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Social media posts that portray vaping in positive social contexts shape people's perceptions and serve to normalize vaping. Despite restrictions on depicting or promoting controlled substances, vape-related content is easily accessible on TikTok. There is a need to understand strategies used in promoting vaping on TikTok, especially among susceptible youth audiences. This study seeks to comprehensively describe direct (ie, explicit promotional efforts) and indirect (ie, subtler strategies) themes promoting vaping on TikTok using a mixture of computational and qualitative thematic analyses of social media posts. In addition, we aim to describe how these themes might play a role in normalizing vaping behavior on TikTok for youth audiences, thereby informing public health communication and regulatory policies regarding vaping endorsements on TikTok. We collected 14,002 unique TikTok posts using 50 vape-related hashtags (eg, #vapetok and #boxmod). Using the k-means unsupervised machine learning algorithm, we identified clusters and then categorized posts qualitatively based on themes. Next, we organized all videos from the posts thematically and extracted the visual features of each theme using 3 machine learning-based model architectures: residual network (ResNet) with 50 layers (ResNet50), Visual Geometry Group model with 16 layers, and vision transformer. We chose the best-performing model, ResNet50, to thoroughly analyze the image clustering output. To assess clustering accuracy, we examined 4.01% (441/10,990) of the samples from each video cluster. Finally, we randomly selected 50 videos (5% of the total videos) from each theme, which were qualitatively coded and compared with the machine-derived classification for validation. We successfully identified 5 major themes from the TikTok posts. Vape product marketing (1160/10,990, 8.28%) reflected direct marketing, while the other 4 themes reflected indirect marketing: TikTok influencer (3775/14,002, 26.96%), general vape (2741/14,002, 19.58%), vape brands (2042/14,002, 14.58%), and vaping cessation (1272/14,002, 9.08%). The ResNet50 model successfully classified clusters based on image features, achieving an average F -score of 0.97, the highest among the 3 models. Qualitative content analyses indicated that vaping was depicted as a normal, routine part of daily life, with TikTok influencers subtly incorporating vaping into popular culture (eg, gaming, skateboarding, and tattooing) and social practices (eg, shopping sprees, driving, and grocery shopping). The results from both computational and qualitative analyses of text and visual data reveal that vaping is normalized on TikTok. Our identified themes underscore how everyday conversations, promotional content, and the influence of popular figures collectively contribute to depicting vaping as a normal and accepted aspect of daily life on TikTok. Our study provides valuable insights for regulatory policies and public health initiatives aimed at tackling the normalization of vaping on social media platforms.

The present study examined (1) intraindividual changes in the frequency of electronic nicotine delivery systems (ENDS) use across young adulthood, 18 to 30 years old, and (2) if depressive symptoms and sensation-seeking tendencies, independently and in interaction with one another, were associated with these changes. Data were from a longitudinal study of students recruited from 24 Texas colleges and followed across six waves from fall 2015 to spring 2019. Participants (n = 1298; 36.3% non-Hispanic white, 56.3% women) were 18 to 26 years old in fall 2015 and all reported past 30-day ENDS use on at least one wave. We used growth curve modeling for an accelerated longitudinal design to examine if ENDS use frequency changed with increasing age and if depressive symptoms and sensation seeking, independently and in interaction with one another, were associated with these changes. Results showed that ENDS use frequency increased with increasing age. Depressive symptoms and sensation seeking were not independently associated with more frequent ENDS use or an accelerated increase in ENDS use frequency across increasing age. However, a significant two-way interaction indicated that young adults with elevated depressive symptoms used ENDS more frequently, but only when they had higher levels of sensation seeking. Findings indicate that young adults with depressive symptoms are a heterogeneous population and that those with high levels of sensation-seeking tendencies are at elevated risk for more frequent ENDS use. Interventions for young adults high in both sensation-seeking and depressive symptoms may help prevent and decrease ENDS use.

We aimed to determine (1) the most commonly used brands of electronic vaping products (EVPs) by young adults in Texas during Spring 2023, and (2) if brand preferences differ by sociodemographic characteristics, current cigarette smoking, and current cannabis vaping. Participants were 2,491 18-25-year-olds (Mean age = 20.6; 62.9% female; 29.7% sexual gender minority; 35.9% non-Hispanic White, 45.0% Hispanic/Latino, 3.5% non-Hispanic Black, 11.6% non-Hispanic Asian, and 4.0% two or more races or another race/ethnicity) enrolled in 21 Texas colleges during February-March 2023 who used EVPs in the past 30-days. Esco Bar was the most popular EVP brand (32.5%), followed by Elf Bar (19%), Vuse (10.1%), and all other brands were used by < 10% of participants. Nearly 20% of participants reported not having a usual brand. Participants who used Esco Bar, Elf Bar, and Puff Bar were younger (i.e., 18-20 years old), female, and Hispanic/Latino. Vuse, JUUL, and Smok were used by participants who were older (i.e., 21-25 years old), male, non-Hispanic white, used EVPs daily, and currently smoked cigarettes. The present study extends prior research by providing contemporary data on young adult EVP brand preferences in Texas during Spring 2023. Many of the brands commonly used by young adults (e.g., Esco Bar, Elf Bar) are not currently authorized for marketing or sale by the Food and Drug Administration. Findings underscore a need for additional enforcement efforts that prohibit the distribution and sale of these products to, in turn, prevent EVP use among young adults.

To examine the relationship between current cigarette smoking patterns and three established risk factors for suicide using nationally representative data of high school students in the United States. We analyzed cross-sectional data from the national Youth Risk Behavior Surveillance Survey (YRBSS)-United States, 2017. Multivariable, logistic regressions examined the association between 3 cigarette smoking behaviors [i.e., past 30-day cigarette (n = 13,731), frequent (n = 1,093) and heavy (n = 880) smoking] and 3 risk factors for suicidal outcomes [feeling sad or hopeless, suicidal ideation, suicide plan] assessed over the previous year. Among high school cigarette smokers, smoking 11 or more cigarettes per day (i.e., heavy smoking) was associated with 3.43 (95% CI: 1.69, 6.94) greater odds of reporting feeling sad or hopeless, 2.97 (95% CI: 1.60, 5.51) greater odds of reporting suicidal ideations, and 2.11 (95% CI: 1.34, 3.32) greater odds of reporting having ever planned a suicide attempt, controlling for covariates. Our study shows that it is not simply cigarette smoking, but heavy cigarette smoking that is a risk factor for suicidal outcomes among adolescents. A comprehensive plan is needed to accommodate heavy adolescent smokers who are at increased suicidal risk.

The tobacco industry has a history of targeting minority communities, including Hispanic individuals, by promoting vaping through social media. This marketing increases the risk of vaping among Hispanic young adults, including college students. In Texas, college enrollment among Mexican Americans has significantly increased over recent years. However, little research exists on the link between social media and vaping and the underlying mechanisms (ie, outcome expectations, attitudes, and beliefs) explaining how vaping-related social media impacts vaping among Mexican American college students. Moreover, there is limited knowledge about how acculturation moderates the association between social media and vaping. Hispanic individuals, particularly Mexican Americans, are the largest ethnic group in Texas colleges; thus, it is crucial to understand the impact of social media and acculturation on their vaping behaviors. We outline the mixed methods used in Project Vaping, Acculturation, and Media Study (VAMoS). We present descriptive analyses of the participants enrolled in the study, highlight methodological strengths, and discuss lessons learned during the implementation of the study protocol related to recruitment and data collection and management. Project VAMoS is being conducted with Mexican American students attending 1 of 6 Texas-based colleges: University of Texas (UT) Arlington, UT Dallas, UT El Paso, UT Rio Grande Valley, UT San Antonio, and the University of Houston System. This project has 2 phases. Phase 1 included an ecological momentary assessment (EMA) study and qualitative one-on-one interviews (years 1-2), and phase 2 includes cognitive interviews and a 4-wave web-based survey study (years 2-4) with objective assessments of vaping-related social media content to which participants are exposed. Descriptive statistics summarized participants' characteristics in the EMA and web-based survey. The EMA analytic sample comprised 51 participants who were primarily female (n=37, 73%), born in the United States (n=48, 94%), of middle socioeconomic status (n=38, 75%), and aged 21 years on average (SD 1.7 years). The web-based survey cohort comprised 1492 participants self-identifying as Mexican American; Tejano, Tejana, or Tejanx; or Chicano, Chicana, or Chicanx heritage who were primarily female (n=1042, 69.8%), born in the United States (n=1366, 91.6%), of middle socioeconomic status (n=1174, 78.7%), and aged 20.1 years on average at baseline (SD 2.2 years). Of the baseline cohort, the retention rate in wave 2 was 74.7% (1114/1492). Project VAMoS is one of the first longitudinal mixed methods studies exploring the impact of social media and acculturation on vaping behaviors specifically targeting Mexican American college students. Its innovative approach to objectively measuring social media exposure and engagement related to vaping enhances the validity of self-reported data beyond what national surveys can achieve. The results can be used to develop evidence-based, culturally relevant interventions to prevent vaping among this rapidly growing minority population. DERR1-10.2196/63584.

Introduction Social media use and vaping nicotine are highly prevalent in the daily lives of young adults, especially among Mexican-American college students. The excessive and compulsive use of social media platforms, coupled with the urge to stay continuously connected, can lead to problematic social media use. To date, no studies have explored the impact of problematic social media use on the daily patterns of vaping among this vulnerable population. Methods In Spring 2023, we employed Ecological Momentary Assessment over a period of 14 days to collect real-time daily data on participants’ social media use and vaping behaviors via a mobile phone–based application. Participants were 51 Mexican-American college students aged 18–25 years, 72.5% female, who were current vapers. We used generalized linear regression models to examine differences in vaping behaviors among participants with and without problematic social media use. All regression models adjusted for age, sex, and SES. Results Participants with problematic social media use vaped on an average of 5.9 days compared to 5.7 days reported by those without problematic social media use (p < .05). Problematic social media use is associated with more frequent daily vaping [b = 0.03; 95% CI: 0.02–0.05], increased number of days vaping [b = 0.14; 95% CI: 0.07–0.20], and vaping higher nicotine concentrations [b = 0.08; 95% CI: 0.03–0.14]. Conclusion Results suggest that problematic social media use significantly increases the risk of daily vaping among Mexican-American college students. Findings highlight the need to strengthen digital resilience and social media literacy to help college students navigate and mitigate the risks of social media.

We conducted an exome-wide association study of childhood acute lymphoblastic leukemia (ALL) among Hispanics to confirm and identify novel variants associated with disease risk in this population. We used a case-parent trio study design; unlike more commonly used case-control studies, this study design is ideal for avoiding issues with population stratification bias among this at-risk ethnic group. Using 710 individuals from 323 Guatemalan and US Hispanic families, two inherited SNPs in ARID5B reached genome-wide level significance: rs10821936, RR = 2.31, 95% CI = 1.70-3.14, p = 1.7×10-8 and rs7089424, RR = 2.22, 95% CI = 1.64-3.01, p = 5.2×10-8. Similar results were observed when restricting our analyses to those with the B-ALL subtype: ARID5B rs10821936 RR = 2.22, 95% CI = 1.63-3.02, p = 9.63×10-8 and ARID5B rs7089424 RR = 2.13, 95% CI = 1.57-2.88, p = 2.81×10-7. Notably, effect sizes observed for rs7089424 and rs10821936 in our study were >20% higher than those reported among non-Hispanic white populations in previous genetic association studies. Our results confirmed the role of ARID5B in childhood ALL susceptibility among Hispanics; however, our assessment did not reveal any strong novel inherited genetic risks for acute lymphoblastic leukemia among this ethnic group.

Community health assessment and improvement planning processes (CHA/CHIP) are often challenged with developing health actions that reach across a large community, city or county and that incorporate locally informed issues and place-specific strategies. In co-learning about approaches for enhancing CHA/CHIP processes through youth stakeholder input, a partnership of academic and community leaders came together to create The Youth-Led Community Health Learning Initiative (YLCHLI), a 1-year pilot initiative aimed at identifying health needs and assets in partnership with youth leaders and two central Texas communities. To describe our approach, key findings, and lessons learned in implementing the YLCHLI in two different organizational settings: a high school-based setting and a community-based organization setting. Guided by a community advisory board and the Mobilizing for Action through Planning and Partnerships framework, the YLCHLI incorporated a mixed methods design consisting of quantitative community health indicator analysis for topics identified in the Austin/Travis County CHA followed by a youth-led qualitative assessment of selected health issues via methods that included participatory mapping, data walks, and photovoice. Youth-informed findings provided rich insights and context for understanding disparities in selected health issues, including identification of social and environmental barriers to physical activity, healthy eating, health services, and mental health, and locally informed recommendations for community health improvement. High school health science tracks and community- based organizations represent promising settings for fostering community partnerships and youth engagement in identifying local health needs and opportunities that can enhance community health improvement planning and contribute to positive youth development.

No studies have examined the longitudinal relationship between e-cigarette use and elevated depressive symptoms among young adults. The main objective of the current study was to establish a potential bi-directional relationship between e-cigarette use and elevated depressive symptoms among college students in Texas, across a 1 year period of time. A survey of 5445 college students in Texas was conducted with 6-month and 1-year follow-ups. A longitudinal cross-lagged model was used to simultaneously examine the bi-directional relationships between current, or past 30-day, e-cigarette use and elevated depressive symptoms across the three study waves. Depressive symptoms were measured using a 10-item Center for Epidemiologic Studies Depression Scale (CES-D) with a cutpoint of ≥ 10 to measure elevated depressive symptoms. Covariates included baseline age, gender, college type (2- or 4-year), and other alternative tobacco products used. E-cigarette use did not predict elevated depressive symptoms at 6-month and 1-year follow-ups. However, depressive symptoms predicted e-cigarette use at both 6-month and 1-year follow-ups. The current study indicates that depressive symptoms predict subsequent e-cigarette use and not vice versa. Future studies are needed to replicate current findings and also further establish the mechanisms for causality, which could inform Food and Drug Administration regulatory planning. There has been recent evidence for cross-sectional associations between e-cigarette use and elevated depressive symptoms and mental health problems. There have been no studies examining these associations using longitudinal designs. This study established a temporal relationship, such that elevated depressive symptoms predicted e-cigarette use 6 months later among college students. Future research is needed to establish the mechanisms of association as well as causality.