnicity, other tobacco product use, primary e-cigarette device type (i.e., disposable; pod; mod/tank).
Overall, 49.5% of adolescent e-cigarette users reported using JUUL in the past 30 days, 40.1% reported symptoms of nicotine dependence, and 36.2% reported using an e-cigarette on 20–30 days. JUUL users were 1.77 (95% CI: 1.36–2.31) times as likely to report symptoms of nicotine dependence and 1.43 (95% CI: 1.02–2.01) time as likely to report using e-cigarettes on 20–30 days, compared to 1–5 days, relative to non-JUUL users, controlling for covariates.
JUUL use was associated with greater odds of nicotine dependence and more frequent e-cigarette use among adolescents. Greater prevention and regulatory efforts should be made to prevent adolescent use of high dose nicotine devices such as JUUL.
•Nearly half (49.5%) of adolescent e-cigarette users reported using JUUL.•JUUL users had nearly doubled (aOR: 1.77) odds of nicotine dependence.•JUUL users had 1.43 times greater odds of using an e-cigarette on 20–30 days per month.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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