Products and patterns through which adolescents, young adults, and adults initiate co-use of tobacco and cannabis.

BACKGROUND: Co-use of tobacco and cannabis is common. However, few studies have examined the temporal sequencing through which individuals initiate co-use, and how these patterns vary across age. This study addresses this gap by examining the specific products and temporal sequencing through which adolescents, young adults, and adults initiate co-use of tobacco and cannabis. Among adolescents, young adults, and adults who co-used tobacco and cannabis in the past 30 days, we examined (a) whether tobacco or cannabis was used first in their lifetime and (b) which specific tobacco or cannabis product (e.g., nicotine e-cigarettes, cannabis edibles) was the first used. METHODS: Data were from a cross-sectional national survey (N = 6,131, 13-40 years old) in which participants reported ever use, past-30-day-use, and order of use for 17 different tobacco and cannabis products. Results were analyzed overall and by age group (13-20; 21-24; 25-40). RESULTS: 38.4% of participants reported use of both tobacco and cannabis in the past 30 days. Among these participants, 70.9% used tobacco first in their lifetime (66.6% < 21; 71.7% 21-24; 76.6% > 24). Approximately 60% of participants who initiated co-use with tobacco reported nicotine e-cigarettes as their first tobacco product (63.3% < 21; 66.7% 21-24; 49.6% > 24). CONCLUSIONS: The majority of participants who used both tobacco and cannabis used tobacco first in their lifetime, and nicotine e-cigarettes were the most common form of tobacco initiation, particularly among adolescents and young adults. Findings emphasize the need for co-use prevention programs to target common products of initiation.

Effects of a short school-based vaping prevention program for high school students.

Educational programs that address adolescents' misperceptions of e-cigarette harms and benefits and increase refusal skills play an important role in preventing initiation and use. This study evaluates changes in adolescents' e-cigarette perceptions, knowledge, refusal skills, and intentions to use following a real-world implementation of a school-based vaping-prevention curriculum. Study participants were 357 9th-12th grade students from one high school in Kentucky, United States who participated in a 60-minute vaping prevention curriculum from the Stanford REACH Lab's Tobacco Prevention Toolkit. Participants completed pre- and post-program assessments regarding their e-cigarette knowledge, perceptions, refusal skills, and intentions to use e-cigarettes. Matched paired t-tests and McNemar tests of paired proportions were applied to assess changes in study outcomes. Following the curriculum, participants indicated statistically significant changes on all 15 survey items related to e-cigarette perceptions (p's < 0.05). Participants demonstrated improved knowledge that e-cigarettes deliver nicotine in the form of an aerosol (p <.001), reported that if a friend offered them a vape it would be easier to say no (p <.001), and indicated they would be less likely to take the vape (p <.001) after receiving the curriculum. Other survey items related to knowledge, refusal skills, and intentions did not demonstrate significant changes. Overall, participation in a single session vaping-prevention curriculum was associated with several positive changes in high school students' e-cigarettes knowledge, perceptions, refusal skills, and intentions. Future evaluations should examine how such changes affect long-term trajectories of e-cigarette use.

Adolescents, Young Adults, and Adults Continue to Use E-Cigarette Devices and Flavors Two Years after FDA Discretionary Enforcement.

This study assesses the use of e-cigarette devices and flavors using a large, cross-sectional survey of adolescents, young adults, and adults (N = 6131; ages 13−40 years old; Mage = 21.9) conducted from November to December 2021, 22 months after the FDA announced its prioritized enforcement policy against some flavored pod/cartridge-based e-cigarettes. We analyzed the patterns of use by age group: adolescents and young adults (AYAs) under 21 (minimum age of e-cigarette sales), young adults (21−24 years old), and adults (25−40 years old). The participants reported using e-cigarettes ever (44.2% < 21; 67.1% 21−24; 58.0% > 24), in the past 30 days (29.8% < 21; 52.6% 21−24; 43.3% > 24), and in the past 7 days (24.5% < 21; 43.9% 21−24; 36.5% > 24). Disposables were the most used e-cigarette device type across age groups (39.1% < 21; 36.9% 21−24; 34.5% > 24). Fruit, sweet, mint, and menthol flavors were popular across age groups; however, chi-squared tests for trends in proportions revealed age-related trends in past 30-day flavor use by device type. Findings suggest current AYA e-cigarette use may be higher than recorded by the NYTS 2021. The FDA, states, and localities should adopt more comprehensive restrictions on flavored e-cigarette products in order to reduce adolescent and young adult e-cigarette use.

Family and individual risk factors for triangulation: Evaluating evidence for emotion coaching buffering effects.

Adolescents who are triangulated into interparental conflict are at increased risk for psychological maladjustment. However, little is known about factors that may predict family risk for triangulating adolescents, or protective factors that can off-set this risk. In this study, we conducted longitudinal tests of family, parent, and adolescent factors that might predict increases in triangulation over time. The sample included 174 adolescents and their mother figures from two-parent families (58% female; Mage  = 14.75 years) who provided data on two occasions, six months apart. Hierarchical linear regression models evaluated family, parent, and adolescent risk factors for triangulation into interparental conflict, and subsequently parent's emotion coaching and adolescent gender as potential moderators of risk for triangulation. Findings revealed that low family cohesion, parent depression, and adolescent difficulties with emotion regulation represented risks for triangulation. Parent emotion coaching moderated the association between low interparental love and triangulation differentially based on adolescent gender.

Distal and proximal family contextual effects on adolescents' interparental conflict appraisals: A daily diary study.

Adolescent appraisals of interparental conflict (IPC)-perceiving IPC as threatening to their well-being or that of the family, and self-blaming attributions-are well-established processes through which IPC confers risk for developmental disruptions and psychopathology. Recent work documents intraindividual change in IPC and appraisals that occur on a daily timescale. However, considerably less is known about how the broader family context may temper appraisals of IPC. This study provides a novel examination of the implications of distal (global ratings of family relationships in general) and proximal (fluctuations in daily family relationships) family context (family cohesion, parent-adolescent closeness, and parent-adolescent conflict) for adolescents' propensity to form negative appraisals of daily IPC. This sample included 144 adolescents (63% female) in two-parent families, who participated in a 21-day daily diary study. Findings indicate that intraindividual variability in adolescents' perception of family cohesion, parent-adolescent closeness, and parent-adolescent conflict all correspond to adolescent appraisals of IPC through direct relations and moderating effects. Unique patterns emerged for boys and girls, suggesting gender differences in how adolescents incorporate the family context into their appraisals of IPC. This study expands our awareness of the importance of daily fluctuations in family relationships for adolescent risk during exposure to IPC. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Same family, divergent realities: How triangulation preserves parents' illusory harmony while adolescents navigate interparental conflicts.

Triangulation is a process in which a child is drawn into conflict between two parents, and is linked to adolescent psychological maladjustment. Although harmful, families may engage in triangulation due to its promotion of diverging realities in which youth become more attuned to interparental conflict (IPC), yet parents are distracted from tension within their interparental relationship. Although central to theoretical depictions of triangulation and carrying robust implications for family science and prevention, the phenomenon of diverging realities in triangulating families has received inadequate empirical evaluation. This study utilized data collected from 150 families in which 1 parent and 1 adolescent completed baseline surveys and 21 daily diary questionnaires on triangulation, IPC, and family cohesion. Multilevel models were applied, nesting days within families, to evaluate within-family associations between triangulation and divergent perspectives of family functioning. Results from multilevel models indicated that on days when adolescents experienced elevated triangulation, discrepancies between adolescent and parent reports of IPC and family cohesion increased, with adolescents reporting significantly higher levels of IPC and lower levels of family cohesion relative to their parents. Further probing of the trends driving these discrepancies yielded a distinct pattern of results for IPC and family cohesion. Adolescent involvement in IPC is associated with more negative perspectives of family functioning relative to parents. These findings imply a mechanism through which triangulation confers risk to adolescents, and highlight that divergence in parent and adolescent perspectives of family functioning fluctuates depending on daily processes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Evaluating school and peer protective factors in the effects of interparental conflict on adolescent threat appraisals and self-efficacy.

INTRODUCTION: Recent work has sought to understand how family-specific risk, such as exposure to interparental conflict, may generalize to developmentally-salient processes in adolescence. A cascade model has been identified in which conflict-specific threat appraisals may erode adolescents' self-efficacy over time, and in turn, undermine their psychological well-being. The goal of this study was to integrate success in the school and peer contexts as potential contextual protective factors that may mitigate the effects of interparental conflict on self-efficacy. METHODS: We tested the additive and interactive effects of success in school and peer contexts on adolescent self-efficacy to better understand these ecological contextual factors for a family risk model. Analyses were conducted using structural equation modeling with a sample of 768 two-parent U.S. families across three measurement occasions. Interparental conflict, threat appraisals, self-efficacy, and school success and peer support were measured using multiple, established scales. RESULTS: Results supported the additive effects model, in that school success and peer support significantly contributed to general self-efficacy above and beyond the effects of threat appraisals of interparental conflict, but did not moderate the association between threat appraisals and self-efficacy. CONCLUSIONS: Findings indicate that strengths in school and peer contexts have potential to compensate for, but do not appear to buffer, the negative effects of threat appraisals of interparental conflict and underscore the importance of these contexts for understanding multifinality in outcomes of adolescents exposed to interparental conflict.