The primary objective of this study was to identify risk factors associated with becoming susceptible to e-cigarette use over the course of a year among e-cigarette-naive adolescents considering a ...comprehensive model of risk factors (risk perceptions, social influences and norms, affective risk factors, and other behavioral risk factors). Data came from the Texas Adolescent Tobacco and Marketing Surveillance system (TATAMS), a longitudinal cohort study of students who were in the 6th, 8th, and 10th grades (n = 3907) during the 2014–2015 academic year. Weighted generalized linear mixed models assessed multiple predictors' associated with the transition to susceptibility to e-cigarettes at 12 months. Among 6th graders, family influence, use of other substances, and positive affect were important. Adolescents transitioning from 8th grade to high school presented the greatest number of risk factors (e.g., social and normative influences). Only sensation seeking increased the risk of susceptibility to e-cigarettes among 10th graders. Overall, by grade level, incidence of susceptibility to e-cigarettes at 12 months did not vary, but risk factor profiles varied substantially.
•Incident susceptibility to e-cigarettes at 12 months did not vary by grade (6th, 8th, or 10th); risk factor profiles did vary•Family influence andr substance use increased risk e-cigarette susceptibility for grade 6; positive affect was protective•Social and normative influences for becoming susceptible to e-cigarettes were important during the transition to high school•Only higher sensation seeking increased risk of becoming susceptible to e-cigarettes among the 10th graders•Tailoring intervention efforts to developmental stage can maximize prevention against e-cigarette susceptibility transitions
Body image dissatisfaction (BID) has been inversely associated with breastfeeding initiation particularly among women with obesity. However, less is known on BID and the association with maintaining ...breastfeeding in Mexico, where breastfeeding rate is decreasing across ethnic subgroups. Therefore, we explore this gap of knowledge in diverse ethnic subgroups across levels of maternal weight status.
Data were derived from the Mexican National Health and Nutrition Survey (Encuesta Nacional de Salud y Nutrición ENSANUT 2012), and 10,466 women aged 20-49 years were included. Breastfeeding (<6 months versus ≥6 months) of the last child, BID (Stunkard Figure Rating Scale), anthropometric (body mass index, BMI), sociodemographics, and biological variables were collected. Crude and adjusted target associations and effect modifiers were assessed using weighted-logistic regression models.
Overall, 72.4% of ever breastfeeding mothers breastfed a minimum of 6 months, 22% were indigenous, 74% were dissatisfied with their body image (BID >0), and 37% had obesity (BMI ≥30 kg/m
). In the multivariable analysis, for each one-unit increase in the BID score, the adjusted odds of breastfeeding (≥6 months) decreased by 6% (odds ratio OR = 0.94, 95% confidence interval CI: 0.89-0.99). After stratifications, only among women with obesity, a greater BID score was associated with lower odds of breastfeeding duration by 24% (OR = 0.76, 95% CI: 0.64-0.89) in indigenous and by 10% (OR = 0.90, 95% CI: 0.82-0.98) in non-indigenous women.
Mexican women with a higher BID score reported lower odds of breastfeeding duration (≥6 months). Body image concerns should be integrated into a health promotion curriculum to mitigate their negative effect particularly in certain segments of the populations, such as women with obesity and among indigenous women.
E-cigarette use harms adolescent health, yet it continues to escalate rapidly among teens nationwide. This longitudinal study sought to identify and differentiate between developmental trajectories ...of past 30-day e-cigarette use with and without marijuana (i.e., liquid THC) across adolescence (11–19 years old). Three population-based cohorts of adolescents (n = 3907; N = 461,069) living in major metropolitan areas of Texas (Houston, Dallas-Ft. Worth, San Antonio, Austin) completed up to 9 Waves of an e-cigarette use survey, from 2014 to 2019. Growth curve models (GCMs) were used to identify average trajectories of past 30-day e-cigarette use, by cohort. Growth mixture models (GMMs) were used to investigate developmental patterns in these trajectories, by cohort. Sociodemographic differences in trajectories were also investigated. Stable trajectories of e-cigarette use with and without marijuana were identified, from 11 through 19 years of age. Trajectories varied by age of onset; frequency and escalation in use; and substance used. With one exception, all trajectories of e-cigarette use escalated with age. Moreover, age of onset and progression in use were positively related. The most problematic trajectories, corresponding to more frequent use, were observed among the younger cohorts compared to the oldest. Primary prevention is critical. Interventions to prevent the onset and progression in e-cigarette use among teens must begin early (e.g., in middle school) and be sustained throughout adolescence.
•Identifies trajectories of e-cigarette use across adolescence (11–19 years old).•Trajectories are modeled separately for use with and without marijuana (i.e., liquid THC).•Trajectories vary by age of onset; frequency and escalation in use; substance use.•Primary prevention of e-cigarette use among younger adolescents is especially critical.
To investigate the contexts in which college students use e-cigarettes and marijuana, perceptions about the benefits and harms, and health effects of use.
College student e-cigarette and marijuana ...ever users (n = 20; 18-21 years old) from the Texas Adolescent Tobacco and Marketing Surveillance System (TATAMS).
Participants completed a one-hour long online interview about their experiences using e-cigarettes and marijuana. Thematic content analysis in NVivo identified prominent themes.
Vaping nicotine and marijuana were preferred and perceived as normal, trendy and useful in circumventing smoke-free campus policies. Preference for nicotine versus marijuana fluctuates during the academic school year in response to campus restrictions and work and school-related activities. College students commonly experienced health effects (shortness of breath, wheezing) attributed to vaping, did not perceive their use as very harmful, and perceived their use as a college-related phase.
Findings have implications for college-based health education, resources, and smoke-free policies.
Although machine learning techniques that estimate propensity scores for observational studies with multivalued treatments have advanced rapidly in recent years, the development of propensity score ...adjustment techniques has not kept pace. While machine learning propensity models provide numerous benefits, they do not produce a single variable balancing score that can be used for propensity score stratification and matching. This issue motivates the development of a flexible ordinal propensity scoring methodology that does not require parametric assumptions for the propensity model. The proposed method fits a one‐parameter power function to the cumulative distribution function (CDF) of the generalized propensity score (GPS) vector resulting from any machine learning propensity model, and is henceforth called the GPS‐CDF method. The estimated parameter from the GPS‐CDF method, ã, is a scalar balancing score that can be used to group similar subjects in outcome analyses. Specifically, subjects who received different levels of the treatment are stratified or matched based on their ã value to produce unbiased estimates of the average treatment effect (ATE). Simulation studies presented show remediation of covariate balance, minimal bias in ATEs, and maintain coverage probability. The proposed method is applied to the Mexican‐American Tobacco use in Children (MATCh) study to determine whether an ordinal treatment of exposure to smoking imagery in movies causes cigarette experimentation in Mexican‐American adolescents.
•Spain is among the OECD countries with the highest truancy rates.•Adolescents’ truancy behavior is evaluated using a Spanish nationally representative survey of students aged 14–18 years ...old.•Several count data models analyze both the probability and frequency of truancy.•Reducing cyberbullying and improving parenting style could reduce truancy.•Peer truancy is associated with both higher probability and higher frequency of truancy.
This study extends the truancy literature by exploring correlates of both committing truancy and the numbers of days truant among Spanish secondary school students. The study incorporates cyberbullying, peer truancy and parenting style as key predictors. Several count data regression models are estimated using a nationally representative survey of Spanish students (N = 37,476; Mage = 15.73; 50.9 % females). The results suggest that cyberbullying and parenting style play a significant role in a student’s decision to commit truancy, while peer truancy plays a significant role in both the decision of whether or not to commit truancy (OR = 1.61) and the number of days truant (IRR = 1.41). These results suggest that reducing cyberbullying and promoting specific parenting styles may serve to reduce truancy, and that this direct effect or reduction could be further increased indirectly via peer or social multipliers.
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Carbohydrates are appealing non-ionic surfactant head-groups as they are naturally abundant, generally biocompatible and biodegradable, and readily functionalized. Recent work has ...produced a promising molecular candidate for the formation of viscoelastic worm-like micellar solutions: a tri(ethylene glycol)-linked oleyl-β-D-glucoside surfactant (GlcC18:1) exhibited near ideal Maxwell behavior at low concentrations (2.9 wt%) without additives at room temperature. Here, fourteen surfactants have been synthesized with structural variations based around GlcC18:1. Each contain an oligo(ethylene glycol) linker of varying length (2, 3, 4, 6 EO units) between a carbohydrate head-group (glucose, galactose, mannose, maltose, lactose, cellobiose) and a cis-unsaturated alkyl tail-group (oleyl, linoleyl, erucyl). The aqueous adsorption kinetics and self-assembly of these surfactants was explored using tensiometry and small-angle neutron scattering (SANS), respectively. With SANS we observed the formation of worm-like micelles for four surfactants, and vesicles for two surfactants which exhibited behavior similar to insoluble lipids. We also observed temperature-induced micellar elongation due to dehydration of the oligo(ethylene glycol) linker, resulting in a further three surfactants forming worm-like micelles at 50 °C. Worm-like micellar fluids were further characterized using rheology to reveal two surfactants with vastly superior viscoelastic properties compared to GlcC18:1, with >2 orders of magnitude increase in viscosity and >3 orders of magnitude increase in stress relaxation time. These results provide insight into structure-function relationships for non-ionic surfactants and demonstrate a class of designed amphiphiles with a special propensity for forming viscoelastic worm-like micellar solutions at low concentrations.
•14.6% of young adults reported exposure to digital smokeless tobacco marketing.•Racial/ethnic minorities were significantly more likely than their white peers to report exposure.•Exposure was ...significantly associated with smokeless tobacco uptake one-year later.
This study examines the relationships between recall of exposure to digital marketing of smokeless tobacco, via the internet and social media, and subsequent initiation of smokeless tobacco use at one-year follow-up, among young adult never users of smokeless tobacco in Texas.
Data were from waves 6 (Spring 2017) and 7 (Spring 2018) of the Marketing and Promotions Across Colleges in Texas Study (Project M-PACT); a longitudinal study of two- and four-year Texas college students. Participants were 2731 young adult never smokeless tobacco users (ages 20–32) with complete data at both assessment periods. A multi-level, multiple logistic regression model was applied, accounting for school clustering, to examine the relationship between recall of exposure to digital marketing of smokeless tobacco at baseline (wave 6) and smokeless tobacco use initiation at one-year follow-up (wave 7). Analyses controlled for important baseline covariates (socio-demographic factors, other marketing exposure, other tobacco product use).
Overall, 14.6% of never smokeless tobacco users reported exposure to smokeless tobacco marketing via digital media. Exposure to digital marketing of smokeless tobacco at baseline was associated with greater odds of smokeless tobacco use initiation among young adult never users (AOR: 2.14; 95%CI: 1.12 – 4.06) at one-year follow-up.
Findings reveal exposure to smokeless tobacco marketing via digital media was common. Further, there appears to be a strong relationship between this exposure and subsequent smokeless tobacco use among young adult never smokeless tobacco users.
Abstract Cigarette smoking is the leading preventable cause of death in the United States; smoking in Mexican American adolescents, a rapidly growing population, remains a major concern. Factors ...associated with escalation or progression along the smoking trajectory have not been studied in adolescent Mexican Americans. A better understanding of escalation is needed for cancer prevention and overall health. N = 1,328 Mexican American adolescents joined a cohort in 2005–06. At baseline participants provided demographic, acculturation and psychosocial data, and reported their smoking status using the Minnesota Smoking Index. Those that never tried a cigarette or only had a few puffs in their life were included in this study. The primary outcome of interest, escalation in smoking status, was defined as moving up the Minnesota Smoking Index by 2010–2011. The current analysis is based on 973 participants of whom 48.2% were male, mean age = 11.8 (SD = 0.8), and 26.0% were born in Mexico. By 2010–2011, 283 (29%) escalated their smoking status and 690 (71%) remained the same. Being older (OR = 1.30; CI = 1.07–1.57), male (OR = 1.88, CI = 1.40–2.53), having higher levels of anxiety (OR = 1.03, CI = 1.02–1.05), intending to smoke (OR = 1.70, CI = 1.18–2.46), having friends who smoke (OR = 1.73, CI = 1.12–2.70) and having parents' friends who smoke (OR = 1.38, CI = 1.02–1.88) increased risk for smoking escalation. Higher levels of subjective social status (OR = 0.91, CI = 0.83–0.99) were protective against smoking escalation. Contrasting previous work in smoking experimentation, parents' friends influence was a stronger predictor than the family household influence. Preventative interventions for Mexican American youth could address this risk factor to reduce smoking escalation.
National data reveal that the age-adjusted prevalence of leisure-time physical inactivity is higher among Blacks and Hispanics compared with Whites. However, these estimates do not consider ...nonleisure physical activity (PA). Also, race/ethnicity in these findings may by confounded by socioeconomic status disparities in PA. Here, we examine racial/ethnic differences in multiple measures of PA within a lower socioeconomic status sample.
Participants in the current cross-sectional study (n = 1526 adults, aged ≥ 18 y) were recruited from Supplemental Nutrition Assistance Program-Education classes (nutrition education classes that target low-income people) in Texas. Self-report data were obtained using survey questionnaires in spring and fall 2018. PA outcomes of 4 different intensities were assessed: mean daily time spent walking, engaging in moderate and vigorous PA, and sitting. Additional PA-related measures included use and awareness of community PA resources. Linear regression models examined racial/ethnic differences in the 4 PA outcomes after adjusting for participant gender, age, household composition measures, and various socioeconomic status measures.
In this low-income sample, Hispanic and Black participants spent 6 to 9 more minutes per day walking and engaging in moderate and vigorous PA compared with White/other participants (P < .05 for each measure). Conversely, White/other participants reported spending 82 more minutes sitting per day than Black and Hispanic participants (P < .01). Overall, Black participants were most likely to utilize community PA resources and report ease of engaging in exercise.
Together, these results reveal greater engagement in PA by racial/ethnic minorities in low-income communities compared with Whites. Our results have implications for tailoring PA programming to these communities.
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