Kathleen L. Egan

E-cigarette Availability and Promotion Among Retail Outlets Near College Campuses in Two Southeastern States

INTRODUCTION E-cigarettes are relatively new products that simulate the smoking experience. This descriptive study assessed changes in e-cigarette availability and promotions among retailers in 11 college communities in North Carolina and Virginia during a 1-year period. METHODS During the spring of 2012 and 2013, observers completed assessments in 320 tobacco-selling retailers, including grocery and convenience stores, pharmacies, and tobacco shops. Assessors collected e-cigarette availability, advertising, price, and promotions. RESULTS E-cigarette availability increased among retailers from 24.7% in 2012 to 59.9% in 2013. They were available in the form of disposables and reusable kits and were most frequently available in tobacco shops, convenience stores, and pharmacies. The average price for disposables was

Simultaneous use of non-medical ADHD prescription stimulants and alcohol among undergraduate students

9.70 (SD = 1.07) in 2012 and

Marijuana use trajectories and academic outcomes among college students.

9.61 (SD = 2.10) in 2013; the average price for kits was

K2 and Spice use among a cohort of college students in southeast region of the USA

39.58 (SD = 15.79) in 2012 and

From dispensed to disposed: evaluating the effectiveness of disposal programs through a comparison with prescription drug monitoring program data

32.59 (SD = 18.65) in 2013. The presence of interior advertising increased from 12.7% to 50.6% (p < .0001), and the presence of exterior advertising increased from 7.6% to 22.8% (p = .0002). Convenience stores with gas (16.4%-70.4%; p < .0001) and without gas (6.0%-48.4%; p < .0001) had significant increases in the presence of interior advertising. Convenience stores with gas also had a significant increase in the presence of exterior advertising (8.2%-33.3%; p < .0001). Only 3% of retailers offered price promotions. CONCLUSIONS Availability of e-cigarettes, including rechargeable kits and disposables, more than doubled during the study. The presence of interior and exterior advertising also significantly increased. Results underscore the need for further surveillance to understand how these environmental characteristics impact individual exposure and use of e-cigarettes.

The role of smokeless tobacco use in smoking persistence among male college students.

BACKGROUND Use of prescription stimulants used to treat Attention Deficit/Hyperactivity Disorder (ADHD) for reasons other than prescribed, known as non-medical use, is a growing problem among undergraduates. Previous studies show that non-medical prescription stimulant (NMPS) users consume more alcohol than individuals who do not use NMPS. However, research on simultaneous use of NMPS and alcohol is limited. The objectives of this study were to: (1) determine the prevalence of simultaneous use of alcohol and NMPS; (2) examine predictors and consequences of simultaneous NMPS and alcohol use among undergraduates. METHODS In fall 2009, 4090 students from eight North Carolina universities completed a web-based survey. RESULTS Past year prevalence of NMPS use among this sample was 10.6% and simultaneous use of NMPS with alcohol was 4.9%. Among NMPS users, 46.4% used NMPS simultaneously with alcohol within the past year. Multivariable analysis revealed that simultaneous NMPS and alcohol use was associated with low grade point averages, use of other substances, and increased alcohol-related consequences. Simultaneous NMPS and alcohol users reported experiencing significantly more negative consequences than either past year drinkers who did not use prescription stimulants and concurrent NMPS and alcohol users (use over the past year but not at the same time). CONCLUSIONS Simultaneous use of NMPS and alcohol is high among NMPS users in our sample of undergraduate students. Simultaneous users are at increased risk of experiencing negative consequences. Thus, prevention and intervention efforts should include a focus on simultaneous NMPS and alcohol use.

Synthetic Cannabinoid Use and Descriptive Norms among Collegiate Student-Athletes

BACKGROUND Marijuana is the most commonly used illicit drug by college students. Prior studies have established an association between marijuana use and poor academic performance in college, but research on the frequency of marijuana use over the entire college career is limited. The study objective was to examine the association of marijuana use trajectories on academic outcomes, including senior year enrollment, plans to graduate on time, and GPA. METHODS Data were collected from a cohort of 3146 students from 11 colleges in North Carolina and Virginia at six time points across the college career. Group-based trajectory models were used to characterize longitudinal marijuana use patterns during college. Associations between marijuana trajectory groups and academic outcomes were modeled using random-effects linear and logistic regressions. RESULTS Five marijuana trajectory groups were identified: non-users (69.0%), infrequent users (16.6%), decreasing users (4.7%), increasing users (5.8%), and frequent users (3.9%). Decreasing users and frequent users were more likely to drop out of college and plan to delay graduation when compared to non-users. All marijuana user groups reported lower GPAs, on average, than non-users. CONCLUSION These results identify marijuana use patterns that put students at risk for poor academic performance in college. Students who use marijuana frequently at the beginning of the college career are especially at risk for lower academic achievement than non-users, suggesting that early intervention is critical.

Availability and Placement of Electronic Nicotine Delivery Systems at the Point-of-Sale

Abstract Background: K2 and Spice consist of an herbal blend of plant matter and chemical synthetic cannabinoids. These substances emerged in the early 2000s as a popular alternative to marijuana among youth and young adults. Objectives: This study sought to identify rates and correlates of K2 and Spice at college entry and first use during college. Methods: In Fall 2010, 3146 students at 11 colleges in North Carolina and Virginia were recruited to participate in a longitudinal cohort survey. The cohort was invited to participate in a total of six surveys over their college career. Random-effects logistic regression models were used to identify factors associated with lifetime K2 and Spice use at college entry and first use during college, adjusting for clustering within schools and sample weights. Results: Weighted lifetime prevalence of K2 and Spice use at college entry was 7.6%. An additional 6.6% of students reported first use during college. By the cohort’s fourth year, 17.0% reported lifetime K2 and Spice use. While lifetime prevalence increased, past 6-month prevalence decreased substantially over time. K2 and Spice use at college entry was associated with sensation seeking; hookah, marijuana, and illicit drug use; and low religiosity. First use during college was associated with having a father with less than a four-year degree; alcohol and hookah use. Conclusion: Universities should ensure that prevention efforts address current substance use, including K2/Spice, and that treatment options are available for first year students who use substances.

Correlates of Alcohol Mixed with Energy Drink Use Among First Year College Students: Clinical and Research Implications

ABSTRACT Background: Organized disposal of controlled medications, such as take-back events and permanent drug donation boxes, is a prevention strategy that has been widely used to reduce the availability of controlled medications for diversion or abuse. However, little is known as to whether this strategy actually reduces the overall availability of these medications for the purposes of diversion or abuse. Objectives: The objective of this study was to compare the number and types of controlled medications that were disposed through organized efforts to the number dispensed in local communities. Methods: The quantity and type of controlled medication collected from three take-back events and permanent drug donation boxes over 4-week-long periods in five counties in south-central Kentucky was measured and compared to the number of controlled medications dispensed, as reported by Kentucky All Schedule Prescription Electronic Reporting system. Results: In 2013, 21,121,658 controlled medications units were dispensed in the participating counties. Of those, 46.9% were opioid analgesics, 13.1% tranquilizers, and 37.3% “other.” During the assessment periods, a total of 21,503 controlled medication units were collected. Of those, 39.9% were opioid analgesics, 2.7% tranquilizers, and 57.4% “other.” Annually, controlled medications disposed were estimated to account for 0.3% of those dispensed. Conclusion: Controlled medications collected by take-back events and permanent drug donation boxes constituted a miniscule proportion of the numbers dispensed. Our findings suggest that organized drug disposal efforts may have a minimal impact on reducing the availability of unused controlled medications at a community level.

Trends in point-of-sale tobacco marketing around college campuses:Opportunities for enhanced tobacco control efforts

Abstract Background: Significant changes in the tobacco industry have led to heightened concern about co-use of cigarettes and smokeless tobacco (SLT) products. Objectives: The aim of this study was to assess whether male cigarette smokers who also used SLT products, in the first semester of their first year of college, were more or less likely than male cigarette smokers who did not use SLT products to still be smoking by the first semester of their senior year. Methods: Using a longitudinal, observational study, we followed a cohort of undergraduate students from 11 four-year universities in North Carolina and Virginia through their college career. Mixed-effects logistic regression analysis was conducted to estimate the likelihood of being a current smoker fall of senior year for male students who used both cigarettes and SLT at baseline, compared to those who only smoked cigarettes, after adjustment for potential confounders (n = 274). Results: At baseline, 67.2% of participants were smoking cigarettes only (no SLT use) and 32.8% were dual users (cigarettes and SLT). A total of 62% were still smoking at senior year. Dual users were 30% more likely to be current smokers senior year compared to cigarette only users, although this difference was not statistically significant. Having at least one friend who smoked cigarettes and heavier cigarette smoking at baseline were significantly related to senior year smoking. Conclusions: Our findings do not support the argument that SLT use may help male college smokers discontinue their smoking habit. In fact, it may contribute to smoking persistence.