The role of electronic cigarette use for quitting or reducing combustible cigarette use in the 30s: Longitudinal changes and moderated relationships.

BACKGROUND: Evidence for use of electronic cigarettes (e-cigs) as a potential aid in quitting or reducing combustible cigarette (c-cig) use is mixed. This study examined the extent to which e-cig initiation among smokers in their 30 s predicted quitting or reducing smoking or nicotine dependence symptoms by age 39, and whether the role of e-cigs in quitting differed by prospectively assessed moderators. METHODS: Data were from the Seattle Social Development Project (SSDP), a panel study of 808 diverse participants with high retention. A subsample of 221 smokers at age 33 was selected for analysis. Self-reports of c-cig use and dependence were assessed longitudinally at ages 33 and 39. Sixteen potential moderators were examined, including social demographics, smoking attitudes and desire to quit, other health behaviors and status, and adolescent and early adult assessments of smoking history. RESULTS: The use of e-cigs was consistently associated with a lower likelihood of quitting c-cigs by age 39, after accounting for frequency of prior c-cig use at age 33. This negative association persisted across all moderators examined, although it was nonsignificant among those with a definite desire to cut down. Among those who did not quit smoking, e-cig use had no association with decreases in either quantity of c-cigs used or dependence symptoms. CONCLUSIONS: Results indicate that e-cigarette use was not helpful for quitting or reducing combustible cigarette use in the 30 s. Rather, across extensive tests of moderation, e-cig initiation consistently predicted less quitting during this important age period for successful cessation.

Adult Social Environments and the Use of Combustible and Electronic Cigarettes: Opportunities for Reducing Smoking in the 30s.

INTRODUCTION: Reducing cigarette use is a major public health goal in the United States. Questions remain, however, about the potential for the social environment in the adult years-particularly in the 30s and beyond-to influence cigarette use. This study tested pathways hypothesized by the social development model to understand the extent to which social environmental factors at age 33 (eg, involvement with smokers or with physically active people) contribute to changes in cigarette use from age 30 to age 39. Both combustible and electronic cigarette use were investigated. METHODS: Data were from the Seattle Social Development Project, a longitudinal study of 808 diverse participants with high retention. Self-reports assessed social developmental constructs, combustible and electronic cigarette use, and demographic measures across survey waves. RESULTS: At age 30, 32% of the sample reported past-month cigarette use. Using structural equation modeling, results showed high stability in cigarette use from age 30 to 39. After accounting for this stability, cigarette-using social environments at age 33 predicted personal beliefs or norms about smoking (eg, acceptability and social costs), which in turn predicted combustible cigarette use at age 39. Cigarette-using environments, however, directly predicted electronic cigarette use at age 39, with no significant role for beliefs about smoking. CONCLUSIONS: Cigarette use was highly stable across the 30s, but social environmental factors provided significant partial mediation of this stability. Pathways were different for combustible and electronic cigarette use, however, with personal smoking norms playing an important role for the former but not the latter. IMPLICATIONS: This study addresses the need for longitudinal investigation of social mechanisms and cigarette use in the 30s. Findings reinforce efforts to prevent the uptake of cigarettes prior to the 30s because, once started, smoking is highly stable. But social environmental factors remain viable intervention targets in the 30s to disrupt this stability. Addressing personal norms about smoking's acceptability and social costs is likely a promising approach for combustible cigarette use. Electronic cigarettes, however, present a new challenge in that many perceived social costs of cigarette use do not readily translate to this relatively recent technology.

E-cigarette use is associated with subsequent cigarette use among young adult non-smokers, over and above a range of antecedent risk factors: a propensity score analysis.

BACKGROUND AND AIMS: There is a public health concern that the use of e-cigarettes among non-smoking young adults could be associated with transition to combustible cigarette use. The current study is a quasi-experimental test of the relationship between e-cigarette use and subsequent combustible cigarette use among young adult non-smokers, accounting for a wide range of common risk factors. DESIGN: Logistic regression was used to predict combustible cigarette use on three or more occasions at age 23 years based on age 21 e-cigarette use. Inverse probability weighting (IPW) was used to account for confounding variables. SETTING: Data were drawn from the Community Youth Development Study (CYDS), a cohort study of youth recruited in 2003 in 24 rural communities in seven US. states PARTICIPANTS: Youth in the CYDS study (n = 4407) were surveyed annually from ages 11 to 16, and at ages 18, 19, 21 and 23 years (in 2016). The sample was gender balanced (50% female) and ethnically diverse (20% Hispanic, 64% white, 3% black and 12% other race or ethnicity). The current study was limited to participants who had never used combustible cigarettes by age 21 (n = 1825). MEASUREMENTS: Age 21 use of e-cigarettes and age 23 use of combustible cigarettes (three or more occasions) were included in the regression analysis. Age 11-19 measures of 22 common predictors of both e-cigarette and combustible cigarette use (e.g. pro-cigarette attitudes, peer smoking, family monitoring) were used to create IPWs. FINDINGS: After applying IPW, e-cigarette use at age 21 was associated with a twofold increase in odds of combustible cigarette use on three or more occasions 2 years later (odds ratio = 2.16, confidence interval 1.23, 3.79). CONCLUSIONS: Among previously never-smoking US young adults, e-cigarette use appears to be strongly associated with subsequent combustible cigarette smoking, over and above measured preexisting risk factors.

Evaluating the effect of retail marijuana legalization on parent marijuana use frequency and norms in U.S. States with retail marijuana legalization.

OBJECTIVES: To examine post-retail marijuana legalization (RML) change in marijuana use frequency and pro-marijuana norms among parents. METHODS: The Intergenerational Study, a longitudinal panel of parents (N = 668) and children, followed participants from 2002 to 2018, when parents were 27 and 43 years old, respectively. Three quarters of participants (74%) lived in an RML state and 142 (21%) had used marijuana in the 8 years prior to RML. Piecewise growth modelling compared pre- and post-RML slopes of use frequency and pro-marijuana norms. RESULTS: Frequency of use and pro-marijuana norms increased following legalization in both RML and non-RML states, though norms rose significantly faster in RML states. Growth in use was primarily driven by new users of marijuana. There were no differences in frequency of marijuana use or pro-marijuana norms by race/ethnicity, gender, or education. CONCLUSIONS: An increase in marijuana use frequency associated with RML among parents poses risk to both parents' well-being and the health of their children. A faster pace of increase in pro-marijuana norms in RML states may signal continued increases in use in the future.

Supporting LGBTQ+ Foster Teens: Development of a Relationship-Focused, Self-Guided Curriculum for Foster Families.

LGBTQ+ youth are over-represented in the foster care system. Child welfare systems across the country have been struggling with how to make their systems work better for the LGBTQ+ youth they serve. One strategy is developing foster caregiver trainings that bolster caregivers' knowledge and support of LGBTQ+ youth in their care. This study has three aims: (1) to provide an overview of a module designed to support relationship building between LGBTQ+ youth in foster care and their caregivers, (2) to describe the theater testing procedure used to assess usability of the developed module with foster caregivers and adults, and (3) to share the results of the theater test. Overall, participants provided positive usability feedback about the module activities, as well as a wide variety of recommendations for strengthening the content for widespread use. Participants felt the module should be directed specifically toward caregiver skill development rather than toward both caregiver and youth support. This module represents one example of how materials focused on building foster caregivers' knowledge and support have the potential to help LGBTQ+ teens who are overrepresented in the foster care system.

An intergenerational investigation of the associations between parental marijuana use trajectories and child functioning.

Diverse patterns of life-course marijuana use may have differential health impacts for the children of users. Data are drawn from an intergenerational study of 426 families that included a parent, their oldest biological child, and (where appropriate) another caregiver who were interviewed 10 times from 2002 to 2018; the current study used data from 380 families in waves 6-10. Analyses linked parent marijuana use trajectories estimated in a previous publication (Epstein et al., 2015) to child marijuana, alcohol, and nicotine use; promarijuana norms; internalizing; externalizing; attention problems; and grades using multilevel modeling among children ages 6 to 21. Four trajectories had been found in the previous study: nonuser, chronic, adolescent-limited, and late-onset. Results indicate that children of parents in the groups that initiated marijuana use in adolescence (chronic and adolescent-limited) were most likely to use substances. Children of parents in the late-onset group, where parents initiated use in young adulthood, were not at increased risk for substance use but were more likely to have attention problems and lower grades. Results held when parent current marijuana use was added to the models. Implications of this work highlight the importance of considering both current use and use history in intergenerational transmission of marijuana use, and the need to address parent use history in family based prevention. Prevention of adolescent marijuana use remains a priority. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Does Adolescent Alcohol Harm Minimization Policy Exposure Reduce Adult Alcohol Problems? A Cross-National Comparison.

PURPOSE: Adolescent alcohol use carries risks for problem behaviors, such as injury and school dropout, as well as increases the risk of alcohol dependence later on, making public health approaches that curb youth alcohol use a key concern. The present study uses a two-state comparison of alcohol-related policies in Victoria, Australia and Washington State, U.S. (harm minimization in Australia and zero tolerance in the U.S.) to examine whether youth alcohol use in each state is related to alcohol-related problems in young adulthood. METHODS: Data were drawn from the International Youth Development Study (N = 1,965) that followed youth in Victoria and Washington states from age 13 years, with follow-up at ages 14 and 15 years, and then again at age 25 years. Multiple-group structural equation modeling was used to test whether early alcohol use was equally related to alcohol problems (measured by the Alcohol Use Disorder Identification Test) at age 25 years and whether the relationship was moderated by family and school environments that were tolerant of youth drinking and by gender. RESULTS: Youth in Victoria reported greater rates of alcohol use compared with youth in Washington, as well as more permissive family and school environments. Early alcohol use was equally associated with Alcohol Use Disorder Identification Test problems at age 25 years in the two nations, and none of the moderators significantly changed the association. CONCLUSIONS: Results suggest that harm minimization policies adopted in Victoria are less effective at reducing alcohol problems during young adulthood compared with the stricter zero-tolerance approaches adopted in Washington State.