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Tobacco Use in Adolescents and Youth

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (30 September 2024) | Viewed by 35671

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Dr. Uma S. Nair

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Guest Editor

College of Nursing, University of South Florida, Tampa, FL 33612, USA
Interests: health equity; nicotine and tobacco treatment interventions; health promotion; sexual and gender diverse populations; social determinants of health

Special Issue Information

Dear Colleagues,

Tobacco use remains the leading preventable cause of morbidity and mortality globally. Despite significant strides in tobacco control efforts, the use of tobacco products by adolescents and youth continues to rise. In 2021 alone, 34% of high school students said they had ever tried a tobacco product and 14.6% reported trying two or more tobacco products. This is alarming given that dual and poly users are at a higher risk for developing nicotine dependence than those who use a single product and are more likely to continue tobacco use in adulthood. The explosion of e-cigarettes and vaping devices has further complicated the tobacco use and cessation landscape. For almost 10 years, e-cigarettes have been the most used tobacco product among youth. This is of particular concern since the potentially harmful consequences of e-cigarette use in this population have been highlighted by many organizations, including the American Academy of Pediatrics (AAP) and the United States Centers for Disease Control and Prevention (CDC). Some of these include the downstream initiation of tobacco or other substance use, nicotine dependence and its adverse effects on the developing brain, and impaired lung function due to chemicals and flavorings in e-cigarette liquids. Thus, it is imperative that there are focused efforts to reduce the initiation of tobacco use while developing evidence-based behavioral interventions for tobacco treatment in adolescents and youth. The disproportionate rate of tobacco use within specific sub-populations needs special attention. For instance, due to factors related to minority stress, discrimination, victimization, and targeted marketing by the tobacco industry, cigarette smoking among lesbian, gay, bisexual, transgender, queer (LGBTQ +) youth is alarmingly high and there is great a disparity when compared to the non-LGBTQ + population. Patterns of tobacco use also vary by race. While emerging studies have supported racial disparities in cigarette use, less is known about dual and poly tobacco use across racial and ethnic groups. There is also a distinct absence of the application of an intersectional lens to examine factors related to tobacco use in adolescents and youth. A better understanding of these factors can provide empirical evidence needed to develop culturally tailored and sensitive interventions for these populations. Papers addressing these topics are invited for this Special Issue.

Disclaimer: We will not accept research funded in part or full by any tobacco companies in this Special Issue. For more details, please check: https://www.mdpi.com/1660-4601/15/12/2831/htm.

Dr. Uma S. Nair
Guest Editor

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Keywords

adolesecent tobacco use
youth and tobacco use
vaping e-cigarettes
minority stress and tobacco
health equity
smokeless tobacco
cigarettes

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Published Papers (5 papers)

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Research

8 pages, 836 KiB

Open AccessArticle

Cigar-Specific Health Warnings: Attention, Recall, and Perceived Effectiveness Among Young Adult Users and Non-Users

by Elizabeth G. Klein, Anne E. Driscoll, Abigail B. Shoben, Joseph M. Macisco, Stephanie Pike Moore, Amanda J. Quisenberry and Erika S. Trapl

Int. J. Environ. Res. Public Health 2024, 21(11), 1442; https://doi.org/10.3390/ijerph21111442 - 30 Oct 2024

Viewed by 998

Abstract

Limited research has examined attention to these cigar-specific health warnings and their perceived effectiveness among young people. The objective of our study was to evaluate the attention to and perceptions of a set of cigar-specific health warnings among young adult tobacco users and non-users. Methods: Young adults ages 18–24 in Columbus, Ohio, were recruited into an eye-tracking experiment examining cigarillo packaging between May 2022 and February 2023. Participants (n = 124) were shown 12 unique, branded cigarillo packages featuring a rotation of four of the Food and Drug Administration’s mandated health warnings: (1) Cigar smoking can cause lung cancer and heart disease (“disease”); (2) tobacco smoke increases the risk of lung cancer and heart disease, even in nonsmokers (“nonsmokers”); (3) cigar smoking can cause cancers of the mouth and throat, even if you do not inhale (“inhale”); and (4) cigars are not a safe alternative to cigarettes (“alternative”). Software captured visual attention to each product package, including the health warning. Participants also ranked the most effective message to motivate people to quit; one week later, the participants (n = 118) self-reported unaided recall of the experiment. Results: Study participants were an average of 21.2 years old, 54.2% were female, 73.7% were White, 65.3% had some college education, and 26.3% reported tobacco use in the previous month. The health warning, “Cigar smoking can cause cancers of the mouth and throat, even if you do not inhale” was ranked the most effective cigar warning (41.5%) and drew the greatest proportion of visual attention (26.1%). More than half (52.5%) recalled details regarding the health warning messages one week following the experiment, with few recalling (17.7%) specific warning message themes. Conclusions: Understanding the best performing health warnings is a crucial strategy to share accurate information on the risks of tobacco use. Our findings suggest that the warning on cancer risk even without inhaling drew the greatest visual attention and highest rating of perceived effectiveness among this sample of young adult cigarillo users and non-users. Full article

(This article belongs to the Special Issue Tobacco Use in Adolescents and Youth)

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16 pages, 623 KiB

Open AccessArticle

Exploring Youths’ Offers to Use E-Cigarettes in Rural Hawai‘i: A Test Development and Validation Study

by Scott K. Okamoto, Andrew M. Subica, Kelsie H. Okamura, Katlyn J. An, Sarah D. Song, Paula Angela Saladino, Adabelle B. Carson, Zarek K. Kon, Sarah Momilani Marshall, Steven Keone Chin, Joseph Keawe‘aimoku Kaholokula, Ian Pagano and Pallav Pokhrel

Int. J. Environ. Res. Public Health 2024, 21(11), 1427; https://doi.org/10.3390/ijerph21111427 - 28 Oct 2024

Viewed by 1025

Abstract

The purpose of this study is to describe the development and initial validation of a survey focused on problematic situations involving e-cigarette use by rural Native Hawaiian and Pacific Islander (NHPI) youths. A 5-phase approach to test development and validation was used. In Phase 1 (Item Generation), survey items were created from a series of focus groups with middle school youths on Hawai‘i Island (N = 69). In Phase 2 (Item Refinement and Selection), situational items were reduced to 40 e-cigarette offer situations that were selected for inclusion in the survey. In Phase 3 (Item Reduction), items were administered to 257 youths from 11 middle, intermediate, or multi-level public or public-charter schools on Hawai‘i Island. Exploratory factor analysis indicated the presence of three factors accounting for 50% of the variance: E-Cigarette Offers from Friends (24%), E-Cigarette Offers from Non-Friends (16%), and Coercive Pressure to Use E-Cigarettes (10%). Hypothesized relationships between offer situations and e-cigarette use were partially confirmed, supporting the construct validity of the survey. This survey helps to fill the scientific and practice gap in measuring ecodevelopmental risk and protection for e-cigarette use and has implications for e-cigarette use prevention with rural, NHPI, and/or Indigenous youth populations. Full article

(This article belongs to the Special Issue Tobacco Use in Adolescents and Youth)

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10 pages, 288 KiB

Open AccessArticle

Health Risks Associated with Adopting New-Generation Disposable Products Among Young Adults Who Use E-Cigarettes

by Shuyao Ran, James J. Yang, Megan E. Piper, Hsien-Chang Lin and Anne Buu

Int. J. Environ. Res. Public Health 2024, 21(10), 1375; https://doi.org/10.3390/ijerph21101375 - 18 Oct 2024

Cited by 1 | Viewed by 1619

Abstract

New-generation disposable e-cigarettes have become increasingly popular among young adults in the USA since the FDA’s partial flavor ban. This study aims to examine longitudinal changes in health risks among young adults who adopted these novel products, as well as the health effects of device types beyond the effects of other important e-cigarette characteristics. This study recruited e-cigarette users via voluntary response sampling from three college campuses in the USA to respond to four-wave online surveys conducted in four consecutive semesters. Among the participants who adopted disposables during the study, their health risks (dependence symptoms, respiratory symptoms, combustible tobacco use) and e-cigarette consumption characteristics (use frequency, nicotine concentration and flavors) before and after the adoption were compared using paired-sample t- or McNemar’s tests. Generalized linear mixed models with a random intercept were conducted on data from the entire sample to investigate the effects of device type (tank, cartridge/pod, disposable) on health risks, controlling for other e-cigarette consumption characteristics. The study sample of 650 e-cigarette users were, on average, 20 years old, with 49% being male, 70% being White, and 13% being Hispanic. Adopting disposables may increase secondary dependence motives (t = 2.42, p < 0.05) and the use of higher levels of nicotine concentration (t = 2.09, p < 0.05) and sweet flavors (x² = 22.53, p < 0.05) but decrease the number of times of vaping per day (t = −2.18, p < 0.05) and the use of menthol flavors (x² = 4.57, p < 0.05). Tank use is associated with a higher level of primary dependence motives (b = 0.1998, p < 0.05) and a greater odds of using combustible tobacco (b = 0.4772, p < 0.05). Although disposable use is not associated with the likelihood of using combustible tobacco, it is associated with higher levels of both primary (b = 0.2158, p < 0.05) and secondary (b = 0.2533, p < 0.05) dependence motives. It is not the device type, but rather the frequency of vaping, that affects respiratory symptoms (b = 0.0602, p < 0.05). The findings indicate that when young adults switch to disposables, their e-cigarette dependence and use of sweet-flavored e-liquids increase. Even after controlling for use frequency, nicotine concentration and flavors, using disposables is related to not only instrumental motives that are influenced by psychological and environmental contexts but also heavy, automatic use that can operate without environmental cues. Given the health risks associated with disposable e-cigarettes, more comprehensive tobacco product regulations that consider the impact of device types may be needed. Full article

(This article belongs to the Special Issue Tobacco Use in Adolescents and Youth)

11 pages, 456 KiB

Open AccessArticle

A Randomized Clinical Trial of a Quitline Vaping Cessation Intervention: Baseline Characteristics of Young Adult Exclusive E-Cigarette Users Seeking Treatment

by Elizabeth G. Klein, Abigail B. Shoben, Kelly M. Carpenter, Kristina Mullis, Julianna M. Nemeth, Elizabeth Mayers and Katrina A. Vickerman

Int. J. Environ. Res. Public Health 2024, 21(6), 809; https://doi.org/10.3390/ijerph21060809 - 20 Jun 2024

Cited by 2 | Viewed by 2023

Abstract

Despite interest in quitting vaping among young adults (YAs), little is known about characteristics of e-cigarette (EC) users seeking treatment. In this study, YAs aged 18–24 living in the United States interested in vaping cessation treatment were recruited to complete an online survey regarding demographics and EC use. Primary eligibility criteria were EC use on at least 20 days per month (no other tobacco use), and interest in quitting in the next month. We report descriptive statistics for those who did and did not complete a mandatory coaching call (n = 981). In this sample, most EC users reported high nicotine dependence, a history of unsuccessful quit attempts (including 29.4% with previous NRT use), along with stress, anxiety, and depression. There were few meaningful differences in demographics, EC use behaviors, or behavioral health factors between those who engaged with a phone coaching call (fully enrolled in study; n = 508), and those who did not (n = 473). YAs demonstrated interest in vaping cessation support, but there were no clear characteristics for the half who did not complete a coaching call. Vaping cessation program designers should consider tailoring for the self-reported behavioral health concerns present in this population. Full article

(This article belongs to the Special Issue Tobacco Use in Adolescents and Youth)

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10 pages, 307 KiB

Open AccessArticle

Prevalence and Covariates of Electronic Cigarette Use among Students Aged 13–15 Years in the Philippines: 2019 Global Youth Tobacco Survey

by Chelsea Serra, Gibril Njie, Nerline Jacques and Liping Pan

Int. J. Environ. Res. Public Health 2023, 20(24), 7193; https://doi.org/10.3390/ijerph20247193 - 18 Dec 2023

Cited by 3 | Viewed by 29060

Abstract

Electronic cigarette use is growing in popularity and accessibility among youth in the Southeast Asia region. We analyzed data on 6670 students, aged 13–15 years, from the Philippines’ 2019 Global Youth Tobacco Survey. Prevalence estimates and 95% confidence intervals (CI) were estimated for current use (i.e., past 30 days), ever use, and awareness of e-cigarettes. Chi-square tests compared prevalence differences between groups. Multiple logistic regression models assessed factors associated with e-cigarette use while controlling for sociodemographic characteristics, current use of other tobacco products, and secondhand smoke exposure. Prevalence of current e-cigarette use was 14.1% (95% CI = 12.4%, 15.8%), ever use was 24.6% (95% CI = 22.4%, 26.9%), and awareness was 75.5% (95% CI = 73.0%, 78.0%). Current use of any other tobacco products and exposure to secondhand smoke at home, school, or other public places were positively associated with current and ever use of e-cigarettes. Boys and youth living in Luzon or Mindanao had higher odds of current e-cigarette use compared to girls and youth in Visayas. Findings indicated that one in four Philippine students aged 13–15 years ever used e-cigarettes and one in seven currently use e-cigarettes. This study highlights the importance of implementing evidence-based strategies, including relevant tobacco control policies. Full article

(This article belongs to the Special Issue Tobacco Use in Adolescents and Youth)

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