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1.
PLoS One ; 15(11): e0242872, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33232381

RESUMO

BACKGROUND: Tobacco, alcohol, and marijuana are the top three substances used by adolescents. The adverse health effects of these three substances are well documented in epidemiological literature, yet little is known about the substance use and associated factors among adolescents in Bangladesh. This study examines the risk factors for tobacco and other substances use among school-going adolescents in Bangladesh. METHODS: We analyzed data from the 2014 Bangladesh Global School-based Student Health Survey (GSHS) of adolescents aged 13-17 years. We used two outcome measures: tobacco use (TU) and other substance use (SU; alcohol and/or marijuana). We examined a set of reported psychosocial and socio-environmental adverse events as risk factors. Logistic regression analyses were used to identify associations. RESULTS: The prevalence of TU and other SU among school-going adolescents was 9.6% and 2.3%, respectively. The likelihood of TU and other SU was higher among adolescents who reported being bullied (TU: adjusted odd ratio [AOR]: 1.93; 95% confidence interval [CI]: 1.24-3.00; and other SU: AOR: 3.43; 95% CI: 1.46-7.99) and having sexual history (TU: AOR: 19.38; 95% CI: 12.43-30.21; and other SU: AOR: 5.34; 95% CI: 2.17-13.29). Moreover, anxiety-related sleep loss was associated with adolescents' TU (AOR: 2.41; 95% CI: 1.02-5.82) whereas the likelihood of other SU (AOR: 3.27; 95% CI: 1.14-9.44) was higher among lonely adolescents. Experience of adverse socio-environmental factors, such as parental substance use (TU: AOR: 7.81; 95% CI: 5.08-12.01), poor monitoring (TU: AOR: 1.96; 95% CI: 1.16-3.31) and poor understanding (TU: AOR: 2.22; 95% CI: 1.36-3.65), and lack of peer support (TU: AOR: 3.13; 95% CI: 1.84-5.31; and other SU: AOR: 2.45; 95% CI: 1.02-5.91), and truancy (other SU: AOR: 4.29; 95% CI: 1.81-10.12) were also positively associated with TU and/or other SU. Additionally, higher odds of tobacco use were observed among adolescents who reported 1 (AOR: 4.36 times; 95% CI: 1.34-14.24), 2 (AOR: 8.69 95% CI: 1.67-28.23), and ≥3 (AOR: 17.46; 95% CI: 6.20-49.23) adverse psychosocial experiences than who did not report any psychosocial events. CONCLUSIONS: Tobacco and other substance use among school-going adolescents are prevalent in Bangladesh. Several psychosocial and socio-environmental events are associated with TU and other SU, which should be incorporated into adolescent substance use and health promotion programs.


Assuntos
Comportamento do Adolescente/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Uso de Tabaco/psicologia , Tabaco/efeitos adversos , Absenteísmo , Adolescente , Bangladesh/epidemiologia , Bullying/psicologia , Criança , Feminino , Humanos , Masculino , Abuso de Maconha , Fatores de Risco , Instituições Acadêmicas , Comportamento Sexual/psicologia , Estudantes/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Uso de Tabaco/epidemiologia
2.
Artigo em Inglês | MEDLINE | ID: mdl-32962216

RESUMO

The present study is one of the first to analyze the predictive capacity of both trait and ability Emotional Intelligence (EI) based on the Mayer and Salovey model, in relation to tobacco use in a sample of Spanish adolescents. In this study, 799 students between the ages of 12 and 16 participated. A self-report on trait EI, an EI peak performance test, and questions about habits relating to tobacco use were administered. This cross-sectional study developed a quantitative and correlation-type methodology. The main results of the regression analyses, once the sex and age of the participants were controlled, revealed negative associations between the factors of clarity and emotional repair of the trait EI with respect to the variables of tobacco use, and a positive association was found for them and emotional attention. By comparison, with respect to ability EI, emotional perception and understanding were inversely related to adolescent tobacco use. These results underscore the importance of EI skills as protective factors against early initiation and subsequent tobacco abuse.


Assuntos
Inteligência Emocional , Emoções , Uso de Tabaco , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Autorrelato , Uso de Tabaco/psicologia
3.
Indian J Cancer ; 57(3): 296-310, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32769291

RESUMO

Background: Tobacco use has emerged as a major public health problem. But, most graduates in medical and dental schools receive limited systematic training. The objective of this education innovation project was to enhance dental undergraduate student's ability to identify tobacco users through oral manifestations and improve their counseling skills using a customized Tobacco Counseling Training Module (TCTM). Methods: A TCTM for students of dentistry was developed using ADDIE framework as a guide. Content and construct validation of the module was done by six subject experts using Delphi technique for obtaining consensus. Pilot testing was done on 20 students of third year BDS. Pre- and post-intervention assessment of knowledge, attitude, self-confidence was done using learning outcomes questionnaire. Ability to correctly identify oral manifestations was assessed using extended item MCQs and tobacco counseling skills using a modified KEECC. The difference in mean scores were computed and subjected to further statistical analysis using SPSS version 22. Results: There was a significant improvement in post intervention scores for mean knowledge (5.5 ± 1.4 to 13.2 ± 1.1), attitude (5.6 ± 0.9 and 8.5 ± 0.5), self-confidence (1.5 ± 0.5 and 3.1 ± 0.2), ability to correctly identify oral manifestations (5.2 ± 1.4 and 9.4 ± 0.8) and tobacco counseling skills. Conclusion: It is possible to introduce the module in the existing curriculum and its effectiveness evaluation shows benefit in terms of Kirkpatrick's Level 1, 2, 3 (improvement in knowledge, attitude, self-confidence, ability to identify oral manifestations, and tobacco counseling skills) of training effectiveness.


Assuntos
Aconselhamento/métodos , Educação em Odontologia/métodos , Educação/métodos , Estudantes de Odontologia/estatística & dados numéricos , Uso de Tabaco/psicologia , Técnica Delfos , Humanos
4.
Artigo em Inglês | MEDLINE | ID: mdl-32858864

RESUMO

Families play an important role in helping teenagers avoid using tobacco, cannabis, and opioids, but some parents may underestimate the risk of their children using those substances. This study aimed to determine parents' perceived likelihood of their child initiating tobacco, cannabis, and opioid use, as well as the control they have in preventing their child from using those substances. We surveyed 427 parents of children aged 0-18 years old using the online Amazon Mechanical Turk platform in the spring of 2019. We measured participants' perceived likelihood of their child initiating tobacco, cannabis, or opioid use before the age of 18 compared to other children, using a five-point Likert scale. This perceived likelihood was dichotomized between optimistic (less likely than average) and non-optimistic (average or more likely than average). Independent variables included parental tobacco use, perceived parental control, and perceived severity of the behavior. Participants with missing data and participants with children who had already initiated substance use were excluded from statistical analyses. Mean age of participants was 38.1 years (Standard Deviation 8.4); 67% were female. Level of parental optimism was 59% for cannabis, 77% for tobacco, and 82% for opioids. Perceived severity was significantly lower for cannabis use (71/100) than tobacco (90/100) and opioid use (92/100) (p < 0.001). Current smokers were less likely than never smokers to be optimistic about their child's risk of initiating using tobacco (Adjusted Odds Ratio (AOR): 0.18 [95% Confidence Interval (CI) 0.10-0.34]) or cannabis (AOR: 0.21 [95% CI 0.12-0.38]). Parental perceived likelihood of a child initiating substance use represents an understudied and potential target for substance use prevention.


Assuntos
Cannabis/efeitos adversos , Otimismo , Pais/psicologia , Fumar Tabaco , Uso de Tabaco/efeitos adversos , Adolescente , Comportamento do Adolescente/psicologia , Adulto , Controle Comportamental , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Relações Pais-Filho , Poder Familiar , Tabaco , Produtos do Tabaco , Uso de Tabaco/psicologia
5.
BMC Public Health ; 20(1): 815, 2020 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-32473627

RESUMO

BACKGROUND: Few data were available on smoking and smokeless tobacco use in South Asian migrants in the United Arab Emirates (UAE). This study aimed to identify the prevalence and correlates of cigarette smoking and smokeless tobacco use in male South Asian migrants in the UAE. METHODS: We used a cross-sectional study to recruit a random representative sample of male South Asian migrants, including Indian (n = 433), Pakistani (n = 383) and Bangladeshi (n = 559) nationalities. We used multivariable logistic regression analysis to identify significant correlates of cigarettes smoking and smokeless tobacco use. RESULTS: 1375 South Asian migrant adult males participated in the study (response rate 76%) with a mean age of 34 years (SD ± 10). The overall prevalence of cigarette smoking was 28% (95%CI 25-30%) and smokeless tobacco use was 11% (95%CI 10-13%). The prevalence of current cigarette smoking was 21, 23, and 37% among participants from India, Pakistan and Bangladesh, respectively. The prevalence of current smokeless tobacco use was 6, 12, and 16% for Indian, Pakistani, and Bangladeshi participants, respectively. Among study participants, Bangladeshi nationality, hypertension, and alcohol use were significant correlates of current cigarette smoking. Significant correlates of smokeless tobacco use included increased age, less than college level education, alcohol use, and Pakistani or Bangladeshi nationality. CONCLUSIONS: Current smoking and smokeless tobacco use in South Asian migrants represent a significant public health burden in the UAE. Effective public health measures are needed to reduce tobacco use in this migrant population.


Assuntos
Fumar Cigarros/etnologia , Fumar Cigarros/psicologia , Fumantes/psicologia , Uso de Tabaco/etnologia , Uso de Tabaco/psicologia , Tabaco sem Fumaça/estatística & dados numéricos , Migrantes/psicologia , Adolescente , Adulto , Grupo com Ancestrais do Continente Asiático/psicologia , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Bangladesh , Fumar Cigarros/epidemiologia , Estudos Transversais , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Paquistão , Prevalência , Fumantes/estatística & dados numéricos , Uso de Tabaco/epidemiologia , Migrantes/estatística & dados numéricos , Emirados Árabes Unidos/epidemiologia , Emirados Árabes Unidos/etnologia , Adulto Jovem
6.
Nicotine Tob Res ; 22(12): 2134-2140, 2020 12 12.
Artigo em Inglês | MEDLINE | ID: mdl-32531046

RESUMO

Most tobacco-focused clinical trials are based on locally conducted studies that face significant challenges to implementation and successful execution. These challenges include the need for large, diverse, yet still representative study samples. This often means a protracted, costly, and inefficient recruitment process. Multisite clinical trials can overcome some of these hurdles but incur their own unique challenges. With recent advances in mobile health and digital technologies, there is now a promising alternative: Remote Trials. These trials are led and coordinated by a local investigative team, but are based remotely, within a given community, state, or even nation. The remote approach affords many of the benefits of multisite trials (more efficient recruitment of larger study samples) without the same barriers (cost, multisite management, and regulatory hurdles). The Coronavirus Disease 2019 (COVID-19) global health pandemic has resulted in rapid requirements to shift ongoing clinical trials to remote delivery and assessment platforms, making methods for the conduct of remote trials even more timely. The purpose of the present review is to provide an overview of available methods for the conduct of remote tobacco-focused clinical trials as well as illustrative examples of how these methods have been implemented across recently completed and ongoing tobacco studies. We focus on key aspects of the clinical trial pipeline including remote: (1) study recruitment and screening, (2) informed consent, (3) assessment, (4) biomarker collection, and (5) medication adherence monitoring. Implications With recent advances in mobile health and digital technologies, remote trials now offer a promising alternative to traditional in-person clinical trials. Remote trials afford expedient recruitment of large, demographically representative study samples, without undo burden to a research team. The present review provides an overview of available methods for the conduct of remote tobacco-focused clinical trials across key aspects of the clinical trial pipeline.


Assuntos
/epidemiologia , Ensaios Clínicos como Assunto/métodos , Telemedicina/métodos , Uso de Tabaco/epidemiologia , Uso de Tabaco/terapia , /prevenção & controle , Humanos , Adesão à Medicação/psicologia , Uso de Tabaco/psicologia
7.
Artigo em Inglês | MEDLINE | ID: mdl-32340128

RESUMO

Background: Despite the fact that tobacco use during pregnancy produces adverse perinatal effects, some women continue to smoke. Health literacy (HL) is essential for health outcomes in adults. However, little is known about HL in pregnant women or postpartum women. The study aimed to analyse the relationship between the degree of HL of women during the early puerperium and tobacco use during pregnancy. METHODS: A multicentre, descriptive, cross-sectional study was carried out with women in the early puerperium in a region of eastern Spain, between November 2017 and May 2018. Their HL level was obtained using the Newest Vital Sign (NVS) tool. Multivariate logistic models were adjusted to estimate the magnitude of association with tobacco use in pregnancy. Odds ratios (OR) were estimated with a 95% confidence interval. RESULTS: 193 were included in the total. 29.5% (57) of pregnant women smoked tobacco during pregnancy, with a smoking cessation rate of 70.1% (40) while pregnant. 42.0% (81) of pregnant women had inadequate or limited HL. A low level of HL was strongly associated with tobacco use, adjusted by catchment area and age of first pregnancy (LRT p < 0.001; ROC curve = 0.71, 95% CI: 0.64-0.79). CONCLUSION: A low HL is associated with tobacco consumption during pregnancy. Whether low HL reflects the wide constellation of already-known socioeconomic, political and commercial determinants of tobacco use, or whether incorporating HL support interventions strengthens tobacco cessation activities in pregnancy, warrants further research. Still, it should be considered as essential to understanding the health disparities related to its consumption.


Assuntos
Letramento em Saúde , Gestantes/psicologia , Uso de Tabaco/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Período Pós-Parto , Gravidez , Espanha , Uso de Tabaco/prevenção & controle
8.
South Med J ; 113(4): 183-190, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32239231

RESUMO

OBJECTIVE: Although substantial research has explored the Hispanic health paradox (HHP) and suggests that Latinx immigrants experience positive health outcomes relative to those born in the United States, less research has assessed the role of immigration status. Our aim was to examine this role in Latinx health. METHODS: Using survey data collected at two free/reduced-cost clinics in southernmost Texas, we examined differences in the mental and self-rated health, substance, alcohol, and tobacco use of low-income patients by undocumented/documented immigrant and US-born/naturalized citizen status (N = 588). RESULTS: Based on ordinary least squares regression results, undocumented Latinx immigrants report lower negative self-rated health (coefficient -0.27, 95% confidence interval -0.50 to -0.01) and lower depressive symptoms (coefficient -0.34, 95% confidence interval -0.67 to -0.02]) compared with their US citizen peers (P < 0.05). Logistic regression results suggest that undocumented and documented Latinx immigrants do not differ in alcohol, tobacco, or substance use relative to their citizen peers. CONCLUSIONS: Despite facing potentially adverse social environments, undocumented Latinx immigrants experience positive health outcomes relative to US-born/naturalized citizen peers.


Assuntos
Emigrantes e Imigrantes/psicologia , Hispano-Americanos/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Custos de Cuidados de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Inquéritos e Questionários , Texas/epidemiologia , Uso de Tabaco/epidemiologia , Uso de Tabaco/psicologia
9.
Aust J Gen Pract ; 49(3): 155-158, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32113210

RESUMO

BACKGROUND: Use of tobacco, alcohol and other drugs (TAOD) is common in Australia and can cause high morbidity and mortality. It is not uncommon for people who use TAOD to experience stigma when accessing healthcare, including general practice. Stigma communicated through words can affect people seeking help and undertaking treatment for their health issues. The language that clinicians use is an important factor that perpetuates stigma. OBJECTIVE: The aim of this article is to describe how spoken and written language can create stigma and how this affects a person's experience of care, which in turn can adversely affect health outcomes. DISCUSSION: Language matters, and this article suggests that clinicians consider how the language they use might affect the people they see. The use of person-centred language and specific language rather than labels may assist conversations and improve outcomes.


Assuntos
Alcoolismo/psicologia , Idioma , Estereotipagem , Transtornos Relacionados ao Uso de Substâncias/psicologia , Uso de Tabaco/psicologia , Adulto , Alcoolismo/complicações , Austrália , Feminino , Humanos , Masculino , Transtornos Relacionados ao Uso de Substâncias/complicações
10.
Artigo em Inglês | MEDLINE | ID: mdl-31963835

RESUMO

Electronic cigarette (e-cigarette) use has had an exponential increase in popularity since the product was released to the public. Currently, there is a lack of human studies that assess different biomarker levels. This pilot study attempts to link e-cigarette and other tobacco product usage with clinical respiratory symptoms and immunoglobulin response. Subjects completed surveys in order to collect self-reported data on tobacco product flavor preferences. Along with this, plasma samples were collected to test for immunoglobulin G (IgG) and E (IgE) levels. Our pilot study's cohort had a 47.9% flavor preference towards fruit flavors and a 63.1% preference to more sweet flavors. E-cigarette and traditional cigarette smokers were the two subject groups to report the most clinical symptoms. E-cigarette users also had a significant increase in plasma IgE levels compared to non-tobacco users 1, and dual users had a significant increase in plasma IgG compared to non-tobacco users 2, cigarette smokers, and waterpipe smokers. Our pilot study showed that users have a preference toward fruit and more sweet flavors and that e-cigarette and dual use resulted in an augmented systemic immune response.


Assuntos
Aromatizantes/química , Imunoglobulina E/sangue , Imunoglobulina G/sangue , Fumantes/psicologia , Paladar , Comportamento do Consumidor , Projetos Piloto , Fumantes/classificação , Uso de Tabaco/psicologia , Vaping/psicologia , Fumar Cachimbo de Água/psicologia
11.
Rev. psicol. clín. niños adolesc ; 7(1): 59-64, ene. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-194423

RESUMO

Teens tend to identify with social groups that characterize their lifestyles, interest in different musical styles and preference in specific activities. Previous studies conclude that group identification is a significant prospective predictor of drug use and other problematic behaviors but may not operate the same way in all cultures. There are no such studies that have been conducted in Spanish adolescents. This study examines the prevalence of self-identified group name research among Spanish adolescents, and its relationship between substance use and psychosocial constructs. The sample consisted of 791 Spanish adolescents from six secondary schools, aged between 14 to 18 years (M = 15.03; SD = 1.01). The results support the existence of group self-identification by youth. The High risk group reported significantly higher monthly cigarette and alcohol use, and the Others group reported higher monthly marijuana use. Regarding psychosocial correlates, youth with higher drug use report greater sensation seeking preference and higher levels of depression. Group self-identification is a consistent phenomenon among teens in different countries but, contrary to previous work, those youth not falling into a clearly defined group ("Others") were the most likely to use marijuana


Los adolescentes tienden a identificarse con diferentes grupos sociales que caracterizan sus estilos de vida. Estudios previos concluyen que la identificación grupal es un predictor del consumo de drogas y otros comportamientos problemáticos, pero puede no funcionar de la misma manera en todos los países y en España no existen estudios al respecto con adolescentes. Este estudio examina la prevalencia de grupos de referencia entre los adolescentes españoles y su relación con el consumo de sustancias y otras variables psicológicas. La muestra estuvo compuesta por 791 adolescentes de nueve centros de educación secundaria, con edades comprendidas entre los 14 y 19 años (M = 15,03; DT = 1,01). Los resultados apoyan la existencia de grupos de identificación grupal por parte de los jóvenes. El grupo de alto riesgo informó de un consumo mensual significativamente mayor de cigarros y alcohol, y el grupo Otros informó de un consumo mensual más elevado de marihuana, en comparación con los otros grupos. En cuanto a las variables psicológicas, los jóvenes con mayor consumo de drogas informan de una mayor preferencia por la búsqueda de sensaciones y niveles más altos de depresión. La autoidentificación grupal es un fenómeno constante en los adolescentes entre los diferentes países, pero, contrariamente a lo encontrado en estudios previos, los jóvenes que no pertenecen claramente a un grupo definido son los más propensos al consumo de cannabis


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Identificação Social , Transtornos Relacionados ao Uso de Substâncias/psicologia , Usuários de Drogas/psicologia , Transtornos Relacionados ao Uso de Substâncias/etiologia , Usuários de Drogas , Depressão/complicações , Comportamento do Adolescente/psicologia , Uso de Tabaco/psicologia , Consumo de Álcool por Menores/psicologia , Uso da Maconha/psicologia , Inquéritos e Questionários , Espanha
12.
Psychopharmacology (Berl) ; 237(4): 967-978, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31858160

RESUMO

RATIONALE: Alcohol and nicotine addiction are prevalent conditions that co-occur. Despite the prevalence of co-use, factors that influence the suppression and enhancement of concurrent alcohol and nicotine intake are largely unknown. OBJECTIVES: Our goals were to assess how nicotine abstinence and availability influenced concurrent alcohol consumption and to determine the impact of quinine adulteration of alcohol on aversion-resistant alcohol consumption and concurrent nicotine consumption. METHODS: Male and female C57BL/6J mice voluntarily consumed unsweetened alcohol, nicotine, and water in a chronic 3-bottle choice procedure. In experiment 1, nicotine access was removed for 1 week and re-introduced the following week, while the alcohol and water bottles remained available at all times. In experiment 2, quinine (100-1000 µM) was added to the 20% alcohol bottle, while the nicotine and water bottles remained unaltered. RESULTS: In experiment 1, we found that alcohol consumption and preference were unaffected by the presence or absence of nicotine access in both male and female mice. In experiment 2a, we found that quinine temporarily suppressed alcohol intake and enhanced concurrent nicotine, but not water, preference in both male and female mice. In experiment 2b, chronic quinine suppression of alcohol intake increased nicotine consumption and preference in female mice without affecting water preference, whereas it increased water and nicotine preference in male mice. CONCLUSIONS: Quinine suppression of alcohol consumption enhanced the preference for concurrent nicotine preference in male and female mice, suggesting that mice compensate for the quinine adulteration of alcohol by increasing their nicotine preference.


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Comportamento de Escolha/efeitos dos fármacos , Etanol/administração & dosagem , Nicotina/administração & dosagem , Uso de Tabaco/psicologia , Animais , Comportamento de Escolha/fisiologia , Relação Dose-Resposta a Droga , Feminino , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Quinina/administração & dosagem , Autoadministração
13.
Nicotine Tob Res ; 22(8): 1409-1413, 2020 07 16.
Artigo em Inglês | MEDLINE | ID: mdl-31811296

RESUMO

INTRODUCTION: Cannabis-including blunts (cannabis rolled in tobacco-containing cigar casing) -is commonly the first substance used among adolescents and may increase the likelihood of subsequent initiation of combustible tobacco products. AIMS AND METHODS: Data were pooled from two prospective studies of adolescents in California and Connecticut (total N = 4594). Logistic regression models assessed the association of baseline ever blunt use and ever non-blunt cannabis use (vs. never cannabis use) with subsequent initiation of any combustible tobacco-only product (ie, cigarettes, cigars, or cigarillos) by 1-year follow-up after adjustment for demographic characteristics and other tobacco product use at baseline. We also assessed whether estimates differed by prior e-cigarette or hookah use at baseline. RESULTS: Among never combustible tobacco-only product users (N = 2973), 221 (7.4%) had ever used a blunt and 114 (3.8%) had ever used only non-blunt cannabis at baseline. Blunt use (adjusted odds ratio [AOR] = 1.98, 95% confidence interval [CI]: 1.30 to 3.01) and non-blunt cannabis use (AOR = 2.38, 95% CI: 1.41 to 4.00) were independently associated with greater odds of combustible tobacco-only product initiation by follow-up. Among those who had not tried e-cigarettes or who had not tried hookah, blunt use and non-blunt cannabis use were associated with significantly increased odds of combustible tobacco product initiation; among those who had tried e-cigarettes or hookah, the association was not significant. CONCLUSIONS: We found blunt and non-blunt cannabis use to be associated with subsequent combustible tobacco-only product initiation, particularly among adolescents who had not also tried other products containing nicotine. IMPLICATIONS: Adolescent-focused tobacco prevention efforts should consider incorporating cannabis products, including blunts. More research is needed to understand how blunt use and cannabis use more broadly are associated with initiation of tobacco products.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Fumar Maconha/efeitos adversos , Uso de Tabaco/epidemiologia , Adolescente , Comportamento do Adolescente , California/epidemiologia , Connecticut/epidemiologia , Feminino , Humanos , Masculino , Fumar Maconha/psicologia , Estudos Prospectivos , Uso de Tabaco/psicologia
15.
Nicotine Tob Res ; 22(5): 647-654, 2020 04 21.
Artigo em Inglês | MEDLINE | ID: mdl-30820566

RESUMO

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.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Produtos do Tabaco/estatística & dados numéricos , Uso de Tabaco/psicologia , Vaping/epidemiologia , Vaping/psicologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Inquéritos e Questionários , Vermont/epidemiologia , Adulto Jovem
16.
Arch Environ Occup Health ; 75(1): 27-35, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30652517

RESUMO

The aim of this study is to specify factors influencing tobacco consumption in Turkey, which belongs to developing countries group, and to determine the extent of their influence. Factors related to the sociodemographic, economic, personal, environmental, and healthy life indicators influencing tobacco consumption in Turkey were determined using logistic and probit regression analyses. According to the results of the study, age, gender, education, marital status, fruit consumption, exposure to tobacco smoke at home, and frequent of alcohol consumption are the most influential variables effecting tobacco consumption. More effective results in policies aimed at preventing tobacco consumption can be accomplished by giving priority to individuals more inclined to tobacco consumption. People in 25-44 age group, men, graduates of high school and its equivalents, divorced/widowed individuals, individuals exposed to tobacco smoke, and alcohol users are individuals who tend to use tobacco.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Fatores Socioeconômicos , Uso de Tabaco/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise de Dados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Uso de Tabaco/psicologia , Turquia/epidemiologia , Adulto Jovem
17.
Nicotine Tob Res ; 22(6): 1023-1029, 2020 05 26.
Artigo em Inglês | MEDLINE | ID: mdl-31074792

RESUMO

INTRODUCTION: Primary care visits present an opportunity to reduce tobacco use and tobacco smoke exposure (TSE) among adolescents. To date, few studies have examined tobacco-related electronic health record (EHR) documentation in adolescent visits. The purpose of this study was to (1) describe tobacco-related EHR documentation practices in adolescent care clinics, including whether alternative tobacco products, parental use, and TSE were addressed; and (2) identify aspects of adolescent tobacco use that may inform EHR updates and counseling and documentation practices. METHODS: Following a convergent mixed-methods design, we conducted an EHR review of 508 adolescent well-child visits, performed focus groups with pediatric providers and staff, and conducted in-depth interviews with adolescent patients. Record review data and interview transcripts were analyzed and interpreted concurrently. RESULTS: In the EHR review, cigarette screening was documented in 92.3% of visits, smokeless tobacco screening in 51.4%, parental tobacco use in 23.2%, and home TSE in 33.1% of visits. Smoking status options were not mutually exclusive and did not include noncigarette products. No records documented assessment of e-cigarette use, despite nearly half of adolescent interview respondents citing these as the most popular products among adolescents. In interviews, adolescents discussed their experiences with alternative tobacco/nicotine products more than cigarettes. CONCLUSIONS: Tobacco use status prompts should be revised for clarity and include noncigarette tobacco products and TSE. Provider education on noncigarette products and TSE assessment is needed. Improvements in EHR systems, resources, and tools can lead to better tobacco screening, prevention, and treatment practices among primary care providers. IMPLICATIONS: Clinical guidelines call for pediatricians to assess and treat adolescent and parental tobacco use during primary care visits. The use of electronic health records (EHRs) can improve screening and counseling practices; however, few studies have examined tobacco-related EHR documentation practices in adolescent care settings. This mixed-methods study found low rates of EHR documentation related to noncigarette nicotine/tobacco products, parental tobacco use, and tobacco smoke exposure. These results demonstrate the need for increased provider training and EHR modifications to facilitate comprehensive tobacco control efforts in the adolescent population.


Assuntos
Aconselhamento/métodos , Documentação/estatística & dados numéricos , Registros Eletrônicos de Saúde/estatística & dados numéricos , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Programas de Rastreamento/normas , Atenção Primária à Saúde/normas , Uso de Tabaco/epidemiologia , Adolescente , Terapia Comportamental , Criança , Feminino , Grupos Focais , Humanos , Masculino , Uso de Tabaco/psicologia , Estados Unidos/epidemiologia , Vaping/psicologia
18.
Nicotine Tob Res ; 22(6): 1036-1040, 2020 05 26.
Artigo em Inglês | MEDLINE | ID: mdl-31198962

RESUMO

INTRODUCTION: Tobacco companies continue to reach youth through direct-to-consumer marketing, which has been associated with overall tobacco use. We examine how exposure to these marketing activities influences product-specific use behaviors. METHODS: We analyzed data from 10 081 youth (aged 12-18 years) who participated in Waves 1 and 2 (2013-2015) of the Population Assessment of Tobacco and Health (PATH) Study. Participants reported past 6-month tobacco coupon receipt and online tobacco marketing engagement, and susceptibility to ever and current use of cigarette, e-cigarettes, cigars, smokeless tobacco, and hookah. Weighted multivariable logistic regression examined Wave 1 predictors of coupon receipt at Wave 2, and associations between coupon receipt, online engagement, and past 30-day use of different tobacco products. RESULTS: Youth received tobacco coupons at one (9.7%) or both waves (1.2%) and 11.1% engaged with online tobacco marketing. Coupon receipt and online marketing engagement at Wave 1 predicted Wave 2 coupon receipt among susceptible-never, ever-but-not-current, and current tobacco users (p < .05). Coupon receipt and online engagement at Wave 1 was positively associated with past 30-day use of cigarettes, e-cigarettes, cigars, smokeless tobacco, and hookah at Wave 2 (p < .05). The relationships were stronger for those who received coupons at both waves or engaged with more sources of online marketing. CONCLUSIONS: Tobacco direct-to-consumer marketing is reaching youth. Repeated exposure to these marketing activities within and across media is associated with use of different tobacco products. New policies and strong enforcement of existing regulations prohibiting these illegal marketing tactics are critical to protect youth from future tobacco use. IMPLICATIONS: Tobacco companies utilize coupons and online engagement activities to increase brand awareness, knowledge, and sales of their products. These kinds of marketing activities can be influential among youth at a time when they may develop tobacco use behaviors. Our findings suggest that tobacco companies may be targeting at-risk youth through cross-media marketing activities. The findings also indicate that exposure to these marketing activities predicts subsequent use of different tobacco products, with suggestive dose-response relationships. Increased regulations are needed to protect youth from these marketing activities.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Marketing/métodos , Multimídia/estatística & dados numéricos , Produtos do Tabaco/estatística & dados numéricos , Uso de Tabaco/epidemiologia , Adolescente , Criança , Publicidade Direta ao Consumidor , Feminino , Humanos , Masculino , Uso de Tabaco/psicologia
19.
Nicotine Tob Res ; 22(6): 1004-1015, 2020 05 26.
Artigo em Inglês | MEDLINE | ID: mdl-31180498

RESUMO

INTRODUCTION: Widely marketed flavored tobacco products might appeal to nonusers and could be contributing to recent increases in tobacco product use. We assessed flavored product use among current tobacco users; and measured associations between flavored product use and dependence among US adults. METHODS: Data were from the 2014-2015 Tobacco Use Supplement to the Current Population Survey, a cross-sectional household-based survey of US adults ≥18 years (n = 163 920). Current users of cigarettes, cigars, pipes, hookahs, smokeless tobacco, and electronic cigarettes (e-cigarettes) were asked whether their usual product was menthol or came in any characterizing flavors. Proportions of flavored product users were computed nationally and by state and demographic characteristics. Tobacco dependence was assessed with two proxy measures: daily use and use ≤30 minutes after waking. Associations between flavored product use and tobacco dependence were examined using logistic regression adjusted for sex, age, race/ethnicity, and multi tobacco product use. RESULTS: An estimated 41.0% of current users of any tobacco product usually used a flavored product during 2014-2015. The proportion ranged from 22.5% (Maine) to 62.1% (District of Columbia). By product, the proportion ranged from 28.3% (cigars) to 87.2% (hookah). Flavored product use was associated with: daily tobacco product use among current e-cigarette users (adjusted odds ratio [AOR] = 1.71), cigar smokers (AOR = 1.42), and cigarette smokers (AOR = 1.13); and tobacco product use ≤30 minutes after waking among current cigar smokers (AOR = 1.80), and cigarette smokers (AOR = 1.11). CONCLUSIONS: Restricting sales of flavored tobacco products and implementation of proven population-level tobacco control interventions could help reduce tobacco product use among US adults. IMPLICATIONS: During 2014-2015, flavored tobacco products were widely used by US adults with variations across states and demographic characteristics. Use of flavored e-cigarettes, flavored cigars, and menthol cigarettes were associated with daily tobacco use: use of flavored cigars and menthol cigarettes were associated with tobacco use within 30 minutes after waking. These findings suggest associations between flavor use and increased tobacco dependence. Prohibiting sale of flavored products can reduce access to those products, and could help reduce tobacco dependence and promote cessation behaviors among current tobacco product users.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Aromatizantes/química , Fumantes/psicologia , Fumantes/estatística & dados numéricos , Produtos do Tabaco/estatística & dados numéricos , Tabagismo/epidemiologia , Uso de Tabaco/epidemiologia , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Uso de Tabaco/psicologia , Tabagismo/psicologia , Estados Unidos/epidemiologia , Adulto Jovem
20.
Drug Alcohol Depend ; 206: 107729, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31760250

RESUMO

BACKGROUND: The use, misuse and co-use of alcohol, cannabis, tobacco, and other licit and illicit controlled substances has increased in past decades leading to higher rates of morbidity, overdose, and mortality in women of reproductive age. Co-use compounds the adverse health effects of substance use compared to single-use of similar substances. Little is known about the full range of substance combinations used by pregnant and non-pregnant women. We sought to describe patterns of co-use of alcohol, tobacco, and controlled substances, and examine correlates of co-use in a nationally-representative sample of women. METHODS: Cross-sectional study using self-reported survey data from 2006 to 2014 for women ages 18-49 years (N = 160,371) in National Survey on Drug Use and Health data. We use weighted proportions and 95% confidence intervals (CI) to report differences in substance use patterns in pregnant and non-pregnant women. Multivariate logistic regression models assessed association between characteristics and type of substance use pattern. RESULTS: Prevalence of substance co-use among pregnant women is 5.1% and among non-pregnant women is 23.6%. Nearly all of the most frequent co-use patterns included alcohol, cannabis, or tobacco. Determinants of co-use among pregnant women included: younger age (18-25 years) compared to ≥ 26 years [AOR (95% CI): 1.81 (1.18, 2.80)]; and past year history of substance use [AOR 5.42 (3.59, 8.20)]. CONCLUSIONS: Co-use of several substances, including and especially of tobacco, alcohol and cannabis, persists among pregnant women in the United States. Efforts that aim to improve maternal and child health should address the complexity of substance use during pregnancy, including and beyond opioids.


Assuntos
Alcoolismo/epidemiologia , Substâncias Controladas , Complicações na Gravidez/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Uso de Tabaco/epidemiologia , Adolescente , Adulto , Alcoolismo/psicologia , Comorbidade , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Pessoa de Meia-Idade , Gravidez , Complicações na Gravidez/psicologia , Prevalência , Transtornos Relacionados ao Uso de Substâncias/psicologia , Uso de Tabaco/psicologia , Estados Unidos/epidemiologia , Adulto Jovem
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