Internalizing and Externalizing Problems as Risk Factors for Initiation and Progression of E-cigarette and Combustible Cigarette Use in the US Youth Population
“…The higher prevalence of the use of electronic cigarettes among males than females has been reported in many previous studies [42][43][44][45][46]. Additionally, older adolescents in the studied groups showed higher use of e-cigarettes [42,47,48]. Vuolo et al reported a higher likelihood of using e-cigarettes among 17 years old adolescents from families with only one parent or whose parents were divorced [44].…”
Since their introduction, the use of electronic cigarettes has increased considerably in the population and among adolescents. Determinants of smoking conventional cigarettes were thoroughly studied in various social groups. However, we know less about the predictors of the use of e-cigarettes in younger generations. The main aim of this study was the assessment of the factors associated with the use of electronic cigarettes among high school students. Specifically, the roles of health literacy (HL) and health locus of control (HLC) were addressed. The analysis was based on the data from a ‘pen-and-pencil’ survey performed in a large sample of 2223 high school students from southern Poland. The tools used in the survey encompassed 133 items, including a 47-item European Health Literacy Survey questionnaire, an 18-item Multidimensional Health Locus of Control Scale, and a set of questions asking about the health behaviors, and sociodemographic and economic characteristics of respondents. In the study sample, 47.5% of the respondents had used e-cigarettes in the past, and 18.6% had used them in the last month. HL was not significantly associated with dependent variables reflecting the use of e-cigarettes. Two types of external HLC were associated with using e-cigarettes in the past, and ‘Chance’ HLC (CHLC) was also associated with their use in the last month. Males, students of schools providing vocational training, and students declaring more Internet use during the week showed a higher likelihood of ever using e-cigarettes or using them in the last month. Students smoking conventional cigarettes were also more prone to use e-cigarettes. To sum up, it was an unexpected result that HL is not associated with the use of e-cigarettes. A greater likelihood of using e-cigarettes was positively associated with higher CHLC scores, as in the case of smoking traditional cigarettes.
“…The higher prevalence of the use of electronic cigarettes among males than females has been reported in many previous studies [42][43][44][45][46]. Additionally, older adolescents in the studied groups showed higher use of e-cigarettes [42,47,48]. Vuolo et al reported a higher likelihood of using e-cigarettes among 17 years old adolescents from families with only one parent or whose parents were divorced [44].…”
Since their introduction, the use of electronic cigarettes has increased considerably in the population and among adolescents. Determinants of smoking conventional cigarettes were thoroughly studied in various social groups. However, we know less about the predictors of the use of e-cigarettes in younger generations. The main aim of this study was the assessment of the factors associated with the use of electronic cigarettes among high school students. Specifically, the roles of health literacy (HL) and health locus of control (HLC) were addressed. The analysis was based on the data from a ‘pen-and-pencil’ survey performed in a large sample of 2223 high school students from southern Poland. The tools used in the survey encompassed 133 items, including a 47-item European Health Literacy Survey questionnaire, an 18-item Multidimensional Health Locus of Control Scale, and a set of questions asking about the health behaviors, and sociodemographic and economic characteristics of respondents. In the study sample, 47.5% of the respondents had used e-cigarettes in the past, and 18.6% had used them in the last month. HL was not significantly associated with dependent variables reflecting the use of e-cigarettes. Two types of external HLC were associated with using e-cigarettes in the past, and ‘Chance’ HLC (CHLC) was also associated with their use in the last month. Males, students of schools providing vocational training, and students declaring more Internet use during the week showed a higher likelihood of ever using e-cigarettes or using them in the last month. Students smoking conventional cigarettes were also more prone to use e-cigarettes. To sum up, it was an unexpected result that HL is not associated with the use of e-cigarettes. A greater likelihood of using e-cigarettes was positively associated with higher CHLC scores, as in the case of smoking traditional cigarettes.
“…Selon les données dont on dispose, plusieurs facteurs sont associés à l'initiation à la cigarette électronique : le tabagisme (p. ex. cigares, cigarillos) et la consommation de substances [9][10][11][12] , une forte tendance à rechercher des sensations 13,14 , une mauvaise santé mentale 15,16 , l'exposition à la promotion de la cigarette électronique 9,17,18 et des attitudes positives à l'égard des cigarettes électroniques chez la personne, les amis et la famille 9,[19][20][21] . Bien que de nombreuses études aient établi une association significative entre l'initiation à la cigarette électronique et le genre, ces études n'ont pas exploré de quelle façon les facteurs prédictifs pouvaient différer selon le genre 9,10,[13][14][15]18,19…”
Introduction
Une meilleure compréhension des facteurs individuels associés à l’initiation à la cigarette électronique contribuerait à l’amélioration des mesures de prévention. Ainsi, cette étude vise à 1) relever les caractéristiques de départ associées à l’initiation à la cigarette électronique et 2) déterminer si des changements dans ces caractéristiques sont associés à l’initiation à la cigarette électronique chez les adolescents canadiens.
Méthodologie
Cette étude a utilisé les données de l’année 6 (2017-2018, année de référence) et de l’année 7 (2018-2019, année de suivi) de l’étude COMPASS. L’échantillon final comprenait 12 315 élèves de la 9e à la 11e année qui avaient déclaré ne jamais avoir essayé la cigarette électronique au cours de l’année de référence. Les renseignements fournis par les élèves portaient sur leurs caratéristiques individuelles, la consommation d’autres substances, les comportements scolaires, l’activité physique, les comportements sédentaires, les troubles du sommeil, les symptômes d’anxiété et de dépression, la régulation émotionnelle et l’épanouissement. Des modèles hiérarchiques faisant appel aux équations d’estimation généralisées (EEG), stratifiés selon le sexe, ont permis d’analyser l’association entre 1) les caractéristiques de départ et l’initiation à la cigarette électronique lors de l’année de suivi et 2) des changements dans les caractéristiques de départ et l’initiation à la cigarette électronique lors de l’année de suivi.
Résultats
Au total, 29 % des élèves qui n’avaient encore jamais essayé la cigarette électronique ont déclaré en avoir fait l’usage au moment du suivi. Les élèves de 10e et 11e année étaient proportionnellement moins nombreux à avoir essayé la cigarette électronique. La consommation d’autres substances, l’école buissonnière et le respect des directives en matière d’activité physique pendant l’année de référence ainsi que des changements vers ces comportements mesurés au moment du suivi ont été associés à l’initiation à la cigarette électronique à la fois chez les garçons et chez les filles. Certaines différences ont été observées entre les filles et les garçons.
Conclusion
Étant donné que d’autres comportements liés à la santé ont été associés à l’initiation à la cigarette électronique, les stratégies de prévention devraient cibler les combinaisons de comportements à risque pour la santé afin de prévenir l’usage de la cigarette électronique chez les jeunes. De plus, mettre en œuvre des approches en milieu scolaire au début ou pendant le premier cycle du secondaire serait certainement bénéfique.
“…In this study we explore the epidemiology of this novel epigenetic biomarker for smoke exposure in a longitudinal cohort of high-risk adolescents in Eastern Iowa. We examine a number of risk factors traditionally associated with tobacco and cannabis smoking including race ( 46 ) ethnicity ( 47 ), SES ( 48 ), parental education ( 48 ), parental supervision ( 3 , 49 ), parental smoking ( 50 ), peer use ( 51 , 52 ), significant other use ( 53 ), and both externalizing and internalizing psychopathology ( 54 – 57 ). We also examine two variables from the Prototype/Willingness Model of adolescent risk behavior that have been shown to predict non-intentional but volitional adolescent risk behaviors: perceptions of prototypical adolescent cigarette and cannabis smokers ( 58 ), and willingness, an acknowledgment that under certain circumstances, one might engage in a risk behavior that was previously not intended or sought ( 59 ).…”
Objective: Evolving patterns of nicotine and cannabis use by adolescents require new tools to understand the changing epidemiology of these substances. Here we describe the use of a novel epigenetic biomarker sensitive to both tobacco and cannabis smoke in a longitudinal sample of high-risk adolescents. We examine risk factors for positivity for this epigenetic biomarker in comparison to positivity for conventional serum biomarkers of nicotine and cannabis use.Method: Eastern Iowa 10th graders who had a friend or family member who smoked were eligible to participate in a longitudinal study over 10–12th grades. Subjects provided self-report data on nicotine, tobacco, and cannabis use patterns as well as blood samples that were used for serum cotinine and THC assays. DNA was prepared for analysis of methylation at the CpG cg05575921, a sensitive indicator of smoke exposure. Relationships between positivity for each these biomarkers and a variety of risk factors, including demographics, family and peer relationships, psychopathology, willingness to smoke, and perceptions of typical cigarette and cannabis users, were examined at the 10th (n = 442), 11th (n = 376), and 12th (n = 366) grade timepoints.Results: A increasing proportion of subjects were positive for cotinine (5–16%), THC (3–10%), and cg05575921 methylation (5–7%) across timepoints, with some overlap. Self-reported combusted tobacco and cannabis use was strongly correlated with all biomarkers, whereas cg05575921 methylation was not correlated with reported e-cigarette use. Dual users, defined as those positive for nicotine and THC in the 12th grade showed the greatest cumulative smoke exposure, indicated by cg05575921 methylation. Subjects reported more positive attitudes toward cannabis users than cigarette smokers, and willingness to smoke and positive perceptions of tobacco and cannabis smokers were significant risk factors for biomarker positivity across timepoints.Conclusion: We conclude that measurement of cg05575921 methylation in adolescents is a useful tool in detecting tobacco smoking in adolescents, and may be a novel tool for the detection of cannabis smoking and cannabis and tobacco co-use, though non-combusted forms of nicotine use do not appear to be detectable by this method.
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