Sexting and Mental Health in Adolescence: A Longitudinal Study.

PURPOSE: Research has shown that sexting-the practice of sending, receiving, and forwarding sexual messages on digital media services-is associated with poor mental health. However, few studies have moved beyond cross-sectional designs, demonstrating that individuals who engage in sexting differ in mental health from those who do not. The purpose of our study was to investigate whether sexting was associated with increases in depression symptoms and conduct problems over time. METHODS: We analyzed data from three rounds of the longitudinal MyLife study among Norwegian adolescents (n = 3,000). The participants completed e-questionnaires containing instruments on sexting and mental health at three annual assessments. Random intercept cross-lagged panel models were estimated to examine the effect of sexting on within-person changes in mental health, measured one year later. We also examined the potential reverse order of the effects. RESULTS: In accordance with findings from cross-sectional research, the analyses showed that boys who frequently engaged in sexting also reported more depression symptoms and conduct problems. For girls, we found only a significant between-person association for sexting and depression symptoms. However, sexting was not predictive of changes in depression symptoms or conduct problems over time. On the contrary, conduct problems predicted increased sexting scores but only for girls. DISCUSSION: Our results suggest that efforts to reduce sexting may not prevent mental health problems among young people. Intervention efforts should thus redirect attention from sexting as a driver of individual mental health problems to educating adolescents on how to perform safe and responsible sexting.

E-cigarette use in global digital youth culture. A qualitative study of the social practices and meaning of vaping among 15-20-year-olds in Denmark, Finland, and Norway.

BACKGROUND: The introduction of e-cigarettes on the tobacco market has brought new regulatory challenges, and particular concerns relate to e-cigarette uptake among young people. The aim of this study was to explore the use and social meaning of e-cigarettes among Nordic young people and to discuss this in the context of current legislation. METHODS: Thirteen focus groups were conducted with 46 Danish, Finnish, and Norwegian young people (24 boys) with vaping experience aged 15-20 years (mean age 17 years). RESULTS: Young people's vaping stood out as an inherently social practice that was commonly interlinked with experimental use patterns. Relative to smoking, vaping was seen as socially acceptable and less harmful to health. Product innovations like flavour additives and nicotine-free liquid options added to perceptions of low harm, and innovative device design features facilitated new and playful user practices. Finally, digital markets eased the young people's access to e-cigarettes, and the digital world also represented an arena for e-cigarette exposure and self-presentation. They commonly viewed vaping-related content in their social media feeds and also produced such content themselves. CONCLUSION: Young people's vaping is a social practice interwoven in contemporary digital and global youth culture. Transnational regulations are needed to support individual countries in preventing e-cigarette use and exposure among young people.

Single, Dual, and Triple Use of Cigarettes, e-Cigarettes, and Snus among Adolescents in the Nordic Countries.

New tobacco and nicotine products have emerged on the market in recent years. Most research has concerned only one product at a time, usually e-cigarettes, while little is known about the multiple use of tobacco and nicotine products among adolescents. We examined single, dual, and triple use of cigarettes, e-cigarettes, and snus among Nordic adolescents, using data of 15-16-year-olds (n = 16,125) from the European School Survey Project on Alcohol and other Drugs (ESPAD) collected in 2015 and 2019 from Denmark, Finland, Iceland, Norway, Sweden, and the Faroe Islands. Country-specific lifetime use of any of these products ranged between 40% and 50%, and current use between 17% and 31%. Cigarettes were the most common product in all countries except for Iceland, where e-cigarettes were remarkably more common. The proportion of dual and triple users was unexpectedly high among both experimental (24%-49%) and current users (31-42%). Triple use was less common than dual use. The users' patterns varied somewhat between the countries, and Iceland differed substantially from the other countries, with a high proportion of single e-cigarette users. More knowledge on the patterns of multiple use of tobacco and nicotine products and on the potential risk and protective factors is needed for targeted intervention and prevention efforts.

Adolescents' Use of Nicotine-Free and Nicotine E-Cigarettes: A Longitudinal Study of Vaping Transitions and Vaper Characteristics.

INTRODUCTION: Although adolescents' nicotine addiction from e-cigarettes is a concern, few studies differentiate between vaping with and without nicotine. This study examines the prevalence of nicotine and nicotine-free vaping, maps transitions between vaping behaviors, and assesses differences in the personal characteristics of vapers in a sample of Norwegian adolescents. AIMS AND METHODS: Data came from a nationwide longitudinal study of adolescents (n = 2018) conducted in 2017 (T1), 2018 (T2), and 2019 (T3) (mean age: 14.2, 15.0, and 16.2). Using an online questionnaire, we measured vaping with and without nicotine, snus use, smoking, sensation-seeking, conduct problems, and levels of depression. RESULTS: Past 12-month vaping prevalence was stable (12%, 13%, and 15%). Among adolescents reporting vaping at T1, 66% had used e-cigarettes without nicotine, 22% with nicotine, and 12% were unsure of nicotine content. Individual vaping trajectories were unstable: of nicotine-free vapers, 54% became non-users, while 14% became nicotine vapers from T1 to T2. From T2 to T3, 50% became non-users, while 17% became nicotine vapers. Of nicotine vapers, 39% became non-users from T1 to T2, while 46% became non-users from T2 to T3. Compared to nicotine-free vapers, nicotine vapers had more conduct problems (mean = 3.67 vs 2.17), had more symptoms of depression (mean = 11.38 vs 6.95), and comprised more past 30-day snus users (33% vs 14%) and cigarette users (33% vs 9%). CONCLUSIONS: Adolescent vapers most commonly used e-cigarettes without nicotine, few of these transitioned into nicotine vaping, and a majority became non-users. Nicotine vapers were more likely to use other tobacco products and have more conduct problems and symptoms of depression compared to nicotine-free vapers. IMPLICATIONS: Reporting the prevalence of nicotine-free vaping is critical for assessing nicotine exposure and subsequent risks of nicotine addiction. This multi-cohort longitudinal study showed that use of nicotine-free e-cigarettes is common among young vapers in Norway. Adolescents' vaping patterns-both with and without nicotine-are generally temporal and experimental. Despite the majority of nicotine vapers becoming non-users, they are characterized by having more conduct problems and poorer mental health, and they more often used other tobacco products.

'Vaping and fidget-spinners': A qualitative, longitudinal study of e-cigarettes in adolescence.

BACKGROUND: We see the contours of a cigarette-free adolescent cohort in Norway. Simultaneously, increasing use of vaping devices among adolescents internationally, and in the US in particular, has evoked fear of a new nicotine-addicted generation. This longitudinal study explores the vaping phenomenon in a context where nicotine e-liquid is still prohibited. METHODS: Data are from longitudinal, qualitative interviews with a sizable sample of 12-17 year olds (118 8th graders from 6 schools/classes at baseline). Four follow-ups were conducted from 2015 to 2019 (a total of 50 semi-structured group and 175 individual interviews). The interviews were coded using HyperResearch software and thematically analysed in the light of actor network and interaction ritual theory. RESULTS: Gradual and collective shifts in vaping practices and in the symbolic meaning of vaping were observed in three phases. First, in 8th grade, few had tried to vape, even if several were curious about this novel invention, practice and the available flavours. Second, after 9th grade, one in three reported personal use. They emphasised harmlessness, coolness, performance and accessibility online. However, by the end of middle school, a third phase became visible; vaping had lost status and was described as 'childish' and unpopular. Interviewees repeated the lack of relevance in high school, comparing e-cigarettes with the fidget-spinner and reserving vaping for kids and addicted adult smokers. The analysis displays a systematic pattern in which adolescents account for vaping as a time-limited trend. CONCLUSION: E-cigarettes were devalued from novelty and transgression to childish and uninteresting within the same sample over a four-year period. In conclusion, e-cigarettes in the sample represented fashionable experimentation rather than steady user patterns.

Normalisation of non-drinking? 15-16-year-olds' accounts of refraining from alcohol.

INTRODUCTION AND AIMS: In many countries, adolescents' drinking has decreased substantially over recent years. This study aims to explore Norwegian adolescents' accounts of refraining from drinking alcohol and how their explanations are contextualised. DESIGN AND METHODS: Semi-structured qualitative interviews were conducted with 95 adolescents aged 15-16 years (50 females), recruited from six schools in Norway. Interviews examined perceptions and experience of alcohol use, and how non-drinking was reasoned for. RESULTS: The adolescents' accounts of refraining from alcohol were sorted into three categories: (i) influence from non-drinking peers and negative social norms towards alcohol use: non-drinking was described as the norm in their age group; (ii) legal age and relationship to parents: age limits and parents' disapproval of drinking was perceived as justifiable; and (iii) non-drinking to sustain control: alcohol use was perceived as implying loss of control of self-presentation in specific situations, and risk of negative exposure on social media. It was also seen as implying risk of loss of control of future achievement in school or sports. DISCUSSION AND CONCLUSIONS: The adolescents' explanations for non-drinking indicated a devaluation in the social position of alcohol among younger adolescents. Non-drinking was described as majority behaviour and fitting in with a life orientation towards both present-day and future achievement. Their accounts pointed towards a normative effect of age limits on buying alcohol and highlighted the significance of emotional closeness and open communication about alcohol with parents. The results indicate a differentiated normalisation of non-drinking in this age group.

Monitoring young lifestyles (MyLife) - a prospective longitudinal quantitative and qualitative study of youth development and substance use in Norway.

PURPOSE: The Monitoring Young Lifestyles (MyLife) project was initiated as an integrated quantitative and qualitative prospective investigation of correlates, causes, and consequences of adolescent substance use and other addictive behaviours in Norway. PARTICIPANTS: The MyLife cohort was recruited from middle schools in Norway, which were selected from low, medium and high standard of living areas in both rural and urban regions of the country. A total of 3512 eighth, ninth and tenth graders (55% girls) from 33 schools were enrolled in the quantitative project arm (QT), while a total of 120 eighth graders (52% girls) from six schools were enrolled in the qualitative project arm (QL). FINDINGS TO DATE: QT baseline was conducted in the fall of 2017, when 2975 adolescents completed an online questionnaire at school during a regular class time. A total of 2857 adolescents participated in the first QT follow-up 1 year later. QL baseline was conducted across the fall semesters of 2014 (one class) and 2015 (five classes), when a total of 118 eighth graders completed face-to-face interviews. QL follow-ups were conducted in the spring of 2015 and fall of 2017 (n=98) for group interviews, and in the spring of 2017 and 2018 (n=95) for individual interviews. In terms of additional data sources, a total of 3035 parents consented to own participation, of which 1899 completed a brief online questionnaire at QT baseline in late 2017. School principals completed brief surveys at the same time. FUTURE PLANS: Both QT and QL arms have planned follow-ups through 2021. Consents were obtained for individual-level linkages of adolescent and parental quantitative surveys to each other, as well as to the information available in multiple national registries and databases. These supplemental data sources will provide key information on additional putative exposures as well as on the long-term health, educational, and social outcomes of the MyLife participants.

"Cloud chasers" and "substitutes": e-cigarettes, vaping subcultures and vaper identities.

The use of e-cigarettes is increasing, a practice denoted as vaping. We explore user motives, self-identity as vapers and involvement in vaping subcultures, drawing on sociological theory of stigma, subcultures and symbolic boundaries. Based on analyses of semi-structured interviews with 30 Norwegian vapers, we find that there is a vaping subculture in Norway. We identify two dominant vaper identities. The first is labelled cloud chasers. These were dedicated vapers who identified with symbols and values in the subculture. Many were politically engaged in improving vaping regulation regimes and felt a sense of belonging to a vaping community. The second group is labelled substitutes. These were former daily smokers who used e-cigarettes for smoking cessation in a more pragmatic and defensive manner, to avoid health risks, to escape the stigma of smoking and to manage nicotine addiction. In this group, self-identity as a vaper was generally lacking. Vaping was often symbolically linked to the stigmatised smoker identity they wanted to escape, and was restricted to private contexts. The perceived symbolic meaning of e-cigarettes varies: for some, they are a symbol of pleasure and community. For others, they connote the stigmatised status of the addicted smoker seeking an alternative to cigarettes.

"It looks kind of cool when cool people smoke, but " Norwegian adolescents' decoding of smoking scenes in films.

AIMS: Exposure to smoking scenes in films is seen as contributing to smoking initiation among young people. This has triggered calls to include depictions of smoking as a criterion in film ratings. All the same time, little is known about how adolescents interpret different smoking scenes. This study analyses how young people decode smoking scenes by contextualising identification with, and evaluation of, various characters who smoke, as well as the significance of film genres. DESIGN: In order to explore how adolescents conceptualize smoking scenes in different film genres, we conducted eight focus-group interviews with adolescents aged 13-17 years (n = 54), using purposive sampling. The discussions were semi-structured with a standard guide, and we used clips from eight films containing various positive and negative moods and character types as stimuli for the discussions. To analyse interpretations qualitatively, thematic coding was applied. RESULTS: The adolescents acknowledged that smoking is a narrative ingredient designed to illustrate and amplify character traits and situational moods. Characters who smoked were usually interpreted in terms of smoking stereotypes: stress relief, romantic seduction, social interaction between equals, habitual smoking, and as a symbol of "bad guys". The adolescents identified more strongly with elegant, positive, and self-assured smoking characters than with negative, anxious, or ambiguous characters. CONCLUSIONS: Adolescents interpret smoking scenes in accordance with encoded meanings: they tend to get the messages inscribed by the filmmakers. As positive and glamorous representations are more likely to stimulate smoking experimentation and initiation among adolescents than negative representations, future research should distinguish more clearly between exposure to positive and to negative representations.