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Electronic cigarettes (e-cigarette) use is rapidly increasing in the U.S., especially among adolescents. A significant number of adolescents use both cigarettes and e-cigarettes, often referred to as dual use. We used a new classification of dual use, taking into account the frequency of use of both products. In addition, we examined the association between dual use with time to first cigarette after waking (a nicotine dependence measure) and quit intention. Methods: Data were drawn from the 2015e2018 National Youth Tobacco Survey. We grouped participants by dual use frequency. Multivariable logistic regression was used to examine the association of dual use frequency with nicotine dependence and quit intention. Results: Different categories of dual users varied in demographic characteristics and beliefs on the harms of cigarette smoking and e-cigarette use. Compared with cigarette-only smokers, significantly higher odds of nicotine dependence were found for high-frequency e-cigarette dual users (within 5 minutes of awakening, odds ratio [OR]: 1.67, 95% confidence interval [CI], 1.07e2.62; within 30 minutes, OR: 1.61, 95% CI, 1.15e2.27), high-frequency cigarette dual users (5 minutes, OR: 2.85, 95% CI, 1.76e4.63; within 30 minutes, OR: 4.14, 95% CI, 2.96e5.80), and high-frequency dual users (5 minutes, OR: 4.46, 95% CI, 2.88e6.91; 30 minutes, OR: 3.94, 95% CI, 2.43e6.42). In addition, high-frequency e-cigarette dual users had significantly lower quit intention compared with both cigarette-only smokers and low-frequency dual users. Conclusions: Findings highlight the need for a standard, granulated classification of dual user, as important characteristics may vary between different categories. Future studies on dual use should consider categorizing dual use into the four classifications described in this study.

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There is evidence that sexual minority populations have a potentially heightened risk of poor health outcomes due in part to the discrimination they may face. In the present study, we examined whether overweightness and obesity vary by sexual minority subgroup using a large, nationally representative sample. Data were drawn from 2014–2017 Behavioral Risk Factor Surveillance System (BRFSS) surveys (n = 716,609). We grouped participants according to sexual identity (straight, lesbian or gay, bisexual, and other/don’t know/not sure). The propensity score matching technique was used to address covariate imbalance among sexual identity groups. In addition, subgroup analyses were performed for both males and females. Compared to straight adults, lesbian females had significantly higher odds of being overweight (OR (odds ratio) 1.33; 95% CI (confidence interval) 1.17–1.53), whereas gay males had significantly lower odds (OR 0.66; 95% CI 0.59–0.73). Similarly, lesbians were more likely to be obese (OR 1.49; 95% CI 1.31–1.70), whereas gay men had significantly lower odds of obesity (OR 0.77; 95% CI 0.69–0.86) when compared to straight adults. Bisexual females had significantly higher odds of being overweight (OR 1.21; 95% CI 1.10–1.34) and obese (OR 1.43; 95% CI 1.29–1.59), whereas bisexual males showed no significant difference. Our results strengthen previous findings and further highlight the need for research by sexual minority subgroup.

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Background: Alcohol misuse is one of the leading causes of preventable death in the United States each year. Objectives: In the present study, we examine trends in binge and heavy drinking. We used data from the 2011–2017 Behavioral Risk Factor Surveillance System. For trend analyses, we used logistic regression for heavy drinking and binge drinking variables. Joinpoint model analysis was conducted to identify where significant changes in trend occurred. Results: The trend analysis indicated that the overall prevalence of binge drinking decreased significantly from 18.3% in 2011 to 16.0% in 2014, then increased significantly to 17.0% in 2017. This trend was also found for heavy drinking, with a significant decrease from 6.6% in 2011 to 5.8% in 2014, then increased significantly to 6.2% in 2017. This trend persisted for certain subgroups; males, females, White participants, and the 35–54 age group all had a similar decrease in prevalence followed by an increase from 2014–2017. Conclusions: Overall, our results indicate a recent significant increase in both binge and heavy drinking among the general population.

BACKGROUND Bullying has been associated with several adverse health outcomes, including substance use. However, little is known about the association between bullying and e‐cigarette use. This study examined the association between bully victimization and the frequency of e‐cigarette use. METHODS Data from the 2016‐2017 Canadian Student Tobacco, Alcohol and Drugs Survey were used (N = 49,543). The target population consists of Canadian students enrolled in grades 7‐12. Multivariable logistic regression models were used to examine the association between bullying victimization status and e‐cigarette use. RESULTS Among the students included in the study, 14.1% were bullied less than once a week. Bullying victimization was statistically significantly associated with higher odds of any e‐cigarette use in the last 30 days. Likewise, those bullied daily or almost daily were more likely to use e‐cigarettes more frequently compared to students not bullied. We found a statistically significant difference in analysis stratified by sex, with female bullying victims having higher odds of all measures of e‐cigarette use. CONCLUSIONS Bullying victims were significantly more likely to use an e‐cigarette, and findings appeared to vary by sex. Female bullying victims had a higher likelihood of e‐cigarette use.