Objectives
To compare e-cigarette flavors preferred and reasons for use and discontinued use across never, current, and former e-cigarette users and cigarette smokers.
Methods
We recruited 1567 ...participants aged 18–34 years through Facebook ads targeting tobacco users and nonusers in August 2014 to complete an online survey. We assessed tobacco use, preferred flavors, and reasons for e-cigarette use and discontinued use.
Results
Our sample was 49 % male, 87 % White; 56 % current cigarette smokers; and 53 % e-cigarette users. Current e-cigarette users used an average of 20.9 days in the past 30 (SD = 11.7) and 55.2 puffs/day (SD = 37.3). Compared to never and current smokers, former smokers used e-cigarettes more frequently (
p
’s <0.001). Among users and nonusers, the most preferred was fruit flavors, and the most commonly reported reason for e-cigarette use was “they might be less harmful than cigarettes”. The most endorsed reason for discontinued e-cigarette use was “using other tobacco products instead”. Never, current, and former smokers had distinct reasons for e-cigarette use and discontinued use and differed in flavor preferences.
Conclusions
Regulating marketing and flavors may impact e-cigarette uptake by young adults.
To examine whether psychosocial health mediates the association between food insecurity and grade point average (GPA) among college and university students.
Data for the present study are from a ...longitudinal cohort study. Structural equation modelling (SEM) was used to test the proposed mediation hypothesis. Food insecurity was measured using the US Department of Agriculture's Six-Item Short Form. Psychosocial health was operationalized as a latent factor with three indicators: depression, anxiety and hope. Validated scales were used to measure each indicator. GPA was self-reported.
Seven colleges and universities in Georgia, USA.ParticipantsStudents aged 18-25 years were recruited via email and surveyed every four months over a two-year period (analytic n 2377).
Approximately 29 % of students were food insecure. In the final SEM, food insecurity was associated (standardized β, se) with poorer psychosocial health (0·22, 0·03, P<0·0001) and poorer psychosocial health was associated with a lower GPA (-0·21, 0·03, P<0·0001). The indirect effect of food security status on GPA, as mediated by psychosocial health, was significant (-0·05, 0·01, P<0·0001) and accounted for 73 % of the total effect. After accounting for psychosocial health, the direct effect of food security status on GPA was not significant (-0·02, 0·02, P=0·43).
Psychosocial health may be an important mechanism through which food insecurity affects academic performance among college and university students. Multicomponent interventions that address immediate food security needs as well as co-occurring mental health and academic concerns are needed to ensure student success.
Background: There has been an increase in non-daily smoking, alternative tobacco product and marijuana use among young adults in recent years. Objectives: This study examined perceptions of health ...risks, addictiveness, and social acceptability of cigarettes, cigar products, smokeless tobacco, hookah, electronic cigarettes, and marijuana among young adults and correlates of such perceptions. Methods: In Spring 2013, 10,000 students at two universities in the Southeastern United States were recruited to complete an online survey (2,002 respondents), assessing personal, parental, and peer use of each product; and perceptions of health risks, addictiveness, and social acceptability of each of these products. Results: Marijuana was the most commonly used product in the past month (19.2%), with hookah being the second most commonly used (16.4%). The least commonly used were smokeless tobacco products (2.6%) and electronic cigarettes (4.5%). There were high rates of concurrent product use, particularly among electronic cigarette users. The most positively perceived was marijuana, with hookah and electronic cigarettes being second. While tobacco use and related social factors, related positively, influenced perceptions of marijuana, marijuana use and related social factors were not associated with perceptions of any tobacco product. Conclusions/Importance: Marketing efforts to promote electronic cigarettes and hookah to be safe and socially acceptable seem to be effective, while policy changes seem to be altering perceptions of marijuana and related social norms. Research is needed to document the health risks and addictive nature of emerging tobacco products and marijuana and evaluate efforts to communicate such risks to youth.
Intersectionality theory focuses on how one's human experiences are constituted by mutually reinforcing interactions between different aspects of one's identities, such as race, class, gender, and ...sexual orientation. In this study, we asked: 1) Do associations between intersecting identities (race and sexual orientation) and mental health (depressive symptoms) and substance use (alcohol, tobacco, and marijuana) differ between men and women? and 2) How do single or intersecting self-reports of perceived racial and/or sexual orientation discrimination influence mental health and substance use outcomes for men and women? We compared results of assessing identities versus experiences of discrimination.
Multivariable regressions were conducted on cross-sectional data from 2315 Black and White college students. Predictors included measures of sociodemographic characteristics and experiences of discrimination. Outcomes included past 2-week depressive symptoms (PHQ-9), past 30-day alcohol use, past 30-day tobacco use, and past 30-day marijuana use.
Intersecting identities and experience of discrimination had different associations with outcomes. Among women, self-reporting both forms of discrimination was associated with higher depressive symptoms and substance use. For example, compared to women experiencing no discrimination, women experiencing both forms of discrimination had higher depressive symptoms (B = 3.63, CI = 2.22-5.03), alcohol use (B = 1.65, CI = 0.56-2.73), tobacco use (OR = 3.45, CI = 1.97-6.05), and marijuana use (OR = 3.38, CI = 1.80-6.31). However, compared to White heterosexual women, White sexual minority women had higher risks for all outcomes (B = 3.16 and CI = 2.03-4.29 for depressive symptoms, B = 1.45 and CI = 0.58-2.32 for alcohol use, OR = 2.21 and CI = 1.32-3.70 for tobacco use, and OR = 3.01 and CI = 1.77-5.12 for marijuana use); while Black sexual minority women had higher tobacco (OR = 2.64, CI = 1.39-5.02) and marijuana use (OR = 2.81, CI = 1.33-5.92) only. Compared to White heterosexual men, White sexual minority men had higher depressive symptoms (B = 1.90, CI = 0.52-3.28) and marijuana use (OR = 2.37, CI = 1.24-4.49).
Our results highlight the deleterious impacts of racial discrimination and sexual orientation discrimination on health, in particular for women. Future studies should distinguish between and jointly assess intersecting social positions (e.g., identities) and processes (e.g., interpersonal experience of discrimination or forms of structural oppression).
Objective: This study investigated associations between adverse childhood experiences (ACE) prior to age 18 years and multiple health behaviors (eg, cigarette and other substance use) and outcomes ...(eg, obesity, depression) for a large college sample. Participants: 2,969 college students from seven universities in the state of Georgia were included in the analysis. Methods: Web-based surveys were completed by students (45-60 minutes) during the spring semester, 2015. Results: Findings indicate that more ACEs are associated with higher levels of depressive symptoms, ADHD symptoms, cigarette use, alcohol use, marijuana use, and BMI, in addition to lower levels of fruit and vegetable intake, and sleep. Conclusion: ACEs may carry forward in the lifespan to influence a range of unhealthy outcomes among college students. College intervention programs may benefit by recognizing the pervasiveness of ACEs and their associations with health behaviors and outcomes, and include interventions across more than one health behavior.
Aims/hypothesis
The study investigated cross-sectional associations of total amount and patterns of sedentary behaviour with glucose metabolism status and the metabolic syndrome.
Methods
We included ...2,497 participants (mean age 60.0 ± 8.1 years, 52% men) from The Maastricht Study who were asked to wear an activPAL accelerometer 24 h/day for 8 consecutive days. We calculated the daily amount of sedentary time, daily number of sedentary breaks and prolonged sedentary bouts (≥30 min), and the average duration of the sedentary bouts. To determine glucose metabolism status, participants underwent an oral glucose tolerance test. Associations of sedentary behaviour variables with glucose metabolism status and the metabolic syndrome were examined using multinomial logistic regression analyses.
Results
Overall, 1,395 (55.9%) participants had normal glucose metabolism, 388 (15.5%) had impaired glucose metabolism and 714 (28.6%) had type 2 diabetes. The odds ratio per additional hour of sedentary time was 1.22 (95% CI 1.13, 1.32) for type 2 diabetes and 1.39 (1.27, 1.53) for the metabolic syndrome. No significant or only weak associations were seen for the number of sedentary breaks, number of prolonged sedentary bouts or average bout duration with either glucose metabolism status or the metabolic syndrome.
Conclusions/interpretation
An extra hour of sedentary time was associated with a 22% increased odds for type 2 diabetes and a 39% increased odds for the metabolic syndrome. The pattern in which sedentary time was accumulated was weakly associated with the presence of the metabolic syndrome. These results suggest that sedentary behaviour may play a significant role in the development and prevention of type 2 diabetes, although longitudinal studies are needed to confirm our findings.
Cells can be primed by external stimuli to obtain a long-term epigenetic memory. We hypothesize that long-term exposure to elevated blood lipids can prime circulating immune cells through changes in ...DNA methylation, a process that may contribute to the development of atherosclerosis. To interrogate the causal relationship between triglyceride, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol levels and genome-wide DNA methylation while excluding confounding and pleiotropy, we perform a stepwise Mendelian randomization analysis in whole blood of 3296 individuals.
This analysis shows that differential methylation is the consequence of inter-individual variation in blood lipid levels and not vice versa. Specifically, we observe an effect of triglycerides on DNA methylation at three CpGs, of LDL cholesterol at one CpG, and of HDL cholesterol at two CpGs using multivariable Mendelian randomization. Using RNA-seq data available for a large subset of individuals (N = 2044), DNA methylation of these six CpGs is associated with the expression of CPT1A and SREBF1 (for triglycerides), DHCR24 (for LDL cholesterol) and ABCG1 (for HDL cholesterol), which are all key regulators of lipid metabolism.
Our analysis suggests a role for epigenetic priming in end-product feedback control of lipid metabolism and highlights Mendelian randomization as an effective tool to infer causal relationships in integrative genomics data.
Abstract Background As marijuana legalization and acceptability increase in the U.S., it is important to understand the potential impact on tobacco use. Accordingly, we assessed prevalence, ...correlates, and ten-year trends in co-use of marijuana and tobacco among U.S. adults. Methods Data came from 378,459 adults participating in the 2003–2012 National Survey on Drug Use and Health, an annual, cross-sectional, household survey. Data from 2011–2012 were used to compute the most recent prevalence of past 30-day marijuana and tobacco use (co-use). Data from 2003–2012 were used to compute demographic correlates of co-use, overall trends in co-use, and trends by age, race, and sex. We also assessed trends in tobacco use among marijuana users and marijuana use among tobacco users. Results From 2011 to 2012, 5.2% of participants were past month co-marijuana and tobacco users, 24.0% were tobacco-only users, and 2.3% were marijuana-only users. From 2003 to 2012, prevalence of co-use increased overall (p < .0001), and among males and females (p < .001, p < .05), those ages 26–34 (p < .001) and 50 + years (p < .0001), and Whites (p < .01), Blacks (p < .05), and Hispanics (p < .01); there were no changes among adults 18–25 years. Tobacco use among marijuana users decreased between 2003 and 2012 (from 74.3% to 69.6%, p < .0001), while marijuana use increased among tobacco users (from 14.2% to 17.8, p < .0001). Conclusions Co-use of tobacco and marijuana increased from 2003–2012, with marijuana use increasing among past-month tobacco users and tobacco use declining among past-month marijuana users. Improved surveillance of co-use is needed as marijuana legalization policies expand and become more integrated in communities.
Effective models for aligning public health and civil society at the local level have the potential to impact various global health issues, including tobacco. Georgia and Armenia Teams for Healthy ...Environments and Research (GATHER) is a collaboration between Armenia, Georgia and U.S. researchers involving a community randomized trial testing the impact of community coalitions to promote smoke-free policy adoption and compliance in various settings. Community Coalition Action Theory (CCAT) was used to guide and describe coalition formation, implementation and effectiveness. Mixed methods were used to evaluate 14 municipality-based coalitions in Georgia and Armenia, including semi-structured interviews (n = 42) with coalition leaders and active members, coalition member surveys at two timepoints (n = 85 and n = 83), and review of action plans and progress reports. Results indicated successful creation of 14 multi-sectoral coalitions, most commonly representing education, public health, health care, and municipal administration. Half of the coalitions created at least one smoke-free policy in specific settings (e.g., factories, parks), and all 14 promoted compliance with existing policies through no-smoking signage and stickers. The majority also conducted awareness events in school, health care, and community settings, in addition to educating the public about COVID and the dangers of tobacco use. Consistent with CCAT, coalition processes (e.g., communication) were associated with member engagement and collaborative synergy which, in turn, correlated with perceived community impact, skills gained by coalition members, and interest in sustainability. Findings suggest that community coalitions can be formed in varied sociopolitical contexts and facilitate locally-driven, multi-sectoral collaborations to promote health. Despite major contextual challenges (e.g., national legislation, global pandemic, war), coalitions were resilient, nimble and remained active. Additionally, CCAT propositions appear to be generalizable, suggesting that coalition-building guidance may be relevant for local public health in at least some global contexts.
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