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1.
Prev Med ; : 106169, 2020 Jun 26.
Artículo en Inglés | MEDLINE | ID: mdl-32750386

RESUMEN

While prior research suggests a relationship between exposure to tobacco content in movies and smoking, less is known about the impact of exposure to tobacco through episodic programs. This study assessed the relationship between exposure to tobacco content in programs on Netflix and broadcast or cable TV and initiation of combustible tobacco or e-cigarette use among young people. A nationally representative, longitudinal sample (ages 15-21 at baseline) was surveyed about exposure to episodic programs previously analyzed for the presence of tobacco and subsequent use of combustible tobacco and e-cigarettes. Logistic regression models assessed associations between exposure to tobacco imagery and future initiation of combustible tobacco and e-cigarettes among those who were nicotine naïve (N = 4604). Data were collected in February-May 2018 and February-May 2019. All analyses were conducted in 2019. Results suggest a dose-response relationship between exposure to tobacco and vaping initiation, whereby the higher the exposure, the greater the odds of subsequent initiation (OR(low) = 2.19, 95%CI = 1.38-3.48; OR(medium) = 2.20, 95%CI = 1.34-3.64; OR(high) = 3.17, 95%CI = 1.71-5.88). There was no significant association between exposure to tobacco imagery and smoking initiation. Tobacco imagery is common in episodic programming popular among young people. Results suggest exposure to tobacco in episodic programs may impact future e-cigarette use. Ongoing monitoring of the impact of tobacco content in episodic programs is needed as the number of available programs continues to increase. Findings highlight the need for policy and advocacy efforts to reduce young people's exposure to tobacco content across all media platforms.

2.
Ethn Dis ; 30(3): 479-488, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32742153

RESUMEN

Objective: Studies assessing sociodemographic disparities in the tobacco retail environment have relied heavily on non-spatial analytical techniques, resulting in potentially misleading conclusions. We utilized a spatial analytical framework to evaluate neighborhood sociodemographic disparities in the tobacco retail environment in Washington, DC (DC) and the DC metropolitan statistical area (DC MSA). Methods: Retail tobacco availability for DC (n=177) and DC MSA (n=1,428) census tract was assessed using adaptive-bandwidth kernel density estimation. Density surfaces were constructed from DC (n=743) and DC MSA (n=4,539) geocoded tobacco retailers. Sociodemographics were obtained from the 2011-2015 American Community Survey. Spearman's correlations between sociodemographics and retail density were computed to account for spatial autocorrelation. Bivariate and multivariate spatial lag models were fit to predict retail density. Results: DC and DC MSA neighborhoods with a higher percentage of Hispanics were positively correlated with retail density (rho = .3392, P = .0001 and rho = .1191, P = .0000, respectively). DC neighborhoods with a higher percentage of African Americans were negatively correlated with retail density (rho = -.3774, P = .0000). This pattern was not significant in DC MSA neighborhoods. Bivariate and multivariate spatial lag models found a significant inverse relationship between the percentage of African Americans and retail density (Beta = -.0133, P = .0181 and Beta = -.0165, P = .0307, respectively). Conclusions: Associations between neighborhood sociodemographics and retail density were significant, although findings regarding African Americans are inconsistent with previous findings. Future studies should analyze other geographic areas, and account for spatial autocorrelation within their analytic framework.

3.
Subst Use Misuse ; 55(10): 1601-1609, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32326803

RESUMEN

Background: High prevalence of opioid misuse has been noted among youth and young adults-particularly among those who identify as lesbian/gay or bisexual (LGB). Yet, little is known about the relationship between opioid-related attitudes and misuse among those who identify as LGB. Objectives: This study examined the role of opioid-related attitudes (i.e. acceptance of misuse and risk perception) in relation to ever and past 6-month prescription opioid misuse, stratified by sexual orientation. Methods: This study used a nationally representative, probability-based sample of youth and young adults aged 15-34 (N = 12,745; lesbian/gay = 398, bisexual = 857, heterosexual = 11,490). Data were collected via online surveys in Spring 2018. Wald chi-square tests assessed differences in ever and past 6-month opioid misuse by sexual orientation identity. Weighted adjusted logistic regression models estimated the influence of opioid-related attitudes (acceptance of misuse and risk perceptions) in relation to ever and past 6-month opioid misuse, controlling for demographic characteristics, other past drug use, and psychosocial variables. Results: Logistic regression models indicated that attitudes related to the acceptance of opioid misuse was predictive of (a) higher odds of ever misuse among heterosexual and bisexual individuals and (b) higher odds of past 6-month misuse regardless of sexual orientation. Conclusions: Prescription opioid misuse among LGB youth and young adults may be addressed by shifting key attitudes surrounding opioids. To help stem this deadly epidemic, prevention efforts should be guided by the unique stressors facing the LGB community and focus on reducing the acceptability of misusing opioids.

4.
J Public Health Manag Pract ; 26(3): 252-258, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32235207

RESUMEN

CONTEXT: The opioid crisis poses a significant burden at a national level, and certain states have seen particularly high rates of misuse, addiction, and overdose. In 2017, Rhode Island reported opioid-related deaths nearly twice the national average. OBJECTIVE: To test message efficacy and evaluate the effectiveness of campaign messaging to shift attitudes/beliefs related to opioid misuse in Rhode Island. DESIGN: In phase 1, near-final versions of 6 advertisements were shown to a sample of the target audience via an online survey portal to assess responses to the messages (N = 1210). Phase 2 of the study employed a pre/posttest design whereby 2 cross-sectional surveys were conducted, first prior to the campaign launch (N = 456) and another survey 6 months later in Rhode Island (N = 433). SETTING: Phase 1 was conducted online using a nationally representative panel, and phase 2 included a convenience sample of participants in Rhode Island recruited to undergo an online survey. PARTICIPANTS: Eighteen- to 29-year-old members of a nationally representative online panel (phase 1) and 15- to 34-year-olds living in the state of Rhode Island during data collection periods. MAIN OUTCOME MEASURE(S): Empathy and destigmatization ("someone like me could become addicted..." and "those who are dependent on prescription opioids are victims") and perceived risk of developing dependence on opioids. RESULTS: In both phases, there was an increase in empathy ("someone") (phase 1: pretest [31%], posttest [42%; z = 5.5, P < .0001] and phase 2 [34% baseline vs 41% follow-up; z = 2.0, P = .04]) and destigmatization ("victims") (phase 1: pretest [54%], posttest [58%; z = 2.2, P = .01] and phase 2 [46% baseline vs 54% follow-up; z = 2.2, P = .03]). There was also an increase in perceived risk: phase 1 (pretest [65%], posttest [75%; z = 5.4, P < .0001]) and phase 2 (66% baseline vs 74% follow-up; z = 2.5, P = .01). CONCLUSIONS: This study demonstrated the potential efficacy of a media campaign to shift young adults' opioid-related attitudes.

5.
Artículo en Inglés | MEDLINE | ID: mdl-32218265

RESUMEN

Many mass media campaigns aimed at changing young people's health behavior air on digital platforms rather than on broadcast media (e.g., television), given the intended audience's preference for web-based communication. While research suggests self-reported ad recall correlates with exposure to television advertising, it remains unclear whether self-report measures are correlated with exposure to digital advertising. This study examined the association between an objective measure of digital ad exposure and self-reported recall of digital ads from the truth® tobacco prevention campaign. Digital ad tracking methodology was employed to identify members of an online panel (ages 18-34) who had been exposed to ads during their regular web browsing. Demographics of exposed participants were used to develop a matched control group of non-exposed panel members. Members of the Exposed group (n = 458) and matched Control participants (n = 506) were surveyed on recall of truth ads, media use, and demographics. Results indicated that Exposed participants had significantly higher odds of reporting ad recall compared to Control participants. With each additional ad exposure, the odds of self-reporting higher frequency of ad exposure increased by 8% (OR = 1.08, 95% CI = 1.01-1.16). Findings suggest self-reported measures of ad recall are a valid measure of campaign exposure in a digital media environment.

6.
J Health Commun ; 25(3): 223-231, 2020 Mar 03.
Artículo en Inglés | MEDLINE | ID: mdl-32129727

RESUMEN

Mass media campaigns are one of the most effective population-level interventions for the prevention of tobacco use. However, accurately evaluating the effectiveness of these campaigns presents several challenges, particularly as campaign delivery becomes increasingly fractured across media platforms. There are a number of weaknesses associated with traditional, individual-level measures of campaign exposure in an increasingly socially networked, digital media ecosystem. This study evaluated the national truth® campaign using a novel method to measure campaign exposure through an aggregate weekly exogenous measure of awareness. We generated this exogenous measure from a continuous, cross-sectional tracking survey to predict intentions to smoke and current tobacco use among youth in the United States. Results from multi-level models indicated that weeks with aggregate campaign awareness greater than 65% were associated with lower odds of current tobacco use. We conclude with a discussion of implications and practical considerations for using this method for media campaign evaluation.

7.
JAMA Pediatr ; 2020 Jan 21.
Artículo en Inglés | MEDLINE | ID: mdl-31961395

RESUMEN

Importance: The increasing use rates of electronic cigarettes (e-cigarettes) among young people in the United States have been largely associated with the emergence of high-nicotine-delivery device JUUL. Relevant data are needed to monitor e-cigarette, specifically JUUL, use to help inform intervention efforts. Objective: To estimate the prevalence, patterns, and factors associated over time with e-cigarette use among adolescents and younger adults in the United States. Design, Setting, and Participants: Two nationally representative longitudinal samples of adolescents and younger adults aged 15 to 34 years were drawn from the Truth Longitudinal Cohort, a national, probability-based cohort. Participants in this cohort were recruited through address-based sampling, and subsamples were recruited from a probability-based online panel. The present cohort study used data from follow-up online surveys, specifically, wave 7 (N = 14 379; collected from February 15, 2018, to May 25, 2018) and wave 8 (N = 12 114; collected from February 10, 2019, to May 17, 2019). Respondents reported their use of e-cigarettes, JUUL, and combustible tobacco products as well as their harm perceptions, household smoking status, sensation-seeking, friends' e-cigarette use, and demographic information. Main Outcomes and Measures: The main outcomes were ever and current (past 30 days) JUUL use. χ2 Analyses assessed differences in JUUL use by psychosocial and demographic characteristics. Logistic regression models identified the significant factors associated with wave 8 ever and current JUUL use among wave 7 e-cigarette-naive participants. Results: A total of 14 379 participants (mean [SD] age, 24.3 [0.09] years; 8142 female [51.0%]) were included in wave 7 and 12 114 (mean [SD] age, 24.5 [0.10] years; 6835 female [50.1%]) in wave 8. JUUL use statistically significantly increased from wave 7 to wave 8 among ever users (6.0% [n = 1105] to 13.5% [2111]; P < .001) and current users (3.3% [680] to 6.1% [993]; P < .001). JUUL use increased among every age group and was highest among those aged 18 to 20 years (23.9% [491] ever users and 12.8% [340] current users) and 21 to 24 years (18.1% [360] ever users and 8.2% [207] current users). Users reported a higher prevalence of frequent use in wave 8 compared with wave 7 (37.6% vs 26.1%; P < .01). Significant factors associated with future JUUL use among e-cigarette-naive participants included younger age, combustible tobacco use, lower harm perceptions, sensation seeking, and friends' e-cigarette use. Conclusions and Relevance: This study found that the e-cigarette device JUUL appears to be associated with the youth e-cigarette epidemic, attracting new users and facilitating frequent use with their highly addictive nicotine content and appealing flavors. Findings of this study underscore the critical need for increased e-cigarette product regulation at the federal, state, and local levels.

8.
Nicotine Tob Res ; 22(5): 647-654, 2020 Apr 21.
Artículo en Inglés | MEDLINE | ID: mdl-30820566

RESUMEN

INTRODUCTION: The objective of this study was to describe tobacco and nicotine product use state transition probabilities among youth and young adults over time. METHODS: A national sample of young adult tobacco product users and nonusers between the ages of 18 and 34 years at baseline was surveyed at 6-month intervals for 3 years. Use and nonuse states were defined as mutually exclusive categories based on self-reported, past 30-day use of the various products. Never use, noncurrent use, and current use of combustible, noncombustible tobacco, and electronic cigarette (e-cigarette) products was assessed at each interval. A multistate model was fit to estimate transition probabilities between states and length of stay within each state. RESULTS: After 6 months, same-state transition probabilities were high for all use states (0.76-0.96), except for dual product use (0.48). After 3 years, transition probabilities were smaller and tended to converge toward combustible product use for baseline e-cigarette (0.42), combustible (0.51), and dual product users (0.52). Age was inversely associated with transition risk from never or noncurrent use to use of combustible or e-cigarette products. CONCLUSIONS: Never and noncurrent users, followed by combustible product users, were most likely to remain in those states throughout the 3-year observation interval. Users of any tobacco or e-cigarette product at baseline were most likely to transition to combustible product use or noncurrent use by the final follow-up. IMPLICATIONS: This study describes the probability of transitioning between various states of tobacco product use, including never and no current use, over a span of 3 years in a sample of young adults. This type of longitudinal description, which includes all tobacco product use states, is lacking in most studies that tend to focus on one or only a few products. The results suggest that it is important to assess outcomes over a sufficiently long period to capture true variability in patterns of product use.

9.
Drug Alcohol Depend ; 205: 107645, 2019 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-31704376

RESUMEN

INTRODUCTION: Evidence suggests that reducing the nicotine concentration in cigarettes to sub-addictive levels would reduce use. Until a low-nicotine cigarette policy is enacted, population-level effects are unknown. This study examines the behavioral intentions of current U.S. cigarette smokers if a low-nicotine policy were implemented. METHODS: Data were drawn from a nationally representative probability-based panel and opt-in panel. Weighted logistic regressions examined likelihood to (1) smoke lower nicotine cigarettes, (2) quit using tobacco, (3) use e-cigarettes, (4) illegally buy high-nicotine cigarettes, and (5) smoke cigars, cigarillos, or little cigars (CLCCs) among smokers, controlling for demographics, tobacco products used, dependence, and intentions to quit cigarettes. Latent class analyses (LCA) characterized patterns of behavioral intentions. RESULTS: If a low-nicotine policy were implemented, most participants indicated a likelihood to smoke low-nicotine cigarettes (78.4%) or quit tobacco (61.9%), followed by use e-cigarettes (46.5%). Individuals with greater dependence had greater odds of intending to smoke low-nicotine cigarettes, use e-cigarettes, and illegally buy high-nicotine cigarettes. Current e-cigarette or CLCCs users had higher odds of intending to use these products. LCA revealed that individuals would 1) use low-nicotine cigarettes with low intentions to use other tobacco products or 2) use multiple tobacco products, including low-nicotine cigarettes. CONCLUSIONS: A reduced nicotine standard for all combustible tobacco products is needed given that many tobacco users would likely intend to continue to use tobacco products. Differences in intentions by tobacco use and demographic characteristics indicate a need for additional cessation support and education around the harms of continued use of combustible tobacco.

10.
Artículo en Inglés | MEDLINE | ID: mdl-31698724

RESUMEN

Mass media campaigns have been hailed as some of the most effective tobacco prevention interventions. This study examined the cost-effectiveness of the national tobacco prevention campaign, truth® FinishIt, to determine the cost per quality-adjusted life year (QALY) saved and the return on investment (ROI). The cost-utility analysis used four main parameters: program costs, number of smoking careers averted, treatment costs, and number of QALYs saved whenever a smoking career is averted. Parameters were varied to characterize cost-effectiveness under different assumptions (base case, conservative, optimistic, and most optimistic). The ROI estimate compared campaign expenditures to the cost saved due to the campaign implementation. Analyses were conducted in 2019. The base case analysis indicated the campaign results in a societal cost savings of $3.072 billion. Under the most conservative assumptions, estimates indicated the campaign was highly cost-effective at $1076 per QALY saved. The overall ROI estimate was $174 ($144 in costs to smokers, $24 in costs to the smoker's family, and $7 in costs to society) in cost savings for every $1 spent on the campaign. In all analyses, the FinishIt campaign was found to reach or exceed the threshold levels of cost savings or cost-effectiveness, with a positive ROI. These findings point to the value of this important investment in the health of the younger generation.


Asunto(s)
Análisis Costo-Beneficio , Medios de Comunicación de Masas , Uso de Tabaco/prevención & control , Adolescente , Femenino , Humanos , Masculino , Años de Vida Ajustados por Calidad de Vida , Prevención del Hábito de Fumar , Adulto Joven
11.
Prev Med ; 129: 105845, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31518628

RESUMEN

Young adults have the highest prevalence of misuse of prescription opioids. In 2016, 7.1% of 18- to 25-year-olds reported misuse, meaning use other than as prescribed. While smoking is known to be associated with opioid use, to our knowledge no study has examined the relationships between smoking, prescribed use of opioids, and opioid misuse in young adults at the population level. Online survey data were collected in spring 2018 from a nationally representative sample of 18-25-year-olds from the Truth Longitudinal Cohort (N = 10,502). Respondents self-reported cigarette smoking, and both lifetime and recent (past 6-month) prescribed use and misuse of opioids. Generalized ordered logistic regression modeling was used to determine associations between cigarette smoking and recent prescribed use and misuse while controlling for demographic characteristics, other substance use, sensation seeking, and mental health status. Overall, 61.0% of respondents reported lifetime prescribed use of opioids and 16% reported recent prescribed use. Lifetime misuse was reported by 19.4%, with 7.8% reporting recent misuse. Together, the models revealed a graded relationship, with current smokers having higher odds of both prescribed use and misuse, never smokers having lowest odds of use or misuse, and ever smokers, those who had smoked but not in the past 30 days, falling between current and never smokers. Findings indicate a clear association between smoking and use of opioids even after accounting for a strong association between prescribed use and misuse among young adults.

12.
Am J Prev Med ; 57(5): 695-699, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31420121

RESUMEN

INTRODUCTION: The purpose of this study is to examine awareness, attitudes, and related knowledge of e-cigarettes, and JUUL specifically, among parents of middle and high school students. METHODS: Data were collected in October-November 2018 from a nationally representative sample of U.S. parents of middle and high school students aged 11-18 years (n=2,885) to examine e-cigarette and JUUL awareness, concern about e-cigarette use, and school communication regarding e-cigarettes. Weighted frequencies and percentages are reported; Rao-Scott chi-square tests examined differences by school level. Data were analyzed in 2019. RESULTS: Although most parents (96.2%) had seen or heard of e-cigarettes, only 55.9% had seen or heard of JUUL, and only 44.2% accurately identified an image of JUUL as a vaping device. Many parents reported concern about adolescent e-cigarette use (60.6%), but fewer reported concern about their own child's use (32.9%). Most parents (73.5%) reported receiving no communication from their child's school about e-cigarettes or JUUL. CONCLUSIONS: There are notable gaps in parents' awareness of JUUL. School-to-parent communication efforts are necessary to build parents' knowledge of e-cigarettes like JUUL to prevent the growing youth uptake of these novel and addictive products.

13.
Drug Alcohol Depend ; 203: 1-7, 2019 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-31386973

RESUMEN

INTRODUCTION: Considerable declines in cigarette smoking have occurred in the U.S. over the past half century. Yet emerging tobacco products, including e-cigarettes, have increased in popularity among U.S. youth and adults in recent years. Nicotine content is an important factor in weighing the potential benefits and risks of e-cigarettes on individual and population level health. This study examined how nicotine concentrations of e-cigarette products sold have changed from 2013 to 2018. METHODS: E-cigarette sales data aggregated in 4-week periods from March 2, 2013 to September 8, 2018 (66 months total) from convenience store and mass market channels were obtained from Nielsen. Internet and vape shop sales were not available. Internet searches were used to supplement information for nicotine concentration and flavor. Products were categorized by nicotine concentration, flavor, type (disposable or rechargeable), and brand. Dollar sales, unit sales, and average nicotine concentration were assessed. RESULTS: During 2013-2018, the average nicotine concentration in e-cigarettes sold increased overall, for all flavor categories, and for rechargeable e-cigarettes. The proportion of total dollar sales comprised of higher nicotine concentration e-cigarettes (>4% mg/mL) increased from 12.3% to 74.7% during 2013-2018, with a similar increase in unit share. Zero-nicotine products accounted for less than 1% of dollar market share across all years analyzed. CONCLUSIONS: E-cigarettes with higher nicotine concentrations comprise a substantial and increasing portion of U.S. e-cigarette sales. Higher nicotine concentrations may influence patterns of e-cigarette use, including harms from e-cigarette initiation among youth and potential health benefits for adult smokers switching completely to e-cigarettes.


Asunto(s)
Comercio/estadística & datos numéricos , Sistemas Electrónicos de Liberación de Nicotina/economía , Nicotina/análisis , Aromatizantes , Humanos , Productos de Tabaco/análisis , Productos de Tabaco/economía , Estados Unidos
14.
Am J Health Promot ; 33(8): 1152-1158, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31337224

RESUMEN

PURPOSE: Examine association between emotional valence and intensity prompted by anti-tobacco advertising messages and perceived ad effectiveness among youth/young adults. DESIGN: Online forced-exposure survey data from a nationally weighted, cross-sectional sample of youth/young adults, collected periodically over a 4-year period. SETTING: National. PARTICIPANTS: Thirty-seven cross-sectional surveys conducted online from June 2015 to January 2018; total N = 9534. All participants, aged 15 to 21, were in the intervention; no control group. INTERVENTION: Individuals participating in premarket testing of truth ads were forced exposed to one of 37 anti-tobacco ads. MEASURES: Emotional response, emotional intensity, and perceived ad effectiveness. Emotional response has been previously studied and measured. Including the discrete measure of "concerned" in positive emotions is unique to our study. It patterned with the other positive emotions when each ad was examined by each emotion. Intensity as measured in this study through the 5-point scale ("how much does this ad make you feel") is unique in the anti-tobacco ad literature. Although several past studies ranked the degree of emotion elicited by ads, they have not incorporated the intensity of emotion as reported by the participant themselves. The scale was used to determine whether perceived ad effectiveness is similar to those used in previous studies. ANALYSIS: Linear regressions were estimated to assess type of emotional sentiment and level of intensity in relation to perceived effectiveness of the message. RESULTS: All 9534 participants were exposed; no control group. The ßs indicate how strongly the emotion variable influences the study outcome of perceived ad effectiveness. Positive emotions (ß = .76) were more highly associated with perceived ad effectiveness (ß = .06). Higher intensity with positive emotional sentiment and high-intensity negative produced the highest scores for perceived ad effectiveness (ß = .30). CONCLUSION: Eliciting a positive, high-impact emotional response from viewers can help improve perceived effectiveness, and in turn, overall ad effectiveness.

15.
Am J Health Behav ; 43(2): 361-372, 2019 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-30808475

RESUMEN

Objectives: In this study, we investigated perceptions of prescription opioid misuse among young adults who had or had not been prescribed opioids in the past. Methods: Participants from a national online panel, age 18-34 (N = 1220), completed a survey about their medical use of opioids and their perceptions of the risks and prevalence of opioid misuse and dependence. Associations between prescription history and perceptions of opioids were tested using generalized ordered logistic models. Results:Most respondents reported receiving at least one prescription for opioids in their lifetime (68%), with 57% reporting past-year prescriptions. Re spondents with more lifetime prescriptions perceived higher rates of misuse and dependence. More lifetime prescriptions were associated with lower perceived risk of occasional prescription opioid misuse but higher perceived risk for regular misuse. Conclusions: Prior experience with receiving a prescription for opioid pain relievers is associated with young adults' perceptions of opioid misuse. Taking prescription opioids, even as directed, provides young adults with expo- sure to the drugs that may shape these perceptions both by increasing awareness of the drug and through exposure to misuse of the drug.


Asunto(s)
Analgésicos Opioides/uso terapéutico , Prescripciones de Medicamentos/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Mal Uso de Medicamentos de Venta con Receta/estadística & datos numéricos , Adolescente , Adulto , Femenino , Humanos , Masculino , Prevalencia , Adulto Joven
16.
Tob Control ; 28(6): 603-609, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-30377241

RESUMEN

OBJECTIVE: To estimate the prevalence of JUUL use and identify demographic and psychosocial correlates of use among youth and young adults in the USA. METHODS: A national, probability-based sample was recruited via address-based sampling, with subsamples recruited from an existing probability-based online panel. Participants (N=14 379) ages 15-34 were surveyed about JUUL use, tobacco use, electronic nicotine delivery system (ENDS) harm perceptions, sensation seeking and demographic characteristics. Data were collected February-May 2018. Χ2 analyses assessed differences in JUUL use by demographic and psychosocial characteristics. Logistic regressions identified significant correlates of ever and current JUUL use. RESULTS: Overall, 6.0% reported ever JUUL use, and 3.3% reported past 30-day (ie, current) use. Rates were higher among participants aged 15-17 and 18-21 years, with 9.5% and 11.2% reporting ever use, and 6.1% and 7.7% reporting current use, respectively. Among current users aged 15-17 years, 55.8% reported use on 3 or more days in the past month, and over a quarter reported use on 10-30 days. Significant correlates of use included younger age, white race, greater financial comfort, perceptions of ENDS as less harmful than cigarettes, household ENDS use, high sensation seeking and current combustible tobacco use. CONCLUSION: JUUL use was significantly higher among young people, with those under 21 having significantly higher odds of ever and current use. Frequency of use patterns suggest youth may not be experimenting with the device but using it regularly. Given the high nicotine content of JUUL, there is concern over the potential for addiction and other serious health consequences among young people. Findings suggest strong regulatory actions are needed to prevent youth and young adult uptake.

17.
Tob Induc Dis ; 15: 22, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28396620

RESUMEN

BACKGROUND: Awareness and use of electronic cigarettes has rapidly increased among U.S. adults. The aim of this study was to examine awareness and likeability of e-cigarette print advertisements in a national sample of young adults and to examine ad likeability as a correlate of intended e-cigarette use among never e-cigarette users. METHODS: Participants (n = 2110, unweighted) of the Truth Initiative Young Adult Cohort (January 2013) were randomized to see four print ads (blu, Fin, NJOY, and White Cloud). Bivariate analyses provided descriptive characteristics of all participants and multivariable logistic regression examined the relationships between the average likeability score (across all four ads), curiosity about e-cigarettes, and susceptibility to using e-cigarettes among respondents who had never used e-cigarettes. RESULTS: Nearly 20% of participants reported awareness of the blu ad. Of the four e-cigarette ads, likeability was highest for the NJOY ad. Participants with higher ad likeability ratings had more than twice the odds of being curious to try an e-cigarette (AOR 2.33; 95% CI 1.84-2.95), try an e-cigarette soon (AOR 2.93; 95% CI 1.96-4.38), and try an e-cigarette if offered by best friend (AOR 2.48; 95% CI 1.95-3.15), after adjusting for other covariates. Current cigarette use was the strongest correlate of susceptibility to using an e-cigarette (p < .01) in the multivariable models. CONCLUSIONS: Higher ad likeability was correlated with greater susceptibility to try an e-cigarette among U.S. young adults. Future studies are needed to monitor how awareness and likeability of e-cigarette advertising influence patterns of e-cigarette and other tobacco use in young people.

18.
Addict Behav ; 70: 83-89, 2017 07.
Artículo en Inglés | MEDLINE | ID: mdl-28214741

RESUMEN

The phenomenon of "social smoking" emerged in the past decade as an important area of research, largely due to its high prevalence in young adults. The purpose of this study was to identify classes of young adult ever smokers based on measures of social and contextual influences on tobacco use. Latent class models were developed using social smoking measures, and not the frequency or quantity of tobacco use. Data come from a national sample of young adult ever smokers aged 18-24 (Truth Initiative Young Adult Cohort Study, N=1564). The optimal models identified three latent classes: Class 1 - nonsmokers (52%); Class 2 - social smokers (18%); and Class 3 - smokers (30%). Nearly 60% of the "social smoker" class self-identified as a social smoker, 30% as an ex-smoker/tried smoking, and 12% as a non-smoker. The "social smoker" class was most likely to report using tobacco mainly or only with others. Past 30-day cigarette use was highest in the "smoker" class. Hookah use was highest in the "social smoker" class. Other tobacco and e-cigarette use was similar in the "social smoker" and "smoker" classes. Past 30-day tobacco and e-cigarette use was present for all products in the "non-smoker" class. Young adult social smokers emerge empirically as a sizable, distinct class from other smokers, even without accounting for tobacco use frequency or intensity. The prevalence of hookah use in "social smokers" indicates a group for which the social aspect of tobacco use could drive experimentation and progression to regular use.


Asunto(s)
Fumar/epidemiología , Conducta Social , Adolescente , Adulto , Femenino , Humanos , Masculino , Estados Unidos/epidemiología , Adulto Joven
19.
J Public Health Manag Pract ; 23(5): 487-495, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-27798530

RESUMEN

PURPOSE: Young adulthood is an important period for preventing the establishment of negative health behaviors that can influence trajectories to chronic disease and early death. Given the evolving nature of educational attainment and income variation during this developmental period, identifying indicators of socioeconomic status (SES) remains a challenge. This study examines measures of subjective and objective indicators of SES to predict health risk for young adults. METHODS: This study uses data from the Truth Initiative Young Adult Cohort Study from respondents aged 18 to 34 years who completed 3 consecutive surveys between June 2011 and August 2012 (n = 2182). Analyses were conducted to compare a measure of subjective financial situation (SFS) to commonly used SES measures for adults and adolescents. Age-stratified, multivariable logistic regression was used to model the relationship between 5 SES indicators (SFS, household income, respondent education, parental education, and subjective childhood financial situation) and dichotomized versions of 3 health status measures (body mass index, self-reported health status, and quality of life), controlling for gender, race/ethnicity, and region. RESULTS: Findings indicate that SFS is associated with other commonly used SES measures. Prospective associations with health outcomes revealed that SFS is a stronger predictor of health outcomes among young adults aged 18 to 24 years as compared with other SES measures. CONCLUSION: This study provides evidence that subjective financial situation may be more robust than traditional SES indicators in predicting health outcomes among young adults, particularly for 18- to 24-year-olds, and should be considered a viable candidate measure for assessing SES among this age group.

20.
JMIR Res Protoc ; 5(3): e142, 2016 Jul 11.
Artículo en Inglés | MEDLINE | ID: mdl-27401019

RESUMEN

BACKGROUND: There is little research on how young adults or young adult subgroups utilize and engage with Web-based cessation interventions when trying to quit smoking. Addressing this knowledge gap is important to identify opportunities to optimize the effectiveness of online cessation programs across diverse young adult users. OBJECTIVE: This study examines utilization of the BecomeAnEX.org smoking cessation website among young adults and young adult subgroups compared with older adults to identify patterns of use by age, gender, and race/ethnicity. METHODS: Study participants were 5983 new registered users on a free smoking cessation website who were aged 18 to 70 years. Website utilization was tracked for 6 months; metrics of use included website visits, pages per visit, length of visit, and interaction with specific website features. Differences in website use by age were examined via bivariate analyses and multivariate logistic regression adjusted for age, gender, and race/ethnicity. Interactions were examined to determine differences by gender and race/ethnicity within young (18- to 24-year-olds and 25- to 34-year-olds) and older (35 years and older) adult segments. RESULTS: A greater percentage of young adults aged 18 to 34 years visited the site only once compared with older adults aged 35 years and older (72.05% vs 56.59%, respectively; P<.001). Young adults also spent less time on the site and viewed fewer pages than older adults. In adjusted analyses, young adults were significantly less likely than older adults to visit the site more than once (18-24 years: adjusted odds ratio [AOR] 0.58, 95% CI 0.49-0.68, P<.001; 25-34 years: AOR 0.56, 95% CI 0.50-0.64, P<.001), spend more than 3 minutes on the site (18-24 years: AOR 0.67, 95% CI 0.57-0.79, P<.001; 25-34 years: AOR 0.56, 95% CI 0.49-0.64, P<.001), view 12 or more pages (18-24 years: AOR 0.72, 95% CI 0.61-0.83; P<.001; 25-34 years: AOR 0.67, 95% CI 0.59-0.76, P<.001), utilize the BecomeAnEX.org community (18-24 years: AOR 0.61, 95% CI 0.48-0.79, P<.001; 25-34 years: AOR 0.73, 95% CI 0.60-0.88, P<.001), or utilize Separation Exercises (18-24 years: AOR 0.68, 95% CI 0.51-0.89, P<.01; 25-34 years: AOR 0.77, 95% CI 0.63-0.94, P<.01). Gender differences in utilization were more pronounced among young adults compared with older adults, with lower levels of utilization among young men than young women. For all age groups, utilization was higher among whites and African Americans than among Hispanics and other racial minorities, with one exception-BecomeAnEX.org community utilization was significantly higher among Hispanic young adults compared with white and African American young adults. CONCLUSIONS: Results point to important areas of inquiry for future research and development efforts. Research should focus on enhancing demand and increasing engagement among younger adults and men, examining strategies for capitalizing on young adult developmental needs, and increasing utilization of effective site features among diverse young adult users.

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