Remote Versus In-Person Learning During COVID-19: Comparison of E-Cigarette Susceptibility and Ever Use Among a Diverse Cohort of 6th-Grade Students in Texas.

BACKGROUND: In response to SARS-CoV2 (COVID-19), school districts incorporated remote learning as a mitigation strategy. This study examines the association between classroom setting (ie, on-campus versus remote) and e-cigarette susceptibility or ever use among a sample of Texas public middle school students. METHODS: Data from n = 985 students enrolled in the CATCH My Breath E-Cigarette Prevention Program trial were collected in Spring 2021. Participants were 6th-grade students in urban Texas. E-cigarette use was examined using the "at-risk" definition described by FDA, indicating either: (1) susceptible never user; or (2) experimental ever use. A multilevel, logistic regression model examined the association between classroom setting and e-cigarette susceptibility/ever use. Covariates included sex, race/ethnicity, academic achievement, household e-cigarette use, perceived school connectedness, and school-level economic status. Models account for nesting within school district. Analyses stratified by race/ethnicity were also conducted. RESULTS: Overall, 36.3% of the sample were susceptible never users or ever e-cigarette users. The sample was comprised of 55.0% on-campus and 45.0% remote learners. On-campus learners had greater odds of reporting e-cigarette susceptibility or ever use (aOR: 1.45; p = .014). These findings were observed among Latino (aOR: 1.77; p = .026) and White (aOR: 2.10; p = .099) but not African American/Black (aOR: 0.86; p = .728) youth. CONCLUSIONS: On-campus learning during the Spring 2021 semester was associated with greater risk for e-cigarette susceptibility or ever use among a diverse sample of 6th-grade students. E-cigarette susceptibility and ever use is a risk factor for progression to long-term e-cigarette use in later adolescence. IMPLICATIONS: As school districts prepare to return to on-campus learning in 2022, a focused approach to e-cigarette prevention may be needed to prevent widespread e-cigarette initiation and continued use. Further, study findings demonstrate a need for further research on the school environment as a determinant of e-cigarette use.

Language Gap in Reach of "The Real Cost": Examination of a Federal Mass Media Campaign From 2017 to 2019.

INTRODUCTION: Approximately 25% of youth in the United States speak a language other than English at home. These youth may have less exposure to English-speaking media, including public smoking prevention initiatives such as the FDA's "The Real Cost" campaign. Research is needed to explore potential gaps in the reach of "The Real Cost" campaign among bilingual youth. AIMS AND METHODS: Data were pooled from the 2017-2019 National Youth Tobacco Surveys. Participants were n = 12 803 middle and high school students who were either: (1) susceptible never smokers; or (2) ever smokers that had smoked less than 100 cigarettes; these criteria reflect the FDA's definition of "target population" for "The Real Cost" campaign. Multiple, logistic regression analyses examined the relationship between speaking a language other than English at home (ie, bilingual) and self-reported exposure to "The Real Cost" campaign among both samples. Analyses controlled for sex, race/ethnicity, grade level, tobacco marketing exposure, and current tobacco use. RESULTS: The majority (61.7%) of youth who met "target population" criteria self-reported exposure to "The Real Cost" from 2017 to 2019. Regression analyses found that youth who reported speaking a language other than English at home were significantly less likely to self-report exposure to "The Real Cost" campaign (adjusted odds ratio: 0.85; p < .001), adjusting for covariates. CONCLUSIONS: Bilingual youth were significantly less likely to report exposure to "The Real Cost" campaign. Findings suggest the need to develop methods of increasing reach among bilingual youth, given the high smoking prevalence among these youth. IMPLICATIONS: This study highlights a social and cultural gap in the reach of the FDA's "The Real Cost" campaign. Agencies such as FDA should consider enhancing existing mass media campaigns to reach diverse communities, including the nearly 25% of youth who speak a language other than English.

Association between observing peers vaping on campus and E-cigarette use and susceptibility in middle and high school students.

BACKGROUND: This study examines the association between exposure to e-cigarette use on school campus and e-cigarette use behaviors among adolescents in the United States. METHODS: Data were obtained from the 2019 National Youth Tobacco Survey. First, two multivariate logistic regression models examined the association between in-school exposure to e-cigarette use and ever and past 30-day (i.e., current) e-cigarette use. Next, a multivariate logistic regression model to examine the relationship between in-school exposure to e-cigarette use and susceptibility to use was conducted among a subsample (n = 11,958) of never e-cigarette users. Covariates included grade, race/ethnicity, marketing exposure, and ever use of other tobacco products. RESULTS: Approximately 64.3 % of adolescents reported seeing someone use an e-cigarette on school campus; the most common locations being in the bathroom/locker room (34.4 %) and parking lot (34.0 %). In-school exposure to e-cigarette use was associated with greater odds of ever (Adj OR: 2.06; 95 % CI: 1.82-2.33) and current (Adj OR: 1.70; 95 % CI: 1.46-1.98) e-cigarette use among adolescents as well as greater odds of susceptibility to use (Adj OR: 2.00; 95 % CI: 1.82-2.20) among never e-cigarette users. CONCLUSIONS: Observing e-cigarette use on school campus was associated with greater odds of e-cigarette use and susceptibility. It is plausible that observing e-cigarette use on campus reinforces the social acceptability of adolescent e-cigarette use. Findings inform on the prevalence of e-cigarettes use on-campus as well as how this phenomenon may influence e-cigarette use/susceptibility among youth. The observed relationship highlights the role of schools in the efforts to reduce adolescent e-cigarette use.