Socioeconomic status is associated with the prevalence and co-occurrence of risk factors for cigarette smoking initiation during adolescence

Wellman, Robert J.; Sylvestre, Marie‐Pierre; O’Loughlin, Erin K.; Dutczak, Hartley; Montreuil, Annie; Datta, Geetanjali D.; O’Loughlin, Jennifer

doi:10.1007/s00038-017-1051-9

Cited by 33 publications

(20 citation statements)

References 34 publications

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“…The interesting point of our study results was that a lower perceived economic status was associated with higher numbers of ever having used e-cigarettes and HNB tobacco products. Socioeconomic status has been widely known as an important determinant of cigarette smoking in adolescents, in that higher rates of conventional cigarette use are associated with lower SES [42–44]. Research has focused on the link between SES and e-cigarette use; however, the evidence is inconsistent [45–48].…”

Section: Discussionmentioning

confidence: 99%

Association of alcohol and drug use with use of electronic cigarettes and heat-not-burn tobacco products among Korean adolescents

Lee

2019

PLoS ONE

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Background The tobacco industry has aggressively introduced new and diverse products in the market, including electronic cigarettes (e-cigarettes) and heat-not-burn (HNB) tobacco products, to which adolescents are readily susceptible. Conventional cigarettes have a well-established relationship with adolescent risky behaviors such as alcohol and drug use; however, no studies exist on the association between alcohol consumption and use of e-cigarettes or HNB tobacco products among Korean adolescents. This study evaluated alcohol-related behaviors and drug use in relation to whether a Korean nationally representative adolescent sample had ever used e-cigarettes and HNB tobacco products. Methods Data from the 2018 Korean Youth Risk Behavior Web-based Survey were analyzed. The final study sample comprised 60,040 adolescents. Chi-square and logistic regression were used to examine whether the ever having used e-cigarettes and HNB tobacco products was associated with alcohol-related behaviors and drug use. P-values for trends were calculated to examine the dose-response relationship for each variable. Results Respondents with higher drinking frequency, drinking quantity, alcohol intoxication, alcohol availability, and drug use were more likely to report having used e-cigarettes and HNB tobacco products, thus implying a significant relationship between substance use and novel tobacco product (P < .001). Conclusions Our findings suggest that at-risk adolescents who are engaged in other forms of risk-taking behaviors are prone to attract the experimentation with e-cigarettes or HNB tobacco products. Thus, smoking cessation programs related to substance use should be implemented, and there is an urgent need to monitor and regulate these products effectively.

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Section: Discussionmentioning

confidence: 99%

Association of alcohol and drug use with use of electronic cigarettes and heat-not-burn tobacco products among Korean adolescents

Lee

2019

PLoS ONE

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“…However, given that the relationship between e-cigarettes and other tobacco products might be bidirectional (i.e. no specific order is required) and can be attributed to other factors beyond nicotine (detailed later) such as socioeconomic background (Wellman et al 2018), the common liability theory (i.e. common risk factors are shared between e-cigarette and other tobacco use that would lead to switching between them in a non-specific order) might be a good fit to describe the observed association (Vanyukov et al 2012; Mayet et al 2016; Van Leeuwen et al 2011).…”

Section: Discussionmentioning

confidence: 99%

“…Using e-cigarettes at home was included to control for parents’ (or other household members’) influence and accessibility of e-cigarettes. The included covariates are known risk factors for tobacco use among adolescents (Wellman et al 2018; Veeranki et al 2017; Cardenas et al 2015; Tyas and Pederson 1998), which were collected in the NYTS 2014 and 2015. Missing data accounted for < 5% and were excluded from the analysis, consistent with other published research from the same survey (Dutra and Glantz 2014).…”

Section: Methodsmentioning

confidence: 99%

E-cigarette use is associated with other tobacco use among US adolescents

Auf

Trepka

Selim

et al. 2018

Int J Public Health

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Objectives To examine whether tobacco initiation via e-cigarettes increases the likelihood of subsequent tobacco use among a large representative sample of US adolescents. Methods This study is a retrospective longitudinal analysis from a representative sample of US middle and high school students (n = 39,718) who completed the 2014 and 2015 National Youth Tobacco Survey. The adjusted odds ratios of lifetime and current use of tobacco use were estimated by logistic regression analysis while controlling for important socioecological factors associated with tobacco use. Results E-cigarette initiators were more likely to report current use of cigarettes (AOR 2.7; 1.9–4.0, p < 0.001), cigars (AOR 1.7; 1.2–2.4, p < 0.01), or smokeless tobacco (AOR 3.1; 2.2–5.4, p < 0.001), and lifetime use of the same products as well. Also, lifetime and current use of e-cigarettes significantly increased the likelihood of cigarettes, cigars, and smokeless tobacco use. Conclusions Initiation of tobacco via e-cigarette, lifetime, and current use of e-cigarettes are associated with higher odds of lifetime and current use of cigarettes, cigars, and smokeless tobacco. Collectively this suggests e-cigarettes may lead to an increased use of tobacco among adolescents.

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“…While it is common to speak of smoking prevalence as being particularly high in certain vulnerable populations (e.g., those with mental illness or other substance use disorders) these findings illustrate how those rates inevitably involve the presence of other co-occurring risk factors. The present research focuses exclusively on current smoking among adults but recent research demonstrates a similar pattern for smoking initiation among adolescents (Wellman et al 2018). Indeed, while in this commentary we focus on current smoking, this approach would be complimented by examinations of uptake and cessation and use of longitudinal data.…”

Section: Discussionmentioning

confidence: 99%

Understanding individual differences in vulnerability to cigarette smoking is enhanced by attention to the intersection of common risk factors

Gaalema

Leventhal

Priest

et al. 2018

Preventive Medicine

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While smoking prevalence in the U.S. and other industrialized countries has decreased substantially, this change has been unevenly distributed, with dramatic decreases in certain subpopulations but little change or even increases in others. Accordingly, considerable attention has been fruitfully devoted to identifying important risk factors for smoking (e.g., mental illness, other substance use disorders). However, there has been little research on the intersection of these risk factors. As risk factors rarely occur in isolation, it is important to examine risk-factor profiles as is commonly done in studying other chronic conditions (e.g., cardiovascular disease). The purpose of this Commentary is to encourage greater interest in the intersection of multiple risk factors using cigarette smoking as an exemplar. We focus on the intersection of eight well-established risk factors for smoking (age, gender, race/ethnicity, educational attainment, poverty, drug abuse/dependence, alcohol abuse/dependence, mental illness). Studying the intersection of risk factors is likely to require use of innovative data-analytic methods. We illustrate, using years 2011-2016 of the US National Household Survey on Drug Use and Health, how Classification and Regression Tree (CART) analysis can be an effective tool for identifying risk profiles for smoking. Examination of the intersection of these risk factors elucidates a series of risk profiles with associated, orderly gradations in vulnerability to current smoking, including the striking and reliable strength of a college education as a stand-alone profile predicting low risk for current smoking, and illustrating the potentially increasing importance of drug abuse/dependence as a risk factor.

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Socioeconomic status is associated with the prevalence and co-occurrence of risk factors for cigarette smoking initiation during adolescence

Abstract: Tobacco control efforts must address the higher prevalence and co-occurrence of risk factors in lower SES contexts since these may render initiation highly probable in many lower SES youth.

Cited by 33 publications

References 34 publications

Association of alcohol and drug use with use of electronic cigarettes and heat-not-burn tobacco products among Korean adolescents

Association of alcohol and drug use with use of electronic cigarettes and heat-not-burn tobacco products among Korean adolescents

E-cigarette use is associated with other tobacco use among US adolescents

Understanding individual differences in vulnerability to cigarette smoking is enhanced by attention to the intersection of common risk factors

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