Dale S. Mantey

E-Cigarette Marketing Exposure Is Associated With E-Cigarette Use Among US Youth

PURPOSE E-cigarettes are currently the most commonly used tobacco product among US youth. However, unlike conventional cigarettes, e-cigarettes are not subject to marketing restrictions. This study investigates the association between exposure to e-cigarette marketing and susceptibility and use of e-cigarettes in youth. METHODS Data were obtained from the 2014 National Youth Tobacco Survey. Participants were 22,007 US middle and high school students. Multivariate logistic regression models assessed the relationship between e-cigarette marketing (internet, print, retail, and TV/movies) and current and ever use as well as susceptibility to use e-cigarettes among never e-cigarette users. RESULTS Exposure to each type of e-cigarette marketing was significantly associated with increased likelihood of ever and current use of e-cigarettes among middle and high school students. Exposure was also associated with susceptibility to use of e-cigarettes among current nonusers. In multivariate models, as the number of channels of e-cigarette marketing exposure increased, the likelihood of use and susceptibility also increased. CONCLUSIONS Findings highlight the significant associations between e-cigarette marketing and e-cigarette use among youth and the need for longitudinal research on these relationships.

Correlates of Blunt Smoking Among African American, Hispanic/Latino, and White Adults: Results From the 2014 National Survey on Drug Use and Health

ABSTRACT Background: Blunt use is highly prevalent in the United States and has been associated with several negative health consequences, such as an increased risk for cardiovascular and pulmonary diseases. Although recent studies have identified characteristics (e.g., gender) that are associated with blunt use, it is unclear if these factors correlate with blunt use equally across racial/ethnic groups. Methods: Using cross-sectional data from the 2014 National Survey on Drug Use and Health, this study aimed to determine if demographic, health and substance use correlates of current (i.e., past 30-day) and lifetime blunt use were similar across 37,628 non-Hispanic African American, Hispanic/Latino and non-Hispanic White adults. Results: Findings revealed 8.3% of African American, 3.3% of Hispanic/Latino and 2.5% of White adults reported current blunt smoking. Across all racial/ethnic groups, age and current and lifetime cigarette and illicit drug use were associated with current and lifetime blunt use. However, gender, educational level, income, current alcohol use and self-reported health status were differentially associated with current and lifetime blunt use across racial/ethnic groups. Employment status and lifetime depression were not associated with blunt use behaviors among any of the racial/ethnic groups. Conclusions: The relationship between gender, socioeconomic status, alcohol use and self-reported health status and blunt use differs among African American, Hispanic/Latino and White adults. Researchers and providers should consider the heterogeneity in factors that are associated with blunt use when designing prevention and treatment interventions for African American, Hispanic/Latino and White adult blunt smokers.

Association of tobacco advertising, promotion and sponsorship (TAPS) exposure and cigarette use among Nigerian adolescents: implications for current practices, products and policies

Background This study investigates the association between exposure to tobacco advertising, promotion and sponsorship (TAPS) and cigarette use behaviours among adolescents in five Nigerian regions. This is imperative given a 2015 WHO report on the global tobacco epidemic, revealing Nigeria has not met any of the MPOWER TAPS ban indicators instituted since 2008. Methods Secondary data analysis of the 2008 Global Youth Tobacco Survey for Nigeria. Participants were 1399 adolescents, representative of 5 Nigerian regions. Weighted multivariable logistic regression models were used to assess the relationship between TAPS exposure and (1) past 30-day (current) cigarette use, (2) ever cigarette use and (3) susceptibility to use cigarettes among never cigarette users. Sensitivity analysis via complete case analysis and multiple imputation were conducted. Results Ninety-five per cent of Nigerian adolescents reported exposure to TAPS. Among adolescents who had never smoked, 15% were susceptible to use cigarettes. Cumulative TAPS exposure was significantly associated with both an increased odds of current cigarette use (AOR: 1.73; 95% CI 1.09 to2.99) and ever cigarette use (AOR: 1.29; 95% CI 1.15 to1.45); as well as increased susceptibility to cigarette smoking (AOR: 1.18; 95% CI 1.03 to 1.34), among non-smokers. Conclusion Given study results, the emergence of new tobacco products and novel platforms for TAPS globally, implementation of existing policies and enhancement of efforts to attain comprehensive bans on all forms of direct and indirect TAPS in line with article 13 of the WHO Framework Convention on Tobacco Control are needed to reduce TAPS exposure and curtail tobacco use in Nigeria.

E-cigarette use and cigarette smoking cessation among Texas college students

OBJECTIVES We examined the relationships between e-cigarette use and subsequent cigarette smoking behaviors at 6- and 12-month follow-ups among young adults. METHODS Participants were 18-29 year-old current and former cigarette smokers (N = 627) at 24 Texas colleges, participating in a 3-wave study. Multi-level, multivariable logistic regression models, accounting for school clustering, examined the impact of self-reported use of e-cigarettes on cigarette smoking status at 6- and 12-month follow-ups. Two mutually-exclusive groups of e-cigarette users were examined: those that used for cigarette smoking cessation and those that used for reasons other than cessation. Baseline covariates included socio-demographics, past quit attempts, nicotine dependence, cigarettes per day, and other tobacco use. RESULTS Use of e-cigarettes for cigarette smoking cessation was associated with increased odds of cigarette smoking cessation at 6- and 12-month follow-ups, while using e-cigarettes for other reasons was not, when adjusting for covariates. CONCLUSIONS Use of e-cigarettes for cigarette smoking cessation may reduce cigarette smoking rates in young adult college students. Additional research is needed examining e-cigarettes as a complement to evidence-based cessation resources that are associated with cigarette smoking cessation among young adults.

Victims of Bullying and Tobacco Use Behaviors in Adolescents: Differences between Bullied at School, Electronically, or Both.

BACKGROUND Being a victim of bullying is associated with greater risk of youth substance use; however, research specifically examining whether tobacco use behaviors differ among adolescents who were bullied at school only, electronically only, or both at school and electronically is limited. METHODS We examined the associations between being a victim of bullying (at school only, electronically only, or both at school and electronically) and use of tobacco products using data from the 2013 national Youth Risk Behavior Survey. RESULTS Girls who were bullied both at school and electronically reported the highest odds of all tobacco use behaviors (ever use of cigarettes, current use of cigarettes, and current use of any tobacco product) as compared with girls who were not bullied after adjusting for covariates. Conversely, for boys, only the association between being bullied electronically only and ever use of cigarettes remained significant after adjusting for covariates. CONCLUSIONS Results from this study indicate that electronic bullying may differentially influence the odds of tobacco use in high school students as compared with bullying that occurs at school only. Confirmation of these findings could inform interventions to reduce both bullying and tobacco use in high school.

Prevalence and correlates of never vaccinated Nigerian children, aged 1–5 years

INTRODUCTION A unique population of Nigerian children, aged 1-5 years, never receive any of the recommended childhood vaccines. However, the characteristics of this population has not been previously described. Given Nigerias historically poor childhood immunization coverage and high child mortality rates, it was imperative we investigate the prevalence and correlates of never-vacccination among Nigerian children. METHODS We conducted secondary analysis of the 2013 Nigeria Demographic Health Survey data of Nigerian children, aged 12-59 months (n = 20,586). Weighted multivariate logistic regressions were used to examine the relationship between socio-demographic factors and never-vaccination of Nigerian children. Further regression analysis was conducted after stratifying by Northern and Southern regions. RESULTS About twenty one percent of study sample, had never been vaccinated. Over eighty percent of the never-vaccinated children in our study resided in the Northern geopolitical zones of Nigeria. Child never-vaccination was found to be significantly associated with key socio-demographic characteristics. Children born into poor households, with mothers who are unemployed and uneducation, were more likely to be never-vaccinated. Unique predictors of child never-vaccination specific to Northern Nigeria were identified. Islam (aOR: 1.56, 95% CI: 1.11-2.17) and lack of access to Television or Radio (aOR: 1.49, 95% CI: 1.22-1.81) promoted never-vaccination, while increasing maternal age and rural residence (aOR: 0.63, 95% CI: 0.42-0.95) were associated with lower odds of never-vaccination. CONCLUSION Socio-demographic factors are predictors of child never-vaccination in Nigeria. Further investigations are needed to better understand the underlying contexts that conribute to child never-vaccination in populations identified in this study. More so, it is important to examine the mechanism through which predictors that are region-speific, culminate in child never-vaccination.

Racial/Ethnic Differences in Prevalence and Correlates of Blunt Smoking among Adolescents

ABSTRACT Blunt use is pervasive among adolescents. The study uses cross-sectional data from the 2014 National Survey on Drug Use and Health to examine sociodemographic, health, and other substance use correlates of current and lifetime blunt use among 12,036 African American, White, and Hispanic/Latino adolescents. Findings revealed that 5.3% of African American, 4.3% of Hispanic/Latino, and 3.8% of White adolescents reported past-30-day blunt use. Age and substance use other than marijuana were consistent correlates of current and lifetime blunt use across all racial/ethnic groups. However, other illicit drug use and alcohol use were differentially associated with lifetime and past-30-day blunt use by race/ethnicity. Gender, family income, lifetime depression, and overall health status were not associated with lifetime or past-30-day blunt use. The link between other substance use and blunt use varies by race/ethnicity among adolescents. Future blunt use prevention and treatment interventions should consider racial/ethnic differences in the association between other substance use and blunt use among African American, White, and Hispanic/Latino adolescents.

Longitudinal predictors of cigarette use among students from 24 Texas colleges

ABSTRACT Objective: The purpose of this study is to examine differences between current and non-current cigarette users, focusing on sociodemographic factors, non-cigarette tobacco product use, parental and friend use, and alcohol and marijuana use; and to identify predictors of cigarette use sixmonths later. Participants: Participants included young adults (n = 4,296) from 24 Texas colleges, participating in a young adult cohort study, beginning in fall 2014. Methods: Mixed effects logistic regressions were conducted accounting for school-level variability. Results: Cigarette users were older, more likely to report use of non-cigarette tobacco products and peer use of cigarettes than non-current users. Wave 1 cigarette and non-cigarette tobacco product use, marijuana use and binge drinking, and peer use all uniquely predicted cigarette use at wave 2. Conclusions: Colleges need prevention programs targeting multiple tobacco products, because non-cigarette tobacco use and other risky behaviors appear to be independent risk factors for cigarette use in young adults.

Exposure to Point-of-Sale Marketing of Cigarettes and E-Cigarettes as Predictors of Smoking Cessation Behaviors

Introduction Cue-reactivity theory suggests that smoking-related visual cues such as point-of-sale (POS) marketing (eg, advertising, product displays) may undermine cessation attempts by causing an increase in nicotine cravings among users. This study examined the relationship between recall of exposure to POS marketing and subsequent cessation behaviors among young adult cigarette smokers. Methods Participants included 813, 18-29 year old (m = 21.1, SD = 2.70), current cigarette smokers attending 24 Texas colleges. Multivariable logistic regression models examined the impact of baseline self-reported exposure to cigarette and e-cigarette advertising and product displays, on using e-cigarettes for cessation and successful cigarette cessation at 6-month follow-up. Two-way interactions between product-specific advertising and between product-specific displays were examined to determine if the marketing of one product strengthened the cue reactivity of the other. Baseline covariates included sociodemographic factors, past quit attempts, intentions to quit smoking, and nicotine dependence. Results Exposure to e-cigarette displays was associated with lower odds of cigarette smoking cessation, controlling for covariates and conventional cigarette display exposure. E-cigarette advertising was positively associated with the use of e-cigarettes for cigarette cessation among participants exposed to low (ie, at least 1 SD below the mean) levels of cigarette advertising. Cigarette advertising was associated with the use of e-cigarettes for cigarette cessation only among those exposed to low levels of e-cigarette advertising. Exposure to cigarette displays was not associated with either outcome. Conclusion Smoking-related cues at POS may undermine successful cigarette cessation. Exposure to product displays decrease odds of cessation. Advertising exposure increased odds for using e-cigarettes for cessation attempts, but may have guided smokers towards an unproven cessation aid. Implications By examining the interaction of conventional cigarette and e-cigarette marketing exposure, this study adds a unique insight into the impact of retail tobacco marketing on cigarette smoking cessation behavior among young adults. These findings suggest that policies that balance encouraging cigarette smoking cessation while limiting marketing strategies should be considered, such as POS product displays, that may undermine successful cessation attempts.