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1.
Drug Alcohol Depend ; 214: 108164, 2020 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-32652375

RESUMEN

BACKGROUND: The prevalence of cigarette smoking is more than two times higher among individuals with versus without opioid misuse and/or opioid use disorders (OUD). Overall, smoking cessation has increased over time although it is unknown whether it has similarly increased for those with opioid misuse or OUD. The current study examined cigarette quit ratios from 2002 to 2018 among US individuals with and without opioid misuse or OUD. METHODS: Data came from the National Survey on Drug Use and Health, a yearly cross-sectional survey of US civilians 12 years or older. Annual quit ratios (i.e., proportion of former smokers among lifetime-smokers) were estimated from 2002 to 2018. Logistic regression tested time trends in quit ratios by opioid misuse/OUD. RESULTS: Past-month smoking prevalence was much higher for persons with versus without opioid misuse (64.6 % versus 25.7 %) and OUD (73.3 % versus 26.0 %). In 2018, quit ratios for individuals with opioid misuse (18.0 %) or OUD (10.0 %) were less than half of those without opioid misuse (48.3 %) or OUD (48.1 %). After adjusting for background characteristics, the quit ratio did not change over time among individuals with opioid misuse or OUD in contrast to an increase in quit ratios for those without opioid misuse or OUD. For those without opioid misuse or OUD, males had higher quit ratios than females. CONCLUSIONS: Cigarette quit ratios remain dramatically lower among those with opioid misuse or OUD. Public health and clinical attention are needed to increase cessation and reduce smoking consequences for individuals with opioid misuse and OUD.

2.
Addict Behav ; 110: 106486, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32688226

RESUMEN

INTRODUCTION: Population studies highlight that alcohol and marijuana use are correlated with cigarette smoking and other tobacco use. The aim of our study was to describe the ways in which alcohol and drug use may affect cigarette smoking and cessation in socioeconomically-disadvantaged young adult (SDYA) smokers. METHODS: Thirty-six SDYA smokers aged 18-29 participated in eight focus groups and two individual interviews in Burlington, Vermont in 2018. Structured focus groups addressed poly-tobacco use, other substance use and co-use with tobacco, and the contexts and facilitators that cue SDYA smoking. Participants were also asked their reasons for smoking, barriers to cessation, and messages or modalities that would make smoking cessation more novel or relevant. Three coders implemented the Framework Method to systematically code focus group transcripts. RESULTS: In this sample of SDYA smokers, four key themes emerged around the relationships between alcohol and drug use and smoking: 1) frequent co-use of tobacco and other substances, 2) changes in frequency of smoking when using other substances, including chain smoking when drinking and substituting cigarettes with marijuana, 3) cigarettes as a last remaining addiction for those in recovery from other substance use and, 4) fears that quitting smoking would cause relapse to other substances. DISCUSSION: Co-use of other substances emerged as a reason for smoking and a barrier to quitting, including a concern that quitting smoking would trigger drug or alcohol relapse. Findings support demand for interventions that address substance co-use to improve smoking cessation in SDYA smokers.

3.
J Med Internet Res ; 22(7): e18446, 2020 Jul 20.
Artículo en Inglés | MEDLINE | ID: mdl-32706681

RESUMEN

BACKGROUND: The standard approach for evaluating the effects of population-level substance use prevention efforts on youth and young adult perceptions and behaviors has been to compare outcomes across states using national surveillance data. Novel surveillance methods that follow individuals over shorter time intervals and capture awareness of substance use prevention policy and communication efforts may provide a stronger basis for their evaluation than annual cross-sectional studies. OBJECTIVE: This study aimed to identify a combination of strategies to recruit a sample of youth and young adults sufficiently representative of the Vermont population and determine how best to retain a web-based panel of youth and young adults over a 6-month period. METHODS: Eligible participants were Vermont residents aged 12 to 25 years who were willing to complete three 10 to 15-minute web-based surveys over a 6-month period. Recruitment was conducted via the following three main mechanisms: (1) web-based recruitment (paid and unpaid), (2) community-based recruitment through partners, and (3) participant referrals via a personalized link. Upon completion of the baseline survey, participants were randomly assigned to one of the following three retention incentive conditions: (1) guaranteed incentive (US $10), (2) lottery incentive (US $50 weekly lottery drawing), and (3) preferred method (guaranteed or lottery). Analyses examined cost per survey start by recruitment source, distribution of demographic characteristics across incentive conditions, and retention by study condition at 3-month and 6-month follow-ups. RESULTS: Over a 10-week period in 2019, we recruited 480 eligible youth (aged 12-17 years) and 1037 eligible young adults (aged 18-25 years) to the Policy and Communication Evaluation (PACE) Vermont Study. Facebook and Instagram advertising produced the greatest number of survey starts (n=2013), followed by posts to a state-wide web-based neighborhood forum (n=822) and Google advertisements (n=749). Retention was 78.11% (1185/1517) at 3 months and 72.18% (1095/1517) at 6 months. Retention was equivalent across all incentive study conditions at both waves, despite a strong stated preference among study participants for the guaranteed payment at baseline. Youth had greater retention than young adults at both waves (wave 2: 395/480, 82.3% vs 790/1037, 76.18%; wave 3: 366/480, 76.3% vs 729/1037, 70.30%). Substance use prevalence in this cohort was similar to national and state-level surveillance estimates for young adults, but was lower than state-level surveillance estimates for youth. Most participants retained at wave 3 provided positive qualitative feedback on their experience. CONCLUSIONS: Our study supports the feasibility of recruiting a web-based cohort of youth and young adults with representation across an entire state to evaluate substance use prevention efforts. Findings suggest that a guaranteed payment immediately upon survey completion coupled with a bonus for completing all survey waves and weekly survey reminders may facilitate retention in a cohort of youth and young adults.

4.
Prev Med ; : 106189, 2020 Jul 03.
Artículo en Inglés | MEDLINE | ID: mdl-32628945

RESUMEN

We examined whether elucidating underpinning smoking motivation and related pharmacological processes enhances understanding of nicotine dependence among smokers from vulnerable populations. Data were obtained between Oct, 2016 and Sept, 2019 from 745 adult smokers with co-morbid psychiatric conditions or socioeconomic disadvantage at University of Vermont, Brown University, Johns Hopkins University. Smoking motivation was assessed using the Cigarette Purchase Task (CPT), a behavioral-economic task that models the relative reinforcing value of smoking under varying monetary constraint. Dependence severity was measured using the Heaviness of Smoking Index (HSI), Fagerström Test for Nicotine Dependence total scores (FTND), and FTND total scores minus items 1 and 4 (FTND2,3,5,6). We also assessed associations between dependence severity and smoking motivation with nicotine levels and metabolism rate. Principal Component Analysis was used to examine the latent structure of the conventional five CPT indices; bivariate and multivariable modeling was used to test associations. Factor analysis resulted in a two-factor solution, Amplitude (demand unconstrained by price) and Persistence (price sensitivity). CPT latent factors were associated with each dependence-severity measure (ps ≤ 0.0001), with associations stronger for Amplitude than Persistence across each, especially HSI which was exclusively associated with Amplitude. Amplitude and each dependence measure were associated with nicotine intake (ps ≤ 0.0002); Persistence was not (p = .19). Demand Amplitude more than Persistence appears key to understanding individual differences in dependence severity. Regarding potential application, the results suggest a need for interventions that more effectively target demand Amplitude to make greater headway in reducing smoking in vulnerable populations. Trial Registration:clinicaltrials.gov identifiers: NCT02232737, NCT02250664, NCT02250534.

5.
Am J Prev Med ; 59(1): 123-136, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32418800

RESUMEN

CONTEXT: Recent data suggest that the onset of cigarette smoking is now more likely during young adulthood than adolescence. Additionally, the landscape of delivering smoking-cessation interventions has changed in the past decade, with the emergence of mobile phone and web-based approaches. The objective of this study is to update a 2010 systematic review of smoking-cessation interventions for U.S. young adults (aged 18-24 years). EVIDENCE ACQUISITION: Electronic searches were conducted in CINAHL, the Cochrane Library, Embase, PsycINFO, PubMed, Scopus, and Sociological Abstracts to identify eligible interventions from August 31, 2009 through July 17, 2019. Two independent coders critically evaluated the methodology and findings of all retrieved articles. Data analysis was conducted in 2019. EVIDENCE SYNTHESIS: A total of 17 RCTs and 1 nonrandomized study were added to the original 14 studies meeting the inclusion criteria for this review; these studies varied with respect to sample size, intervention, assessed outcomes, and smoking measures. Of the new studies, 3 increased cessation in the short term, 2 at 6 months, and 1 had short-term effects on cigarette reduction. Pooled analyses supported the use of interventions employing social cognitive theory, quitline counseling, and text message programs for short-term cessation in young adults. CONCLUSIONS: Of 32 included studies, 9 demonstrated efficacy of smoking cessation or reduction in U.S. young adults. There were no eligible pharmacologic interventions included in this review. Findings support the promise of 3 approaches for young adult cessation not included in the prior review: text message interventions, sustained quit-and-win contests, and multiple behavior interventions.

7.
Artículo en Inglés | MEDLINE | ID: mdl-32027158

RESUMEN

Individuals with opioid use disorder (OUD) have high prevalence of smoking and poor cessation outcomes. Data suggest that smokers with OUD may experience heightened nicotine reinforcement and more severe tobacco withdrawal compared to smokers without OUD. The Food and Drug Administration is currently considering reducing the nicotine content of cigarettes to reduce smoking prevalence and smoking-related disease. It is critical to understand the effects of reduced nicotine content cigarettes (RNCCs) on tobacco withdrawal in this subgroup. In this secondary analysis, we investigated the ability of RNCCs to attenuate acute tobacco withdrawal and craving severity in smokers with OUD versus those without substance use disorders (SUDs). Smokers maintained on methadone or buprenorphine (opioid-maintained [OM]; n = 65) versus without other SUDs (i.e., non-SUD; n = 135) completed 5 laboratory sessions wherein they smoked their usual brand (UB) or a research cigarette varying in nicotine content (0.4, 2.4, 5.2, 15.8 mg/g of tobacco) under double-blind, acute abstinence conditions. Participants completed the Minnesota Tobacco Withdrawal Scale, including a desire to smoke (craving) item, before and every 15 min for 1 hr following smoking each cigarette. Tobacco withdrawal and craving did not differ significantly by OM status in response to UB or RNCCs. In addition to the Dose × Time interaction, greater depression and cigarette dependence consistently predicted withdrawal and craving (ps < .05). Across all cigarettes, tobacco withdrawal and craving did not significantly differ by OM status, suggesting that smokers receiving opioid agonist treatment may respond favorably to RNCCs. Additional studies with larger and more diverse samples are needed to address this question more definitively. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

10.
Nicotine Tob Res ; 22(5): 848-852, 2020 Apr 21.
Artículo en Inglés | MEDLINE | ID: mdl-30339211

RESUMEN

INTRODUCTION: A diverse class of products, "e-cigarettes" present surveillance and regulatory challenges because of nonstandard terminology used to describe subtypes, especially among young adults, where occasional e-cig use is most prevalent. METHODS: Young adults (n = 3364) in wave 9 (Spring 2016) of the Truth Initiative Young Adult Cohort were randomized to see two of five photos of common e-cig products (three varieties of first-generation e-cigs and one variety each of second- and third-generation e-cigs). Qualitative responses were coded into nine classifications: "e-cigarette, e-hookah, vape-related, mod, other or more than one kind of e-cig, marijuana-related, non-e-cig tobacco product, misidentified, and don't know." We characterized the sample and survey responses and conducted multivariable logistic regression to identify participant characteristics associated with correctly identifying the devices as e-cigs. Data were weighted to represent the young adult population in the United States in 2016. RESULTS: The majority of participants identified the pictured devices as some type of e-cig (57.7%-83.6%). The white first-generation e-cig, as well as the second- and third-generation e-cigs caused the greatest confusion, with a large proportion of individuals responding "don't know" (12.2%-25.1%, depending on device) or misidentifying the e-cig as a non-nicotine product (3.4%-16.1%, depending on device) or non-e-cig tobacco product (1.4%-14.6%, depending on device). CONCLUSIONS: Accurate surveillance and analyses of the effect of e-cigs on health behavior and outcomes depend on accurate data collection on users' subtype of e-cig. Carefully chosen images in surveys may improve reporting of e-cig use in population studies. IMPLICATIONS: Survey researchers using images to cue respondents, especially young adult respondents, should consider avoiding use of white or colorful first-generation e-cigs, which were commonly misidentified in this research, in preference for black or dark colored first-generation e-cigs, such as the blu brand e-cig. Given the sizable proportion of respondents who classified second- and third-generation e-cigs with terminology related to vaping, surveys specifically aimed at assessing use of these types of e-cigs should include the term "vape" when describing this subclass of devices.

11.
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.

12.
Nicotine Tob Res ; 2019 Dec 02.
Artículo en Inglés | MEDLINE | ID: mdl-31789377

RESUMEN

The patterns of tobacco product use in the United States (U.S.) have changed during the past several decades. Currently, a large proportion of tobacco users report using multiple tobacco products (MTP). The prevalence of MTP use varies significantly by cigarette smoking frequency, as well: nearly half (46.9%) of all non-daily smokers report using other tobacco products within the past 30 days. Despite this, much of extant tobacco dependence treatment efforts, tobacco regulatory science research, and tobacco product research, in general, has focused largely on single product use (i.e., cigarette smoking). To effectively design interventions and model the potential impact of regulations on tobacco products aimed at reducing tobacco use, as well as effectively study tobacco users, it is essential to consider actual use patterns in the population of tobacco users.

13.
Nicotine Tob Res ; 21(Suppl 1): S117-S124, 2019 12 23.
Artículo en Inglés | MEDLINE | ID: mdl-31867656

RESUMEN

INTRODUCTION: The Food and Drug Administration announced intent to reduce the nicotine content in cigarettes. There is limited evidence on how reduced nicotine content cigarette (RNC) marketing affects product beliefs and use, and research on this is needed to inform regulations. METHODS: In an online experiment, 426 young adult cigarette smokers (aged 18-30 years) were randomized in a 2 (implicit: red package vs. blue package) × 2 (explicit: corrective message vs. no corrective message) design to view an advertisement for previously commercially available RNCs. Outcomes were advertisement content recall, product beliefs, and use intentions. Participants' responses to open-ended assessment of their beliefs about the stimuli were coded to identify prevailing themes. RESULTS: Red packaging and corrective messaging were independently associated with greater advertisement content recall (p = .01 and p = .04, respectively). There were no significant main or interaction effects on product beliefs or use intentions. Controlling for condition, advertisement content recall was significantly associated with less favorable product beliefs (p < .001) and favorable product beliefs were associated with intent to use the product (p < .001). Open-ended responses converged on the finding that respondents were interested in RNCs, but expressed skepticism about effectiveness and value. CONCLUSIONS: Brief exposure to an RNC advertisement with red packaging and corrective messaging were each independently associated with greater advertisement content recall. The results indicate: (1) interest and confusion among young adult smokers regarding RNCs, (2) beliefs about RNCs are influenced by marketing, and (3) beliefs are associated with intention to use RNCs. IMPLICATIONS: Findings from this study demonstrate the importance of advertising effects on beliefs about RNC products and support the need to regulate advertising and labeling alongside product regulation. More detailed study of advertisement features that affect consumers' beliefs about RNCs and how they impact their processing of explicit messaging about product risks will be important to guide regulatory decision-making.


Asunto(s)
Mercadotecnía , Nicotina , Fumadores , Productos de Tabaco , Adolescente , Adulto , Humanos , Embalaje de Productos , Fumadores/psicología , Fumadores/estadística & datos numéricos , Cese del Hábito de Fumar , Adulto Joven
14.
Nicotine Tob Res ; 21(Suppl 1): S91-S100, 2019 12 23.
Artículo en Inglés | MEDLINE | ID: mdl-31867640

RESUMEN

BACKGROUND: Pervasive misperceptions about nicotine may influence uptake of quit smoking aids and the impact of policies addressing nicotine as a tobacco product constituent. METHODS: Latent class analyses were conducted using four items on nicotine beliefs asked of 4037 adults aged 18-40 in wave 9 (February-March 2016) of the Truth Initiative Young Adult Cohort Study. Confirmatory factor analyses identified three factors from 12 items: nicotine susceptibility (NSUS), nicotine severity (NSEV), and tobacco severity (TSEV). Analyses assessed correlations between latent classes, sociodemographics, and nicotine/tobacco factor scores. RESULTS: A four-class model of nicotine beliefs was the best fit, with the largest class believing that nicotine plays a major part in smoking risks (class 1, n = 2070; 52%). Class 2 shared that belief but also responded "Don't know" to addiction questions (class 2, n = 382; 11%). Fewer belonged in class 3, who reported that nicotine plays a small part in health risks (n = 1277; 30%), and class 4, who perceived nicotine as not cancer causing (n = 308; 7%). Latent class membership was correlated with sociodemographics, peer smoking, and past 30-day tobacco use. Classes 1 and 2 had similar NSUS scores and classes 3 and 4 had similar NSEV and TSEV scores. DISCUSSION: Differences in the perceptions of nicotine and tobacco-related harms can be partially explained by clustering of underlying nicotine beliefs. These classes of beliefs are correlated with sociodemographic predictors of smoking. These findings may help to identify specific beliefs or groups to be targeted by public education efforts on nicotine. IMPLICATIONS: The current study supports that underlying nicotine beliefs are associated with perceived harms of specific nicotine and tobacco products (relative to cigarettes), with greater false beliefs about nicotine correlated with greater perceived susceptibility to nicotine addiction. Two important inferences emerge from this study: first, that education to address nicotine beliefs may also reframe perceptions of the harms of nicotine and tobacco products; and second, that this type of education may differentially impact perceptions of the harms of nicotine products (e.g., nicotine replacement therapy and e-cigarettes) and tobacco products (e.g., cigars, smokeless, and hookah).


Asunto(s)
Nicotina , Fumadores , Cese del Hábito de Fumar/psicología , Adolescente , Adulto , Estudios de Cohortes , Conocimientos, Actitudes y Práctica en Salud , Humanos , Fumadores/psicología , Fumadores/estadística & datos numéricos , Adulto Joven
16.
Nicotine Tob Res ; 21(Suppl 1): S49-S55, 2019 12 23.
Artículo en Inglés | MEDLINE | ID: mdl-31867655

RESUMEN

INTRODUCTION: Young adults (aged 18-24 years) have a higher smoking prevalence than younger and older age groups and young adulthood is an important developmental period during which long-term behavior patterns like cigarette smoking are established. The aim of the current study was to examine how young adult smokers with additional vulnerabilities to smoking respond to reduced nicotine content cigarettes. METHODS: This is a secondary analysis of a double-blind, within-subject experiment conducted with 169 cigarette smokers recruited from populations with comorbid psychiatric conditions or socioeconomic disadvantage assessing acute effects of research cigarettes varying in nicotine content (0.4, 2.4, 5.2, 15.8 mg/g). Participants were dichotomized by chronological age (18-24 vs. ≥25 years). Across 14 laboratory sessions effects of nicotine content were examined on measures of relative reinforcing efficacy (Cigarette Purchase Task [CPT] and Concurrent Choice testing), subjective effects, craving/withdrawal, and smoking topography. Repeated measures analysis of variances were used to examine potential moderating effects of age. RESULTS: Young adults exhibited lower demand for reduced nicotine content cigarettes than older adults across three of five CPT indices (ps < .05). No differences by age were observed on other measures of reinforcing efficacy, subjective effects, craving/withdrawal, or smoking topography where effects generally decreased as an orderly function of decreasing nicotine content (ps <.05). CONCLUSION: Overall, these findings suggest that reducing the nicotine content of cigarettes would decrease the addiction potential of cigarette smoking in young adult smokers as much or perhaps more than older adult smokers from populations at increased vulnerability to smoking, addiction, and smoking-related health consequences. IMPLICATIONS: Reducing the nicotine content in cigarettes to lower addiction potential of smoking has been proposed as a means to improve overall population health. It is imperative to examine how young adults may respond to a nicotine reduction policy. We saw minimal evidence that age moderates acute response and where there was evidence it was in the direction of reduced nicotine content cigarettes having less addictive potential among young versus older adults (eg, steeper decreases in demand for very low nicotine content cigarettes among young versus older adults). Overall, a nicotine reduction policy has the potential to reduce smoking across age groups.


Asunto(s)
Nicotina , Fumadores/estadística & datos numéricos , Cese del Hábito de Fumar/métodos , Fumar/epidemiología , Adolescente , Adulto , Factores de Edad , Femenino , Humanos , Masculino , Trastornos Mentales/complicaciones , Trastornos Mentales/epidemiología , Pobreza/estadística & datos numéricos , Productos de Tabaco , Poblaciones Vulnerables/estadística & datos numéricos , Adulto Joven
17.
Drug Alcohol Depend ; 205: 107686, 2019 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-31706253

RESUMEN

BACKGROUND: Cigarette smoking is disproportionately high among adults with two or more psychiatric disorders (psychiatric comorbidities), yet research on non-cigarette tobacco use among this population is scant. Additionally, most studies on tobacco use this among this population rely on psychiatric diagnoses rather than individual symptoms, potentially excluding individuals with symptom-specific issues that increase their risk for tobacco use but do not meet the criteria for diagnosis. The objectives of this study were to identify unique classes of individuals based on symptoms of psychiatric disorders and to assess differences in demographic characteristics and tobacco use behaviors between classes. METHODS: This study used data from Wave 2 of the Population Assessment of Tobacco and Health Study adult dataset. Latent class analysis was used to classify individuals based on internalizing, externalizing and substance use problems. Bivariate and multivariable models examined the association between latent class membership and current use of cigarettes, cigar products, electronic nicotine delivery systems, pipe, hookah and smokeless tobacco products. Poly tobacco use was also examined. RESULTS: Three latent classes were identified. The "normative" class reported low prevalence of all symptoms, the "severe internalizing and non-violent externalizing" class reported severe internalizing problems and non-violent externalizing problems and the "severe" class reported high prevalence of all symptoms. Tobacco use was highest for the "severe" class and lowest for the "normative" class across products. CONCLUSIONS: Individuals in the "severe" class may be at elevated risk of tobacco-related morbidity and mortality and would likely benefit from targeted tobacco control interventions.

18.
JAMA Netw Open ; 2(10): e1913804, 2019 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-31642927

RESUMEN

Importance: Flavors in tobacco products may appeal to young and inexperienced users. Objective: To examine among youth (aged 12-17 years), young adults (aged 18-24 years), and adults (aged ≥25 years) the prevalence of first use of flavored tobacco products among new tobacco users and the association between first flavored use of a given tobacco product and tobacco use 1 year later, including progression of tobacco use. Design, Setting, and Participants: This cohort study represents a longitudinal analysis of data from the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative study with data collected in 2013 to 2014 (wave 1) and 2014 to 2015 (wave 2). Participants were noninstitutionalized individuals, including 11 996 youth and 26 447 adults, in selected households who participated in both waves of the PATH Study. Data analysis was conducted from July 2016 to June 2019. Main Outcomes and Measures: Prevalence of tobacco product use at wave 2. Results: The mean (SE) age of the participants was 14.5 (0.0) years for youth, 21.1 (0.0) years for young adults, and 50.3 (0.0) for adults. Most youth (71.9%; 95% CI, 69.7%-74.0%) and young adults (57.6%; 95% CI, 54.9%-60.3%) who were new users of tobacco products over the 10- to 13-month follow-up period used flavored products. First use of a menthol or mint or other flavored cigarette documented at wave 1 was positively associated with past 12-month and past 30-day cigarette use in all age groups at wave 2 compared with first use of a nonflavored cigarette (youth, flavored cigarette, past 12-month use adjusted prevalence ratio [aPR], 1.14 [95% CI, 1.05-1.25] and past 30-day use aPR, 1.15 [95% CI, 1.00-1.31]; youth, menthol or mint cigarette, past 12-month use aPR, 1.18 [95% CI, 1.08-1.29] and past 30-day use aPR, 1.19 [95% CI, 1.04-1.37]; young adult, flavored cigarette, past 12-month use aPR, 1.09 [95% CI, 1.04-1.15] and past 30-day use aPR, 1.13 [95% CI, 1.06-1.21]; young adult menthol or mint cigarette, past 12-month use aPR, 1.10 [95% CI, 1.05-1.16] and past 30-day use aPR, 1.15 [95% CI, 1.07-1.23]; adult flavored cigarette, past 12-month use aPR, 1.10 [95% CI, 1.05-1.15] and past 30-day use aPR, 1.09 [95% CI, 1.04-1.14]; adult menthol or mint cigarette, past 12-month use aPR, 1.13 [95% CI, 1.08-1.18] and past 30-day use aPR, 1.12 [95% CI, 1.07-1.17]). Among young adults, first use of flavored e-cigarettes (aPR, 2.05; 95% CI, 1.61-2.61), any cigars (aPR, 1.60; 95% CI, 1.26-2.02), cigarillos (aPR, 1.49; 95% CI, 1.08-2.05), filtered cigars (aPR, 3.69; 95% CI, 2.08-6.57), hookah (aPR, 1.91; 95% CI, 1.23-2.98), and any smokeless tobacco (aPR, 1.54; 95% CI, 1.08-2.20) was prospectively associated with current regular use of those products at wave 2 compared with first nonflavored use. Among adults aged 25 years and older, first use of flavored e-cigarettes (aPR, 1.60; 95% CI, 1.41-1.82), any cigars (aPR, 1.56; 95% CI, 1.29-1.87), cigarillos (aPR, 1.29; 95% CI, 1.01-1.64), filtered cigars (aPR, 1.79; 95% CI, 1.25-2.54), hookah (aPR, 5.66; 95% CI, 2.04-15.71), and any smokeless tobacco (aPR, 1.55; 95% CI, 1.32-1.82) was prospectively associated with current regular use of those products at wave 2 compared with first nonflavored use. Conclusions and Relevance: In this longitudinal cohort study, flavors in tobacco products were associated with youth and young adult tobacco experimentation. First use of a flavored tobacco product may place youth, young adults, and adults at risk of subsequent tobacco use.

19.
J Stud Alcohol Drugs ; 80(4): 415-422, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31495378

RESUMEN

OBJECTIVE: Marijuana use is associated with negative cognitive and health outcomes and risky driving. Given the rapidly changing policies regarding legal recreational and medicinal marijuana use, it is important to examine what types of marijuana prevention messages may be effective in minimizing such outcomes. This study examined cognitive and affective responses to anti-marijuana public health messages in a sample of adult marijuana users and nonusers to determine the correlates of perceived message effectiveness. METHOD: Participants (N = 203; mean age = 37.7 years) were adult marijuana users and nonusers recruited via Amazon Mechanical Turk (August 2017). After completing self-report measures of marijuana use, they viewed six anti-marijuana messages presented in a random order, addressing marijuana's effects in each of three topic areas: cognitive performance, driving, and adverse health outcomes (e.g., two messages per topic). Participants completed assessments of cognitive and affective perceptions after viewing each message. For each message topic, a linear regression model was used to determine which cognitive and affective perceptions were most predictive of perceived message effectiveness. RESULTS: For all message topics, nonusers perceived the messages as more effective than did users (p < .001). In the majority of analyses, greater message effectiveness was associated with increased perceived harm of marijuana and increased liking of the message. For driving and health messages, greater message effectiveness was also significantly correlated with lower pleasant affect. CONCLUSIONS: The findings suggest that audience perceptions may be uniquely predictive of message effectiveness, depending on the topic.


Asunto(s)
Conducción de Automóvil/psicología , Cognición , Investigación sobre la Eficacia Comparativa/estadística & datos numéricos , Consumidores de Drogas/psicología , Uso de la Marihuana/psicología , Adolescente , Adulto , Anciano , Femenino , Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Prevención del Hábito de Fumar/métodos , Adulto Joven
20.
Am J Prev Med ; 57(4): e135-e142, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31542145

RESUMEN

INTRODUCTION: The current study pilot tested the effect of a single, brief exposure to nicotine education messages on beliefs about nicotine, nicotine-replacement therapy (NRT), E-cigarettes, and cigarettes with reduced nicotine content (RNC). METHODS: Five hundred and twenty-one U.S. adults (aged ≥18 years) completed a 15-minute survey on Amazon Mechanical Turk in 2018. After completing items on sociodemographics, literacy, and cancer risk behaviors, participants were randomized in a 2:1:1 ratio to 1 of 3 conditions: nicotine education (n=263), sun safety education (attention control, n=128), or no message control (n=130). All participants completed items regarding nicotine, NRT, E-cigarette, and RNC cigarette beliefs, as well as norms about nicotine use, behavioral control regarding cigarette/tobacco use, and intention to use cigarettes, NRT, E-cigarettes, and RNC cigarettes in the next 12 months. Analyses were conducted in 2019. RESULTS: Following exposure, nicotine education participants reported fewer false beliefs about nicotine (p<0.001), NRT (p<0.001), E-cigarettes (p<0.05), and RNC cigarettes (p<0.05) compared with the control conditions. Nicotine messaging doubled the probability of a correct response (false, 78.3% vs 36.8%) to nicotine is a cause of cancer and dramatically reduced the probability of responding don't know to this item (5.3% vs 26.0%). There was no impact of the intervention on beliefs about other substances within cigarette, norms, or behavioral intentions. CONCLUSIONS: Findings from the current study support the hypothesis that a brief nicotine messaging intervention-similar to the messages likely to be seen on warning labels or in media campaigns-is likely to correct misperceptions of nicotine, NRT, E-cigarettes, and RNC cigarettes.

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