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"Youth smoking"
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E-cigarette Use Among Middle and High School Students — United States, 2020
The use of any tobacco product by youths is unsafe, including electronic cigarettes (e-cigarettes). Most e-cigarettes contain nicotine, which is highly addictive, can harm the developing adolescent brain, and can increase risk for future addiction to other drugs. E-cigarette use has increased considerably among US youths since 2011. Multiple factors have contributed to this increase, including youth-appealing flavors and product innovations. Here, Wang et al examine the e-cigarette use among middle and high school students.
Journal Article
Systematic Review: Internet-Based Program for Youth Smoking Prevention and Cessation
Purpose To review the characteristics and effects Internet‐based youth smoking prevention and cessation programs. Design Systematic review of published articles in peer‐reviewed journals in the past 10 years, focused on Internet‐based youth smoking prevention and cessation programs. Methods Twelve articles were selected based on the following criteria: studies reporting the outcomes of Internet‐based smoking cessation or prevention intervention programs for adolescents who are younger than 24 years. Findings The components of youth Internet‐based smoking intervention programs are analyzed based on study features (i.e., sample, design, theoretical basis, analysis, outcome measures) and program characteristics (i.e., focus, setting, frequency, duration, intensity, and different components) that make the programs effective. The most common components of effective Internet‐based programs are identified as the following: the use of multimedia, tailored approaches, personalized feedback, and interactive features. Conclusions The characteristics and effects of the programs vary, but most programs show positive results in youth smoking prevention and cessation in spite of the studies’ limitations. Clinical Relevance The evidence from this review provides useful information of recent efforts related to Internet‐based youth smoking prevention and cessation programs, which can have significant clinical implications in developing future innovative youth smoking prevention and intervention programs.
Journal Article
E-cigarette Unit Sales, by Product and Flavor Type — United States, 2014–2020
Since electronic cigarettes (e-cigarettes) entered the US marketplace in 2007, the landscape has evolved to include different product types and flavored e-liquids, which have contributed to increases in youth use. E-cigarettes have been the most commonly used tobacco product among US youths since 2014; in 2019, 27.5% of high school students reported current e-cigarette use. Here, Ali et al assess the trends in unit sales of e-cigarettes in the US by product and flavor type.
Journal Article
Exposure to e-cigarette advertising, attitudes, and use susceptibility in adolescents who had never used e-cigarettes or cigarettes
Background
Tobacco advertisements have been banned in Hong Kong, but low intensity e-cigarette (EC) advertising can still be found in various media outlets. We investigated the associations between exposure to EC advertising and susceptibility to EC use in adolescents who had never used cigarettes or ECs, with potential mediation by attitudes towards ECs and the tobacco industry.
Methods
The School-based Smoking Survey 2016/17 assessed exposure to EC advertising in the past 30 days, attitudes towards ECs and the tobacco industry, susceptibility to EC use, and other covariates. Generalised linear mixed models and multiple mediation analysis methods were used in data analyses.
Results
Among 7082 students (mean age 14.9 years), 28.8% reported exposure to EC advertising. Exposure was associated with being uncertain about the harm of EC use, being tolerant towards ECs, believing the tobacco industry is respectable, and being susceptible to EC use; the magnitudes of these associations increased with the number of types of advertising exposed (0, 1, and ≥ 2) (all
p
-values < 0.01). These attitudinal factors were in turn associated with EC use susceptibility (all p-values < 0.001). The perception that tobacco companies make youth smoke was not associated with the advertising exposure or EC use susceptibility. Of the total effects of EC advertising on use susceptibility, only 16.6% were mediated by attitudinal factors: perceived harm (3.1%), attitudes towards ECs (8.2%), and attitudes towards the tobacco industry (4.9%).
Conclusions
Even exposure to low intensity EC advertising was associated with susceptibility to EC use in adolescents who had never used cigarettes or ECs. The association was weakly mediated by tolerant attitudes towards ECs and the tobacco industry. The government should reinforce the regulations on EC advertising to protect adolescent health.
Journal Article
Clearing the air: underestimation of youth smoking prevalence associated with proxy-reporting compared to youth self-report
Background
Smoking remains a leading cause of disease burden globally. Declining youth smoking prevalence is an essential feature of effective tobacco control; however, accurate data are required to assess progress. This study investigates bias in youth smoking prevalence estimates by respondent type (proxy-reported, self-report with parent present, or self-report independently) for Aboriginal and Torres Strait Islander and total populations of Australia.
Methods
Repeated cross-sectional analysis of representative Aboriginal and Torres Strait Islander Health and National Health Surveys, 2007–2019. Data were restricted to participants aged 15–17 years. Prevalence ratios (PR) and 95% Confidence Intervals (CI) for ever-smoking by respondent type were calculated using Poisson regression with robust standard errors. National youth current-smoking prevalence was estimated if all data were collected by youth self-report; estimates and trends were compared to observed estimates.
Results
Over 75% of all smoking status data were reported by proxy or with parent present. Ever-smoking prevalence among youth self-reporting independently versus proxy-reported was 1.29 (95% CI:0.96–1.73) to 1.99 (95% CI:1.39–2.85) times as high for Aboriginal and Torres Strait Islander youth, and 1.83 (95% CI:0.92–3.63) to 2.72 (95% CI:1.68–4.41) times as high for total population youth. Across surveys, predicted national current-smoking prevalence if all youth self-reported independently was generally higher than observed estimate.
Conclusions
Estimates of youth smoking prevalence are likely inaccurate and underestimated if data are collected by proxy or with parent present. Increased reliance on data reported by youth independently is crucial to improve data accuracy, including to enable accurate assessment of national prevalence.
Journal Article
A descriptive study of a Smoke-free Teens Programme to promote smoke-free culture in schools and the community in Hong Kong
Background
Youth smoking continues to be a significant global public health concern. To ensure healthier lives for youths, healthcare professionals need to increase awareness among the youth of the health risks and addictive nature of smoking, strengthen their ability to resist negative peer influence and curiosity, and help those who smoked to quit. The Smoke-free Teens Programme was launched in 2012 to equip youngsters with up-to-date information about smoking and global trends in tobacco control and to encourage them to play a pioneering role in tobacco control. This paper describes the process and outcomes of this programme for youths in Hong Kong.
Methods
The Smoke-free Teens Programme contained three major components: (i) a 2-day-1-night training camp; (ii) creative activities to promote smoke-free messages in schools and the community; and (iii) an award presentation ceremony to recognize the efforts of outstanding Smoke-free Teens in establishing a smoke-free culture. All secondary school students or teenagers aged 14 to 18 years from secondary schools, youth centres and uniform groups were invited to join the programme. The outcome measures were changes in (1) knowledge about smoking hazards; (2) attitudes towards smoking, tobacco control, and smoking cessation; and (3) practices for promoting smoking cessation.
Results
A total of 856 teenagers were recruited during the study period (July 2014 to March 2017). The results showed statistically significant changes in participants’ knowledge about smoking hazards, attitudes towards tobacco control, and practice for promoting smoking cessation.
Conclusions
The Smoke-free Teens Programme demonstrated effectiveness in equipping youngsters with up-to-date information about smoking and global trends in tobacco control and in encouraging them to play a pioneering role in tobacco control. The trained Smoke-free Teens not only promoted the smoke-free messages among their schoolmates, friends, and families, but also gathered community support for a smoke-free Hong Kong. The programme has been instrumental in fostering a new batch of Smoke-free Teens to advocate smoke-free culture and protect public health.
Trial registration
Clinicaltrials.gov ID
NCT03291132
(retrospectively registered on September 19, 2017).
Journal Article
Negligible Connections? The Role of Familiar Others in the Diffusion of Smoking among Adolescents
How is the delinquent behavior of adolescents influenced by their peers? Previous studies in criminology have primarily focused on the effects of friendship networks on delinquency, but what is less examined is the influence of weaker and often negligible relationships on behavior. In this paper, we explore the effect of familiar others, namely those socio-demographically similar peers who are not connected through friendships, on the behavioral diffusion of smoking among adolescents. Using data from the National Longitudinal Study of Adolescent to Adult Health, we show that, even after controlling for the behavior of friends, the smoking behavior of familiar others has a significant longitudinal effect on adolescents' likelihood of smoking tobacco and marijuana. The results have important implications for expanding our understanding of the social diffusion of adolescent behavior through contextual mechanisms.
Journal Article
Menthol cigarettes and the public health standard: a systematic review
Background
Although menthol was not banned under the Tobacco Control Act, the law made it clear that this did not prevent the Food and Drug Administration from issuing a product standard to ban menthol to protect public health. The purpose of this review was to update the evidence synthesis regarding the role of menthol in initiation, dependence and cessation.
Methods
A systematic review of the peer-reviewed literature on menthol cigarettes via a PubMed search through May 9, 2017. The National Cancer Institute’s Bibliography of Literature on Menthol and Tobacco and the FDA’s 2011 report and 2013 addendum were reviewed for additional publications. Included articles addressing initiation, dependence, and cessation were synthesized based on study design and quality, consistency of evidence across populations and over time, coherence of findings across studies, and plausibility of the findings.
Results
Eighty-two studies on menthol cigarette initiation (
n
= 46), dependence (
n
= 14), and cessation (
n
= 34) were included. Large, representative studies show an association between menthol and youth smoking that is consistent in magnitude and direction. One longitudinal and eight cross-sectional studies demonstrate that menthol smokers report increased nicotine dependence compared to non-menthol smokers. Ten studies support the temporal relationship between menthol and reduced smoking cessation, as they measure cessation success at follow-up.
Conclusions
The strength and consistency of the associations in these studies support that the removal of menthol from cigarettes is likely to reduce youth smoking initiation, improve smoking cessation outcomes in adult smokers, and in turn, benefit public health.
Journal Article