Shannon Lea Watkins

Association of Noncigarette Tobacco Product Use With Future Cigarette Smoking Among Youth in the Population Assessment of Tobacco and Health (PATH) Study, 2013-2015

Importance Approximately 90% of adult smokers first tried a cigarette by 18 years of age, and even infrequent smoking in adolescence is associated with established adult smoking. Noncigarette tobacco use is increasing and could stimulate subsequent conventional cigarette smoking in youths. Objective To estimate the longitudinal association between noncigarette tobacco use and subsequent cigarette smoking initiation among US youth. Design, Setting, and Participants In this prospective cohort study of the Population Assessment of Tobacco and Health (PATH) waves 1 (September 12, 2013, to December 14, 2014) and 2 (October 23, 2014, to October 30, 2015), a nationally representative sample of youths who never smoked a conventional cigarette at baseline and completed wave 2 follow-up (N = 10 384) was studied. PATH retention at follow-up was 87.9%. Exposures Ever use and past 30-day use of electronic cigarettes (e-cigarettes), hookah, noncigarette combustible tobacco, or smokeless tobacco at baseline. Main Outcomes and Measures Ever use and past 30-day use of cigarettes at follow-up. Results The present analysis was based on the 10 384 PATH youth respondents who reported never having smoked a cigarette in wave 1 and whose cigarette ever or past 30-day use was reported in wave 2 (mean [SD] age, 14.3 [1.7] years; age range, 12-17 years; 5087 [49.1%] female; 4829 [52.5%] white). At 1-year follow-up, 469 (4.6%) of all baseline never-smoking youths had tried a cigarette and 219 (2.1%) had smoked a cigarette within the past 30 days. Cigarette ever use at follow-up was higher among youths who had ever used e-cigarettes (78 [19.1%]), hookah (60 [18.3%]), noncigarette combustible tobacco (45 [19.2%]), or smokeless tobacco (29 [18.8%]) at baseline. After adjusting for sociodemographic, environmental, and behavioral smoking risk factors and for baseline ever use of other tobacco products, the odds of past 30-day cigarette use at follow-up were approximately twice as high among baseline ever users of e-cigarettes (odds ratio [OR], 1.87; 95% CI, 1.15-3.05), hookah (OR, 1.92; 95% CI, 1.17-3.17), noncigarette combustible tobacco (OR, 1.78; 95% CI, 1.00-3.19), and smokeless tobacco (OR, 2.07; 95% CI, 1.10-3.87). Youths who had tried more than 1 type of tobacco product at baseline had 3.81 (95% CI, 2.22-6.54) greater adjusted odds of past 30-day cigarette smoking at follow-up than did baseline never tobacco users. Conclusions and Relevance Any use of e-cigarettes, hookah, noncigarette combustible tobacco, or smokeless tobacco was independently associated with cigarette smoking 1 year later. Use of more than 1 product increased the odds of progressing to cigarette use.

Is Planting Equitable? An Examination of the Spatial Distribution of Nonprofit Urban Tree-Planting Programs by Canopy Cover, Income, Race, and Ethnicity:

This article examines the spatial distribution of tree-planting projects undertaken by four urban greening nonprofit organizations in the Midwest and Eastern United States. We use a unique data set of tree-planting locations, land use data, and socioeconomic information to predict whether a census block group (n = 3,771) was the location of a tree-planting project between 2009 and 2011. Regression results show tree-planting projects were significantly less likely to have occurred in block groups with higher tree canopy cover, higher median income, or greater percentages of African American or Hispanic residents, controlling for physical and socioeconomic conditions. In addition, when canopy cover or income was low, plantings were even less likely to have occurred in neighborhoods with high percentages of racial or ethnic minorities. Findings suggest nonprofit plantings might reduce existing income-based inequity in canopy cover, but risk creating or exacerbating race-based inequity and risk leaving low canopy minority neighborhoods with relatively few program benefits.

Electronic Cigarette Use and Progression From Experimentation to Established Smoking

Among adolescents who experimented with cigarettes, trying e-cigarettes was associated with 1.8 times higher odds of progression to established cigarette smoking in a national prospective cohort. BACKGROUND: It has been shown that never-smoking adolescents who try electronic cigarettes (e-cigarettes) are at increased risk of subsequent conventional cigarette smoking. We evaluated associations between e-cigarette use and progression to established smoking among adolescents who had already tried cigarettes. METHODS: Among participants (age 12–17 years) in the nationally representative Population Assessment of Tobacco and Health survey who had smoked a cigarette (≥1 puff) but not yet smoked 100 cigarettes (N = 1295), we examined 3 outcomes at 1-year follow-up as a function of baseline e-cigarette use: (1) having smoked ≥100 cigarettes (established smoking), (2) smoking during the past 30 days, and (3) both having smoked ≥100 cigarettes and past 30-day smoking (current established smoking). Survey-weighted multivariable logistic regression models were fitted to obtain odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for smoking risk factors. RESULTS: Versus e-cigarette never use, having ever used e-cigarettes was positively associated with progression to established cigarette smoking (19.3% vs 9.7%), past 30-day smoking (38.8% vs 26.6%), and current established smoking (15.6% vs 7.1%). In adjusted models, e-cigarette ever use positively predicted current established smoking (OR: 1.80; 95% CI: 1.04–3.12) but did not reach statistical significance (α = .05) for established smoking (OR: 1.57; 95% CI: 0.99–2.49) and past 30-day smoking (OR: 1.32; 95% CI: 0.99–1.76). CONCLUSIONS: Among adolescent cigarette experimenters, using e-cigarettes was positively and independently associated with progression to current established smoking, suggesting that e-cigarettes do not divert from, and may encourage, cigarette smoking in this population.

The relationship between urban forests and income: A meta-analysis

Urban trees provide substantial public health and public environmental benefits. However, scholarly works suggest that urban trees may be unequally distributed among poor and minority urban communities, meaning that these communities are potentially being deprived of public environmental benefits, a form of environmental injustice. The evidence of this problem is not uniform however, and evidence of inequity varies in size and significance across studies. This variation in results suggests the need for a research synthesis and meta-analysis. We employed a systematic literature search to identify original studies which examined the relationship between urban forest cover and income (n=61) and coded each effect size (n=332). We used meta-analytic techniques to estimate the average (unconditional) relationship between urban forest cover and income and to estimate the impact that methodological choices, measurement, publication characteristics, and study site characteristics had on the magnitude of that relationship. We leveraged variation in study methodology to evaluate the extent to which results were sensitive to methodological choices often debated in the geographic and environmental justice literature but not yet evaluated in environmental amenities research. We found evidence of income-based inequity in urban forest cover (unconditional mean effect size = 0.098; s.e. = .017) that was robust across most measurement and methodological strategies in original studies and results did not differ systematically with study site characteristics. Studies that controlled for spatial autocorrelation, a violation of independent errors, found evidence of substantially less urban forest inequity; future research in this area should test and correct for spatial autocorrelation.

The Relationship between Urban Forests and Income: A Meta-Analysis

Research suggests that urban trees provide substantial public health and public environmental benefits. However, scholarly works suggest that urban trees may be unequally distributed among poor and minority urban communities, meaning that these communities are potentially being deprived of public benefits; a form of environmental injustice. Findings are not uniform across studies, however. Indeed, the evidence of this problem varies in size, strength, and significance across studies. This variation in results suggests the need for a research synthesis and meta-analysis. To conduct a synthesis, we employed a systematic literature search to identify original studies which examined the relationship between urban forest cover and income (n=61) and coded each effect size (n=332). We then used meta-analytic techniques to estimate the average (unconditional) relationship between urban forest cover and income and to estimate the impact that methodological choices, measurement, publication characteristics, and study site characteristics have on the magnitude of that relationship. We leverage variation in study methodology to evaluate the extent to which results are sensitive to methodological choices often debated in the geographic and environmental justice literature but not yet evaluated in environmental amenities research. We find evidence of income-based inequity in urban forest cover that is robust to most measurement and methodological considerations and results do not differ systematically with study site characteristics. However, studies that control for spatial autocorrelation, a violation of independent errors, find evidence of substantially less urban forest inequity, suggesting that future research in this area should test and correct for spatial autocorrelation.