Young adult social smokers: their co-use of tobacco and alcohol, tobacco-related attitudes, and quitting efforts.

OBJECTIVE: Young adults frequently report social smoking. This study examined the relationship between different social smoking definitions and the co-use of cigarettes and alcohol, tobacco-related attitudes, and quitting efforts. METHOD: Cross-sectional data were collected at bars using randomized time location sampling among young adults aged 21-26 in San Diego, California from 2010 to 2011 (73% response rate). Multivariable logistic regression examined if current smoking and quit attempts were associated with tobacco-related attitudes, and whether social smoking self-identification or behavior was associated with cigarette-and-alcohol co-use, tobacco-related attitudes, quit attempts, or quitline use. RESULTS: Among 537 current smokers, 80% self-identified and 49% behaved as social smokers. Social smoking self-identification was positively associated with cigarette-and-alcohol co-use, and quit attempts. Social smoking behavior was negatively associated with tobacco marketing receptivity, quit attempts, and quitline use. Tobacco-related attitudes were associated with smoking but did not generally differ by social smoking status. CONCLUSION: Identification and behavior as a social smoker have opposing associations with co-use of cigarettes and alcohol and quit attempts. Tobacco cessation programs for self-identified social smokers should address co-use. Interventions denormalizing the tobacco industry or emphasizing the health effects of temporary smoking and secondhand smoke may address smoking among young adult bar patrons regardless of social smoking status.

Multiple tobacco product use among adults in the United States: cigarettes, cigars, electronic cigarettes, hookah, smokeless tobacco, and snus.

OBJECTIVE: Noncigarette tobacco products are increasingly popular. Researchers need to understand multiple tobacco product use to assess the effects of these products on population health. We estimate national prevalence and examine risk factors for multiple product use. METHOD: We calculated prevalence estimates of current use patterns involving cigarettes, cigars, electronic cigarettes, hookah, smokeless tobacco, and snus using data from the 2012 RTI National Adult Tobacco Survey (N=3627), a random-digit-dial telephone survey of adults aged 18 and over. Associations between use patterns (exclusive single product and multiple products) and demographic characteristics were examined using Pearson chi-square tests and logistic regression. RESULTS: 32.1% of adults currently use 1 or more tobacco products; 14.9% use cigarettes exclusively, and 6.6% use one noncigarette product exclusively, 6.9% use cigarettes with another product (dual use), 1.3% use two noncigarette products, and 2.4% use three or more products (polytobacco use). Smokers who are young adult, male, never married, reside in the West, and made prior quit attempts were at risk for multiple product use. CONCLUSIONS: Over 10% of U.S. adults use multiple tobacco products. A better understanding of multiple product use involving combustible products, like cigars and hookah, is needed. Multiple product use may be associated with past quit attempts.

Youth use of electronic vapor products and blunts for administering cannabis.

BACKGROUND: The positive association between youth use of cannabis and tobacco is well-established, and reports show that some youth are using electronic vapor products (EVPs) to administer cannabis. This study examines the prevalence and correlates of youth consumption of cannabis via EVP and how this compares with co-use of cannabis with cigars (blunts) among a large statewide sample of youth. METHODS: We used data from the Florida Youth Tobacco Survey (FYTS), a school-based, pencil-and-paper questionnaire given to Florida middle and high school students (N=12,320). We conducted weighted descriptive analyses and logistic regressions examining prevalence and correlates of EVP/cannabis and blunt use. RESULTS: Ever EVP/cannabis use was lower among middle school students (3.4%) than high school students (11.5%). Blunt use was reported by 6.0% of middle school and 24.1% of high school students. Approximately one-third of youth who had ever administered cannabis via either mode reported using both EVP/cannabis and blunts. EVP/cannabis and blunt use were both associated with lower school performance and use of other tobacco products. EVP/cannabis use did not vary by race/ethnicity, but blunt use was higher among black and Hispanic youth than white, non-Hispanic youth. DISCUSSION: A substantial percentage of youth in a statewide sample are using EVPs and blunts to administer cannabis, and overlap between these use patterns is common. Differences in the demographic risk profile for EVP/cannabis and blunt use suggest that EVPs may provide a novel route of administration for delivering cannabis that appeals to groups not otherwise susceptible to using cannabis via blunts.

Delivery of nicotine aerosol to mice via a modified electronic cigarette device.

BACKGROUND: Although both men and women use e-cigarettes, most preclinical nicotine research has focused on its effects in male rodents following injection. The goals of the present study were to develop an effective e-cigarette nicotine delivery system, to compare results to those obtained after subcutaneous (s.c.) injection, and to examine sex differences in the model. METHODS: Hypothermia and locomotor suppression were assessed following aerosol exposure or s.c. injection with nicotine in female and male mice. Subsequently, plasma and brain concentrations of nicotine and cotinine were measured. RESULTS: Passive exposure to nicotine aerosol produced concentration-dependent and mecamylamine reversible hypothermic and locomotor suppressant effects in female and male mice, as did s.c. nicotine injection. In plasma and brain, nicotine and cotinine concentrations showed dose/concentration-dependent increases in both sexes following each route of administration. Sex differences in nicotine-induced hypothermia were dependent upon route of administration, with females showing greater hypothermia following aerosol exposure and males showing greater hypothermia following injection. In contrast, when they occurred, sex differences in nicotine and cotinine levels in brain and plasma consistently showed greater concentrations in females than males, regardless of route of administration. DISCUSSION: In summary, the e-cigarette exposure device described herein was used successfully to deliver pharmacologically active doses of nicotine to female and male mice. Further, plasma nicotine concentrations following exposure were similar to those after s.c. injection with nicotine and within the range observed in human smokers. Future research on vaped products can be strengthened by inclusion of translationally relevant routes of administration.

A Randomized Trial of the Effect of E-cigarette TV Advertisements on Intentions to Use E-cigarettes.

INTRODUCTION: Adolescents' use of electronic cigarettes (e-cigarettes) and exposure to e-cigarette TV advertising have increased in recent years, despite questions about their safety. The current study tests whether exposure to e-cigarette TV advertisements influences intentions to use e-cigarettes in the future and related attitudes. METHODS: A parallel-group randomized controlled experiment was conducted and analyzed in 2014 using an online survey with a convenience sample of 3,655 U.S. adolescents aged 13-17 years who had never tried e-cigarettes. Adolescents in the treatment group viewed four e-cigarette TV advertisements. RESULTS: Adolescents in the treatment group reported a greater likelihood of future e-cigarette use compared with the control group. ORs for the treatment group were 1.54 (p=0.001) for trying an e-cigarette soon; 1.43 (p=0.003) for trying an e-cigarette within the next year; and 1.29 (p=0.02) for trying an e-cigarette if a best friend offered one. Adolescents in the treatment group had higher odds of agreeing that e-cigarettes can be used in places where cigarettes are not allowed (OR=1.71, p<0.001); can be used without affecting those around you (OR=1.83, p<0.001); are a safer alternative to cigarettes (OR=1.19, p=0.01); and are less toxic (OR=1.16, p=0.03). CONCLUSIONS: Exposure to e-cigarette advertising had relatively large and consistent effects across experimental outcomes. Together with the simultaneous increase in e-cigarette advertising exposure and e-cigarette use among adolescents, findings suggest that e-cigarette advertising is persuading adolescents to try this novel product. This raises concerns that continued unregulated e-cigarette advertising will contribute to potential individual- and population-level harm.

Exposure to electronic cigarette television advertisements among youth and young adults.

BACKGROUND AND OBJECTIVE: Currently, the US Food and Drug Administration does not regulate electronic cigarette (e-cigarette) marketing unless it is advertised as a smoking cessation aid. To date, the extent to which youth and young adults are exposed to e-cigarette television advertisements is unknown. The objective of this study was to analyze trends in youth and young adult exposure to e-cigarette television advertisements in the United States. METHODS: Nielsen data on television household audiences' exposure to e-cigarette advertising across US markets were examined by calendar quarter, year, and sponsor. RESULTS: Youth exposure to television e-cigarette advertisements, measured by target rating points, increased 256% from 2011 to 2013. Young adult exposure increased 321% over the same period. More than 76% of all youth e-cigarette advertising exposure occurred on cable networks and was driven primarily by an advertising campaign for 1 e-cigarette brand. CONCLUSIONS: E-cigarette companies currently advertise their products to a broad audience that includes 24 million youth. The dramatic increase in youth and young adult television exposure between 2011 and 2013 was driven primarily by a large advertising campaign on national cable networks. In the absence of evidence-based public health messaging, the current e-cigarette television advertising may be promoting beliefs and behaviors that pose harm to the public health. If current trends in e-cigarette television advertising continue, awareness and use of e-cigarettes are likely to increase among youth and young adults.