Coolants, organic acids, flavourings and other additives that facilitate inhalation of tobacco and nicotine products: implications for regulation.

To inform regulatory policy, this article summarises findings on inhalation facilitation from the ninth report of the WHO Study Group on Tobacco Product Regulation. Some additives counteract the harshness and bitterness of tobacco and nicotine product aerosols, making them easier to inhale. Additives that promote inhalability may perpetuate and increase the use of inhaled tobacco and nicotine products, especially by young people. Thus, as a class, additives that facilitate inhalation are an important regulatory target to prevent tobacco and nicotine product uptake. We defined inhalation facilitation as modifications to products during manufacturing that enhance the sensory experience and (potentially) behaviours associated with inhalation (eg, deeper puffs, faster inhalation, larger puff volume, shorter intervals in between puffs and use episodes). Evidence review showed that: (a) menthol and synthetic coolants decrease irritation caused by aerosol constituents by activating sensory perception receptors (eg, cooling receptors) and may promote dependence in inexperienced users; (b) acid additives and sugars, which lower the pH of aerosols and shift nicotine from free-base to protonated salt forms, reduce harshness and increase blood nicotine yield; (c) e-cigarette flavourings perceived as sweet or fruity reduce subjective bitterness, increase attractiveness and may escalate use, although their effects on perceived harshness are inconclusive; (d) sugars in tobacco impart sweet sensations, but limited industry-independent data preclude strong conclusions for sugars' roles in inhalation facilitation. Given these findings, WHO policy recommendations suggest that regulators might consider banning ingredients that facilitate inhalation in all commercial inhaled tobacco and nicotine products.

A prospective longitudinal investigation of the trajectory of obsessive-compulsive symptoms during adolescence.

Obsessive-compulsive symptoms (OCS) increase with age during childhood and adolescence, and subthreshold OCS in childhood associate with a higher probability of obsessive-compulsive disorder (OCD) diagnosis in adulthood. Additionally, average age of onset for OCD is in adolescence, with the majority of OCD cases emerging by early adulthood. Despite these trends, the specific course of OCS development in adolescence is relatively unknown. To this end, the present prospective longitudinal study used latent growth mixture modeling and a diverse community sample of 3,335 high schoolers to identify and characterize growth trajectories of OCS across middle to late adolescence. Results identified three trajectories: High-but-Remitting, Moderate-but-Escalating, and Low-and-Stable. Results also indicated age, gender, anxiety sensitivity, and distress tolerance as significant predictors of trajectory group membership, such that younger age and being female predicted classification in the High-but Remitting group, greater anxiety sensitivity predicted classification in both the High-but-Remitting and Moderate-but Escalating groups, and greater distress tolerance predicted a lower likelihood of classification in the High-but-Remitting and Moderate-but-Escalating groups. Taken together, these trajectories have illustrated the temporal course and development of OCS across key developmental years. Moreover, the trajectories and their corresponding predictors may help identify adolescents who are particularly vulnerable to developing OCD.

Recall of Flavor at First E-cigarette Use and Its Association with E-cigarette Progression: The Mediating Effects of First Sensory Experience.

OBJECTIVE: To test whether the association between flavor at first vape and continued use is mediated through subjective experience at first vape. STUDY DESIGN: In a 2020 cross-sectional survey, 955 young adult ever-vapers recalled their first flavor vaped, subjective experiences at first use, current vaping behavior, nicotine dependence, and quit attempts. A latent class model grouped first-use subjective experiences into classes. Two-part negative binomial hurdle models for each vaping behavior evaluated whether the association of first flavor used with vaping outcomes was mediated by positive experience. RESULTS: Four latent classes (positive, positive and negative, negative, and minimal experience) were further reduced to "any positive experience" (only positive, positive and negative) vs "no positive experience" (negative or minimal). Class membership mediated the association of first flavor used (mint/menthol/ice [ie, "cooling"] or sweet vs other) with each vaping outcome. For example, cooling flavor (vs. other) was associated with positive class membership (OR = 3.5; 95% CI: 1.5, 8.1), which was then associated with any past 30-day vaping (OR = 3.9; 95% CI: 2.7, 5.8) and greater number of vaping days among current vapers (RR = 1.9; 95% CI: 1.3, 2.7) in the two-part hurdle model. Similar results were observed for nicotine dependence and quit attempts, and for sweet (vs other) flavor for any dependence or quit attempts, but not number of dependence symptoms or quit attempts. CONCLUSIONS: Use of a cooling or sweet flavor at first use was associated with having a positive first vaping sensory experience, and then greater likelihood as a young adult of reporting past 30-day vaping, more vaping days, and greater risk for nicotine dependence, suggesting a key mediating role of first use experience.

Effects of a fruit-ice combination flavor on appeal and sensory experience of vaping and moderation by preexisting e-cigarette flavor preference.

E-cigarettes with ice flavors, which are products with a cooling agent added to a characterizing flavor (e.g., grape-ice), are widely sold. Whether ice flavors appeal to only those who already use them or a to wider population is not widely understood. This secondary analysis of a clinical laboratory experiment tested effects of experimental exposure to e-cigarettes with fruit-ice versus other flavors on the appeal and sensory attributes of vaping and whether fruit-ice effects are moderated by preexisting e-cigarette flavor preference. In a controlled double-blind within-subject randomized online experiment, adults who currently use e-cigarettes, N = 85, M (SD) = 35.5 (13.2) years, 50% female, 54.3% White, self-administered e-liquids varying in flavors (fruit-ice [grape + menthol], tobacco-only, dessert-only [caramel], and fruit-only [strawberry]). Participants rated each product's appeal (liking, disliking, willingness to use again) and sensory attributes (sweetness, smoothness, harshness, bitterness, and coolness). In the overall sample, fruit-ice flavor produced (a) higher appeal, sweetness, smoothness, and coolness and lower bitterness and harshness compared to tobacco and dessert-only flavors and (b) higher coolness and lower sweetness than fruit-only flavors. The appeal-enhancing effect of fruit-ice (vs. tobacco and dessert-only flavors) was stronger among those with preexisting preferences for menthol/mint, fruit, and ice flavors, but not for those who typically used tobacco-only flavors. Our findings suggest that restrictions on fruit-ice-flavored e-cigarettes may reduce the appeal of vaping, particularly among vapers with preferences for products with cooling, fruit, and/or sweet sensory attributes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Vaping Transitions and Incident Depressive Symptoms among Young Adults: A Marginal Structural Model Analysis.

The extent to which vaping influences depression is unclear, but could be estimated through application of novel epidemiologic methods. Among a prospective cohort of young adults from California who screened negative for depression, we estimated repeated measures marginal structural models to examine the association of four vaping transitions from time T to T+1 (persistent use, discontinuation, initiation, persistent nonuse) with risk of clinically significant depressive symptoms at T+1, simultaneously across three ~1.5 year time-intervals between 2017-2021. Stabilized inverse probability of treatment and censoring weights adjusted for time-dependent confounders and selection bias. Among n=3,496 observations (1,806 participants, mean pooled baseline age=19.5), 8.1% reported persistent vaping from T to T+1, 6.2% reported discontinuation (i.e., use at T and no use at T+1), 6.5% initiated e-cigarettes (i.e., no use at T and use at T+1), and 79.2% reported persistent nonuse at both time-points. Compared to persistent vaping at two waves, persistent nonuse (RR=0.76, 95%CI:0.62-0.93) and discontinuation (RR=0.71, 95%CI:0.52-0.96) were associated with lower risk of depression. Associations were robust to sensitivity analyses, including restricting to tobacco naïve participants and varying temporal assumptions to reduce potential for reverse causation. Young adults who consistently avoid or discontinue vaping may be protected from depressive symptom occurrence.

Prevalence of Nicotine Pouch Use Among US Adults.

This cross-sectional study uses data from the 2022 Tobacco Use Supplement of the Current Population Survey to estimate the prevalence of adult US nicotine pouch use and the characteristics of the individuals using pouches.

Alcohol Use and Life Stressors During the COVID-19 Pandemic: A Longitudinal Study of Young Adults.

Objective: To estimate the extent to which drinking to cope with the COVID-19 pandemic and experiencing pandemic-related life stressors are associated with alcohol use escalation among young adults. Methods: Respondents in Los Angeles, CA, USA (N=2,130) completed prospective cohort study surveys before (baseline; October 2018-November 2019; mean age: 19.7[SD=0.4) and during (follow-up; May-August 2020) the COVID-19 outbreak. Past 30-day drinking days and number of drinks per drinking day were assessed from baseline to follow-up. At follow-up, participants reported drinking to cope with social isolation and pandemic-related stressors. Results: Pandemic-related stressor prevalence ranged from 5.5% (evicted/lost home) to 72.6% (worried about education) and 27.1% drank to cope with social isolation during the pandemic. Respondents who did (vs. did not) report pandemic-related coping drinking were more likely to increase past 30-day drinking days and drinks per drinking day from baseline to follow-up after adjustment for possible confounders. Employment loss/reduction, financial problems, and perceived likelihood of contracting COVID-19 or handling the pandemic poorly were each associated with increases in drinking days or drinks per drinking day. Conclusions: Experiencing certain life stressors and drinking to cope with social isolation may be associated with drinking escalation among young adults during the COVID-19 pandemic.

Effects of exposure to snus marketing with versus without modified risk tobacco product claims on snus use intention and perceived harm among young adults.

BACKGROUND: We tested whether snus marketing with modified risk tobacco product (MRTP) claims: (a) promotes accurate knowledge about snus's health effects in young adults and (b) encourages use intentions in only those who use combustible tobacco without attracting other young adult populations. METHODS: A randomised between-subjects experiment was embedded in a 2020 web survey of participants from Los Angeles (aged 19-23 years). Participants viewed mass-marketed snus advertising materials with (n=1212) vs without (n=1225) US Food and Drug Administration-authorised MRTP claims. After advertising exposure, snus use intention and perceptions of snus harms relative to cigarettes or e-cigarettes were measured. RESULTS: Advertisements with versus without MRTP claims did not affect snus use intention (18.0% vs 19.4%) but produced a higher prevalence of perceptions that snus was less harmful than cigarettes (12.6% vs 9.1%; p=0.007) and e-cigarettes (8.0% vs 5.8%; p=0.04). MRTP claim exposure effects did not differ by past 30-day e-cigarette or combustible tobacco use. Snus use intentions after marketing exposure, collapsed across MRTP claim conditions, were higher in those who did versus did not report past 30-day use of e-cigarettes (38.4% vs 14.3%; adjusted OR (95% CI) 2.95 (2.28 to 3.81); p<0.001) or combustible tobacco (44.0% vs 16.2%; adjusted OR (95% CI) 2.26 (1.62 to 3.16); p<0.001). CONCLUSION: Although some young adults who vape or smoke may have snus use intentions, snus MRTP claims might not affect young adults' snus use intentions, regardless of whether they vape/smoke. MRTP claims might modestly increase the accuracy of perceived harms of snus relative to cigarettes while also slightly causing unsubstantiated perceptions of lower harm than e-cigarettes.

Association between cannabis use and nicotine use persistence among adolescents.

INTRODUCTION: Prospective associations of adolescent cannabis use with nicotine use persistence are not well characterized but are important for informing prevention and policy. This study examined the association of 4 types of cannabis product use with subsequent persistent nicotine product use among adolescents. METHODS: We used prospective data from an adolescent cohort (14-17 years) from Southern California surveyed at baseline and at approximately 6-month follow-up (2022-2023). We incorporated three mutually non-exclusive analytic samples comprised of individuals with baseline past 6-month use of: (1) any nicotine product (N=308 [mean[SD] age = 16.3[0.6] years]), (2) e-cigarettes (n = 276), and (3) any combustible tobacco product (n = 137). Baseline past 6-month cannabis smoking, vaping, edible use, cannabidiol [CBD] or hemp product use, and any cannabis product use (yes/no) were separately modeled as predictors of past 6-month persistent use of any nicotine products, e-cigarettes, and combustible tobacco at follow-up. RESULTS: Baseline use of any cannabis product was associated with increased odds of persistent use of e-cigarettes or any nicotine product (adjusted odds ratio[OR] range: 1.96-2.66). Cannabis smoking was positively associated with persistent any nicotine product use (adjusted OR=2.19, 95 % CI=1.20-4.02). Cannabis smoking, vaping, and edible use predicted persistent use of e-cigarettes (adjusted OR range: 2.22-2.79). Cannabis product use did not predict combustible tobacco use persistence. Associations of CBD/hemp product use with nicotine use persistence outcomes were all non-significant. CONCLUSIONS: Adolescents who use cannabis may be at elevated risk for persistent nicotine use.

Effects of intranasal oxytocin on cigarette withdrawal and smoking in the laboratory: Differences by sex and social functioning traits.

Intranasal oxytocin (INOT) has received attention as a treatment for substance use disorders including tobacco dependence. However, it is unclear whether INOT-related effects differ by sex and social functioning traits. This study examined the influence of sex and two trait social functioning measures (hostility and rejection sensitivity) on INOT effects on abstinence-related subjective measures and smoking lapse. Adults who smoked cigarettes daily (N = 64; 21-40 years; 39% female) completed trait hostility and rejection sensitivity surveys at baseline followed by three experimental sessions following 12-hr smoking abstinence. Each session, participants received a single INOT dose (placebo, 20, 40 international units [IU]) in counterbalanced order, completed withdrawal, smoking urges and affect questionnaires, and a smoking lapse analog task. Interactive effects between INOT and sex, hostility, or rejection sensitivity on all outcomes were analyzed. INOT produced differential effects as a function of sex, trait hostility, and rejection sensitivity. The 20 IU dose worsened abstinence-related subjective effects for individuals with high trait hostility. Both INOT doses decreased smoking urges for high rejection sensitivity, and the 20 IU dose increased smoking urges for low rejection sensitivity. INOT increased withdrawal symptoms, smoking urges, and feelings of anger in females but not males. INOT did not improve withdrawal symptoms during abstinence and did not affect smoking lapse. While INOT produced some beneficial effects for a subset of participants with high rejection sensitivity, it worsened abstinence-related symptoms for others. Our results suggest that sex and social functioning should be considered when examining the therapeutic potential of INOT for smoking cessation in future research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Adolescent Δ8-THC and Marijuana Use in the US.

Importance: Gummies, flavored vaping devices, and other cannabis products containing psychoactive hemp-derived Δ8-tetrahydrocannabinol (THC) are increasingly marketed in the US with claims of being federally legal and comparable to marijuana. National data on prevalence and correlates of Δ8-THC use and comparisons to marijuana use among adolescents in the US are lacking. Objective: To estimate the self-reported prevalence of and sociodemographic and policy factors associated with Δ8-THC and marijuana use among US adolescents in the past 12 months. Design, Setting, and Participants: This nationally representative cross-sectional analysis included a randomly selected subset of 12th-grade students in 27 US states who participated in the Monitoring the Future Study in-school survey during February to June 2023. Exposures: Self-reported sex, race, ethnicity, and parental education; census region; state-level adult-use (ie, recreational) marijuana legalization (yes vs no); and state-level Δ8-THC policies (regulated vs not regulated). Main Outcomes and Measures: The primary outcome was self-reported Δ8-THC and marijuana use in the past 12 months (any vs no use and number of occasions used). Results: In the sample of 2186 12th-grade students (mean age, 17.7 years; 1054 [48.9% weighted] were female; 232 [11.1%] were Black, 411 [23.5%] were Hispanic, 1113 [46.1%] were White, and 328 [14.2%] were multiracial), prevalence of self-reported use in the past 12 months was 11.4% (95% CI, 8.6%-14.2%) for Δ8-THC and 30.4% (95% CI, 26.5%-34.4%) for marijuana. Of those 295 participants reporting Δ8-THC use, 35.4% used it at least 10 times in the past 12 months. Prevalence of Δ8-THC use was lower in Western vs Southern census regions (5.0% vs 14.3%; risk difference [RD], -9.4% [95% CI, -15.2% to -3.5%]; adjusted risk ratio [aRR], 0.35 [95% CI, 0.16-0.77]), states in which Δ8-THC was regulated vs not regulated (5.7% vs 14.4%; RD, -8.6% [95% CI, -12.9% to -4.4%]; aRR, 0.42 [95% CI, 0.23-0.74]), and states with vs without legal adult-use marijuana (8.0% vs 14.0%; RD, -6.0% [95% CI, -10.8% to -1.2%]; aRR, 0.56 [95% CI, 0.35-0.91]). Use in the past 12 months was lower among Hispanic than White participants for Δ8-THC (7.3% vs 14.4%; RD, -7.2% [95% CI, -12.2% to -2.1%]; aRR, 0.54 [95% CI, 0.34-0.87]) and marijuana (24.5% vs 33.0%; RD, -8.5% [95% CI, -14.9% to -2.1%]; aRR, 0.74 [95% CI, 0.59-0.94]). Δ8-THC and marijuana use prevalence did not differ by sex or parental education. Conclusions and Relevance: Δ8-THC use prevalence is appreciable among US adolescents and is higher in states without marijuana legalization or existing Δ8-THC regulations. Prioritizing surveillance, policy, and public health efforts addressing adolescent Δ8-THC use may be warranted.

Adult harm perceptions, purchase, and use related to synthetic vs. tobacco-derived nicotine vaping products: A mixed-methods study.

Objective: Synthetic nicotine (SN) e-cigarettes emerged on the market as an alternative to tobacco-derived nicotine (TDN) vaping products. It is critical to understand the harm perceptions, purchase, and use of SN vs. TDN e-cigarettes. Methods: From November 2021 to February 2023, we conducted intercept interviews with 263 adult customers at 37 vape shops in Southern California. Self-reported use and harm perceptions towards SN vs TDN e-cigarettes were examined. A qualitative analysis of researcher-obtained photographs of vaping items just purchased by customer participants was conducted. Results: Past 30-day SN e-cigarette use was reported by 44 (16.7 %) customers. Past 30-day SN e-cigarette users vs. non-users reported vaping on more days in the past month (29.3 vs. 26.1 days, p = 0.02). Overall, 23.8 % of participants perceived SN e-cigarettes as less harmful than TDN ones; never-smoking vapers and dual users perceived SN e-cigarettes as less harmful than salt-based TDN e-cigarettes. Among 44 customers who purchased SN products (verified through qualitative analysis of photographs), only 13 (29.6 %) self-reported using SN products in the past month, while 5 (11.4 %) indicated they were not aware of the existence of SN products. Most SN vaping products (71.4 %) displayed a modified "tobacco-free" warning label. Conclusions: Misperceptions about SN e-cigarettes were documented in this study, including the perception that SN is either less or more harmful than TDN. Further, some customers may be unknowingly purchasing and using SN e-cigarettes. Regulating "tobacco-free nicotine" terminology in SN vaping products marketing is suggested. SN product labeling should not imply that SN is safe/safer than TDN.

Disposable E-Cigarette Use and Subsequent Use Patterns in Adolescents and Young Adults.

BACKGROUND AND OBJECTIVES: Disposable electronic cigarettes (e-cigarettes) are widely used by adolescents and young adults (AYAs). Whether using disposable devices is associated with future e-cigarette use patterns is unknown but important for informing e-cigarette regulation. METHODS: Prospective longitudinal study combining data from adolescent (14-17 years) and young adult (21-24 years) cohorts from Southern California surveyed at baseline and approximately 8-month follow-up during 2021 to 2022. The analyses included AYAs who used e-cigarettes in the past 30 days at baseline and had exposure and outcome data (N = 403; adolescent n = 124, young adult n = 279). RESULTS: In the pooled sample of AYAs who used e-cigarettes at baseline (57.2% cis-gender female, 56.2% Hispanic), 278 (69.0%) reported past 30-day disposable e-cigarette use, and 125 (31.0%) used only nondisposable e-cigarettes. Baseline use of disposable (versus only nondisposable) devices was associated with higher odds of continued e-cigarette use (adjusted odds ratio = 1.92; 95% confidence interval = 1.09-3.42) and a greater number of times used e-cigarettes per day at follow-up (adjusted incidence rate ratio = 1.29; 95% confidence interval = 1.02-1.63). In supplemental analyses, disposable e-cigarette use was associated with greater odds of no changes (versus reductions) in e-cigarette use frequency and puffs per episode from baseline to follow-up but was not associated with increases in use frequency and intensity. No differences in e-cigarette use outcomes were found between those with poly-device (disposable and nondisposable) versus only disposable device use. CONCLUSIONS: Use of disposable e-cigarette devices among AYAs may be associated with higher risks for persistent e-cigarette use patterns, which should be considered in tobacco product regulation designed to protect AYAs.

Correlates of using E-cigarettes with high nicotine concentrations among U.S. adults who exclusively vape E-cigarettes or dual use with cigarettes.

BACKGROUND: Identifying the correlates of using e-cigarettes with high nicotine concentrations in exclusive and dual-using vapers can elucidate which subpopulations might be most impacted by e-cigarette regulatory activities related to nicotine concentration. METHODS: Data are drawn from Wave 5 (December 2018-November 2019) of the Population Assessment of Tobacco and Health (PATH) study. Self-reported nicotine concentration was grouped as high (5.0 %+), moderate (1.8-4.9 %), low (0.1-1.7 %), 0 %, and "I don't know." Multivariable logistic regressions estimated associations of sociodemographic factors, tobacco use status, and e-cigarette use patterns of high nicotine concentration vs. other nicotine levels, stratified by current exclusive e-cigarette use and dual use of e-cigarettes and cigarettes. RESULTS: In the study samples (exclusive e-cigarette use [n = 1,755], dual-use [n = 1,200]), higher proportions of exclusive e-cigarette users reported using high nicotine concentrations than dual users (18.3 % vs. 8.6 %). Among exclusive e-cigarette users, never vs. former smokers and daily (vs. someday) e-cigarette users were more likely to use high vs. low nicotine. In both exclusive and dual users, younger (vs. older) adults were more likely to report using high nicotine concentration e-cigarettes than most other nicotine levels. Current dual users who did vs. did not report using e-cigarettes to quit smoking had higher odds of using high vs. 0 % nicotine concentrations. CONCLUSIONS: High-nicotine e-cigarette use might be elevated in subpopulations that face greater risks for vaping (e.g., never smokers, young adults) than groups who benefit from the potential harm reduction. Regulatory restrictions on high-nicotine products may selectively affect some subgroups adversely impacted by vaping.

Sex-Specific Depressive Symptom Trajectories Among Adolescents in Los Angeles County, 2013 to 2017.

Objective: After remaining stable for many years, the prevalence of depression among adolescents increased over the past decade, particularly among girls. In this study, we used longitudinal data from a cohort of high school students to characterize sex-specific trajectories of depressive symptoms during this period of increasing prevalence and widening gender gap in adolescent depression. Method: Using data from the Health and Happiness Cohort, a longitudinal 8-wave study of high school students residing in Los Angeles County from 2013 to 2017 (N = 3,393), we conducted a multiple-group, latent class growth analysis by sex to differentiate developmental trajectories in depressive symptoms scores measured by the Center for Epidemiological Studies- Depression (CES-D) scale (range, 0-60). Results: A 4-class solution provided the best model fit for both girls and boys. Trajectories among girls included low stable (35.1%), mild stable (42.8%), moderate decreasing (16.2%), and high arching (5.9%). Trajectories among boys included low stable (49.2%), mild increasing (34.7%), moderate decreasing (12.2%), and high increasing (3.9%). Average scores consistently exceeded or crossed the threshold for probable depression (≥16). Across comparable sex-specific trajectory groups, the average CES-D scores of girls were higher than those of boys, whose average scores increased over time. Conclusion: In a diverse cohort of students in Los Angeles County, depressive symptom trajectories were comparable to prior time periods but with a higher proportion of students in trajectories characterized by probable depression. Trajectories differed by sex, suggesting that future research should consider differential severity and onset of depression between boys and girls.

Psychedelic Microdosing among Young Adults from Southern California.

Despite common depictions in the media, there is little scientific evidence on microdosing psychedelic drugs. We assessed awareness, prevalence, and dosing practices of microdosing psychedelic drugs among young adults 18-22 years old from Southern California (2018-2019). We examined whether sociodemographic factors, personality traits, mental health, or other substance use behaviors were correlated with having ever microdosed. Among 2,396 participants, 293 (12%) had heard of microdosing and 74 (3%) ever microdosed. Among those who had heard of microdosing, 79% correctly defined microdosing as taking an amount of a psychedelic much lower than a standard dose, whereas 15% misperceived microdosing as a standard psychedelic dose. Psilocybin was the most common drug ever microdosed (70%), followed by lysergic acid diethylamide (LSD, 57%). Among those who ever microdosed, ~18% reported using psychoactive doses far higher than would be generally considered a microdose. White race, male/masculine gender identity, bisexual identity, past 6-month other drug use, greater attention deficit/hyperactivity disorder symptoms, mindfulness, and sensation-seeking were positively associated with having ever microdosed in multivariable models. Young adult microdosing merits further attention from scientific and public health professionals to help prevent misperceptions and potential adverse consequences as well as explore its potential therapeutic applications.

Association of Race-Ethnicity Intersection With Disparities in Cigarette Smoking in U.S. Adults.

INTRODUCTION: Detailed estimates of disparities in cigarette smoking across single- and multi-race groups and their intersections with ethnicity are lacking. This study estimates the prevalence of self-reported current smoking among intersecting adult race-ethnicity groups in the United States. AIMS AND METHODS: The analysis uses 2018-2019 data from the Tobacco Use Supplement-Current Population Supplement (TUS-CPS; n = 137 471). Self-reported Hispanic origin and race were recoded into 19 mutually exclusive race-by-ethnicity intersecting groups. Weighted race-ethnicity group smoking prevalence were compared to the overall population prevalence and one another. RESULTS: Compared to the U.S. population current smoking prevalence (11.4% [95% CI = 11.2% to 11.6%]), smoking was particularly higher in non-Hispanic American Indian/Alaska Native (AI/AN) groups (20.7% [95% CI = 17.8% to 24.0%]) and non-Hispanic multiracial AI/AN/White (24.4% [95% CI = 20.3% to 29.1%]) and AI/AN/Black (22.4% [95% CI = 14.4% to 33.2%]) groups. Non-Hispanic single-race Asian (5.0% [95% CI = 4.4% to 5.6%]) and Hispanic single-race White (7.2% [95% CI = 6.7% to 7.7%]) smoking prevalence undercut the overall U.S. population prevalence. In pairwise comparisons, smoking prevalence was higher in various non-Hispanic single- and multi-race AI/AN groups than non-AI/AN groups and was lower in various Hispanic groups than non-Hispanic groups. CONCLUSIONS: Smoking prevalence disparities are not monolithic across complex diversity of race and ethnicity in the United States. Accurate identification of priority populations in need of targeted tobacco control efforts may benefit by acknowledging multinomial heterogeneity across intersecting racial and ethnic identities. IMPLICATIONS: Understanding racial and ethnic disparities in cigarette smoking can inform national strategies for reducing health inequities. This study examines cigarette smoking disparities among 19 adult intersecting race-ethnicity groups in the United States using the 2018-2019 TUS-CPS data. Results show higher smoking rates in some non-Hispanic American Indian/Alaska Native and Black groups, while lower rates are seen in Asian and Hispanic individuals. These findings emphasize the need for disaggregated data to tackle smoking disparities and guide targeted prevention efforts.

Effects of mint, menthol, and tobacco-flavored e-cigarettes on tobacco withdrawal symptoms in adults who smoke menthol cigarettes: A laboratory pilot study.

BACKGROUND: Menthol cigarette smoking has remained stable or increased in certain groups, despite an overall decline in cigarette smoking rates in the U.S. Understanding whether e-cigarettes alter patterns of menthol cigarette use is critical to informing efforts for reducing the public health burden of menthol cigarette smoking. This 2019-2020 laboratory pilot study evaluated whether self-administration of mint-, menthol-, or tobacco-flavored e-cigarettes would differentially impact tobacco withdrawal symptoms in e-cigarette-naïve adults who smoke menthol cigarettes daily. METHODS: Participants (N=17; 35.3% Female; mean age=51.8) attended three laboratory sessions after 16-hours of tobacco abstinence. Participants self-administered a study-provided JUUL e-cigarette (0.7mL with 5% nicotine by weight) at each session in which flavor was manipulated (mint vs. menthol vs. tobacco; order randomized). Participants completed pre- and post-e-cigarette administration self-report assessments on smoking urges, nicotine withdrawal, and positive and negative affect states. Multilevel linear regression models tested differences between the three flavor conditions for individual study outcomes. RESULTS: Following overnight tobacco abstinence, vaping either a mint or menthol (vs. tobacco) flavored e-cigarette led to significantly greater reductions in smoking urges over time; menthol (vs. tobacco) flavored e-cigarettes also suppressed urges to smoke for pleasure. Notably, no differences in nicotine withdrawal, positive affect, or negative affect were observed. CONCLUSIONS: In this laboratory pilot study, mint and menthol (vs. tobacco) flavored e-cigarettes provided some negative reinforcement effects via acute reductions in smoking urges during tobacco abstinence, yet only menthol flavored e-cigarettes demonstrated suppressive effects on smoking urges for pleasure in adults who smoke menthol cigarettes daily.

Race/ethnic differences in the association of anxiety, depression, and discrimination with subsequent nicotine and cannabis use among young adults: A prospective longitudinal study.

INTRODUCTION: The shifting patterns in nicotine and cannabis use among young adults is taking place at a time when there is also increased reports of psychosocial stressors such as anxiety, depression, and everyday discrimination. Although race/ethnicity has been found to moderate the impact of psychosocial stressors, there is limited research examining the association of anxiety, depression, and discrimination with patterns of nicotine and/or cannabis product use among diverse young adults. METHODS: Data were from a longitudinal study of 2478 US young adults surveyed between 2019 and 2021. General estimating equation models were used to examine associations of self-reported psychological symptoms (depression, anxiety) and social stressors (discrimination) with substance use (any nicotine and cannabis product use; nicotine and cannabis vaping). RESULTS: Young adults from different racial/ethnic groups differed significantly in their depression and discrimination scores with young adults of color having higher mean scores. Overall, higher depression and everyday discrimination score was associated with increased odds of past 6-month use of any nicotine/tobacco and cannabis products. Higher generalized anxiety score increased odds of any nicotine/tobacco and dual nicotine and cannabis product use. Higher everyday discrimination score was associated with increased odds nicotine and cannabis vaping overall. Stratified models showed variation in associations among different racial/ethnic groups. CONCLUSIONS: Psychosocial stressors are associated with increased substance use odds among young adults. However, these stressors have a differential impact on substance use odds among young adults from different racial/ethnic contexts.

Distress about social problems and tobacco and cannabis use outcomes among young adults in Los Angeles County.

OBJECTIVE: To examine associations of concern, worry, and stress about discrimination, shootings/violence, and police brutality and exclusive and dual tobacco and cannabis use among young adults. METHODS: A prospective, racially/ethnically diverse cohort of young adults (n = 1960) living in Los Angeles, California completed a baseline survey in 2020 (age range: 19-23) and a follow-up survey in 2021. Exploratory factor analysis (EFA) was employed on nine variables assessing levels of concern, worry, and stress about societal discrimination, societal shootings/violence, and community police brutality at baseline. Past 30-day tobacco and cannabis use at follow-up was categorized as current exclusive tobacco, exclusive cannabis, and dual tobacco and cannabis (vs never/former) use based on eleven use variables. Multinomial logistic regressions estimated adjusted associations between each factor score (translated to standard deviation units) with exclusive and dual tobacco and cannabis use. RESULTS: The EFA produced four factor scores representing concern/worry/stress (i.e., distress) about community police brutality (F1), distress about societal shootings/violence (F2), and distress about societal discrimination (F3), as well as generalized stress about police brutality, shootings/violence, and discrimination (F4). F1, F2, and F3 were associated with subsequent exclusive current cannabis use, with F1 having the strongest association (OR: 1.35, 95% CI: 1.18-1.55), while only F1 (OR: 1.51, 95% CI: 1.27-1.78) was associated with dual tobacco and cannabis use. None of the factors were associated with exclusive tobacco use. CONCLUSIONS: Young adult concern, worry, and/or stress about social problems may increase risk of cannabis use with or without concurrent tobacco use 6-12 months later.