Trajectories of Nicotine and Cannabis Vaping and Polyuse From Adolescence to Young Adulthood

Abstract

IMPORTANCE Little is known about cannabis vaping trajectories across adolescence and young adulthood or the co-occurrence with nicotine vaping. OBJECTIVE To evaluate nicotine vaping and cannabis vaping trajectories from late adolescence to young adulthood (Ն18 years of age) and the extent of polysubstance vaping. DESIGN, SETTING, AND PARTICIPANTS In this prospective cohort study, 5 surveys (including information on substance vaped) were completed at 10 high schools in the Los Angeles, California, metro area. Students were surveyed at 6-month intervals from fall of 11th grade (October to December 2015; wave 5) through spring of 12th grade (March to June 2017; wave 8) and again approximately 1 to 2 years after high school (October 2018 to October 2019; wave 9). EXPOSURES Past 30-day nicotine and cannabis vaping frequency across 5 waves. MAIN OUTCOMES AND MEASURES Self-reported frequency of nicotine vaping and cannabis vaping within the past 30 days across 5 time points from late adolescence to young adulthood. Trajectories were measured with these past 30-day use frequencies at each wave. Parallel growth mixture modeling estimated conditional probabilities of polysubstance vaping. RESULTS The analytic sample included 3322 participants with at least 1 time point of data (mean [SD] age, 16.50 [0.42] years at baseline; 1777 [53.5%] female; 1573 [47.4%] Hispanic or Latino). Growth mixture modeling identified the 5-trajectory model as optimal for both nicotine vaping and cannabis vaping. Trajectories for nicotine and cannabis vaping were similar

Factors Associated with E-Cigarette Escalation among High School Students: A Review of the Literature

“…All five studies included for review were longitudinal studies and were conducted in the United States [ 14 , 15 , 16 , 17 , 18 ]. All studies included a form of measurement that investigated either increasing frequency or intensity or an increase in both, representing an escalation of e-cigarette use.…”

“…The third longitudinal study compared the trajectory of cannabis-containing e-cigarette use with the trajectory of nicotine-containing e-cigarette use among high school students [ 16 ]. Vaping frequency was assessed by the following two questions: (1) “In the last 30 days, how many total days have you used an electronic cigarette with nicotine (e-cigs, personal vaporizer, (PV))?”; and (2) “In the last 30 days, how many total days have you used an electronic device to vape THC (tetrahydrocannabinol) or hash oil (liquid pot, cannabis oil, weed pen, PAX Era (PAX Labs, Inc., San Francisco, CA, United States))?” Five trajectories were identified for nicotine e-cigarette use.…”

“…These trajectories were no use (67.6% of sample), infrequent use (17.0% of sample), moderate use (5.0% of sample), young adult-onset frequent use (6.4% of sample), and adolescent-onset escalating frequent use (3.9% of sample). Participants in the “Adolescent-Onset” group saw the average frequency of use increase from an average of 7.38 days in the past 30-days in adolescence to 21.49 days of use in young adulthood [ 16 ]. Males were shown to be at greater odds of belonging to the adolescent-onset escalating frequency trajectory when compared to females (adjusted Odds Ratio (aOR): 2.88, 95%CI: 1.03, 3.66) [ 16 ].…”

“…Participants in the “Adolescent-Onset” group saw the average frequency of use increase from an average of 7.38 days in the past 30-days in adolescence to 21.49 days of use in young adulthood [ 16 ]. Males were shown to be at greater odds of belonging to the adolescent-onset escalating frequency trajectory when compared to females (adjusted Odds Ratio (aOR): 2.88, 95%CI: 1.03, 3.66) [ 16 ].…”

“…While researchers have spent a significant amount of time studying e-cigarette initiation since the introduction of the devices, it appears as though less attention is being paid to the increase in frequency and intensity (both measures of escalation) of e-cigarette use. Frequency of e-cigarette use is typically expressed as the number of days in the last 30 days in which the participant has used an e-cigarette [ 14 , 15 , 16 , 17 , 18 ]. Intensity can be defined as the number of times a participant used their e-cigarette in a given day [ 15 ].…”