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The hundreds of tidewater glaciers found in the Canadian Arctic Archipelago have the potential to enhance delivery of nutrients and other material to the surface ocean. Despite this, their influence on marine ecosystems, specifically phytoplankton, is poorly characterized. Here we developed and applied a quantitative mass spectrometry‐based approach to measure phytoplankton ribulose‐1,5‐bisphosphate carboxylase/oxygenase (Rubisco) concentrations to examine differences in productivity in glacierized and non‐glacierized marine systems in Jones Sound, Nunavut, within Inuit Nunangat. Comparisons to chloroplast 16S rRNA gene amplicon sequencing data suggested that these measurements detect the majority of Rubisco produced in Jones Sound. Because Rubisco catalyzes carbon fixation, we used these measurements to estimate total and group‐specific primary production potential, which were within the range of historical primary production measurements made using classical methods in this region. Our measurements also revealed that up to 2% of total protein in the water column is Rubisco, and that Rubisco concentrations are correlated with chlorophyll fluorescence, with maxima near the nitracline. Rubisco produced by diatom genera Chaetoceros and Thalassiosira were higher in marine regions influenced by glaciers, while Rubisco from Micromonas (Chlorophyta) was greater in non‐glacierized regions. This suggests that future climate scenarios may favor smaller phytoplankton groups, like Micromonas, with consequences for food webs and carbon cycling. This study broadens our understanding of how tidewater glaciers will impact phytoplankton communities, now and in a warmer future, and lays the foundation for using this mass spectrometry‐based approach to quantify phytoplankton group‐specific carbon fixation potential in other marine regions. [ABSTRACT FROM AUTHOR]

Objectives: Nationwide implementation of Tobacco 21 (raising the legal sales age for all tobacco products to 21) is occurring against the backdrop of an electronic cigarette (e-cigarette) epidemic among young people, which makes Tobacco 21 evaluation difficult. To address this issue, we examined young adult use of e-cigarettes separately from use of other tobacco products. Our objective was to determine whether use changed after Tobacco 21 implementation and whether those changes differed by product. Methods: In Columbus, Ohio, which began enforcing Tobacco 21 in 2017, we surveyed incoming first-year undergraduates at a large, public university in 2016 (Cohort 1; n = 529) and re-contacted them in 2018. We surveyed a new sample of incoming first-year students in 2018 (Cohort 2; n = 611). Survey items assessed tobacco use, sources for obtaining tobacco, and attitudes surrounding Tobacco 21. Results: Both cross-sectional (Cohort 1 vs Cohort 2) and prospective (pre–post Tobacco 21 in Cohort 1) analyses indicated a slight decline in most tobacco use from 2016 to 2018, but e-cigarette use more than doubled during the same period. Students enrolled throughout the transition to Tobacco 21 (Cohort 1) perceived little effect of Tobacco 21 on peer use. The largest proportions (35.3%-43.5%) of combustible tobacco were obtained outside Columbus; 61.8% of e-cigarette users reported obtaining e-cigarettes through borrowing. Conclusions: Tobacco 21 was associated with reductions in combustible and smokeless tobacco use, but its impact was not sufficient to curb the surge in e-cigarette use. Tobacco 21 should be contextualized as part of a broader network of tobacco control efforts, including additional youth-access regulations, that may be needed to address e-cigarette use among young people. [ABSTRACT FROM AUTHOR]

Emerging data indicate that many adolescents and young adults ("youth") engage in infrequent, or occasional, e-cigarette use. However, little is known about this population as they are often subsumed into the broader "any past-30-day use" category used to define youth "current use." This study aimed to focus on infrequent e-cigarette use by youth, examining its correlates and transitional outcomes. Participants were from a prospective cohort study of youth (aged 15–24 at baseline). Among youth who had used e-cigarettes, we classified "infrequent use" as using e-cigarettes ≤5 days in the last 30 days (n=273) and "frequent use" as using e-cigarettes ≥6 days in the last 30 days (n=278). Descriptive statistics, Markov modeling, and logistic regression were utilized. By the 12-month follow-up, 76.8% of those using infrequently at baseline remained in the "infrequent use" category, 6.3% reported no recent use, and 16.8% had escalated to the "frequent use" category. Among the youth using infrequently at baseline, those who did (vs. did not) escalate to frequent use by follow-up had higher baseline nicotine dependence and were more likely to have family members who used tobacco. Infrequent e-cigarette use is extremely common, and often fairly stable, among young people. Prevention efforts must certainly attempt to reduce escalation and attend to both individual and interpersonal factors (e.g., nicotine dependence, family use). Yet prevention efforts must additionally attend to the case of continued infrequent use, given the high prevalence of people in this category and their regular exposure to e-cigarette harms. • Many young people use e-cigarettes infrequently (≤5 days in the last 30 days). • This is one of the first studies to focus on youth who vape infrequently. • Some youth (16.8%) escalated from infrequent to frequent use over a 12-month period. • But most youth (76.8%) maintained infrequent e-cigarette use over 12 months. • Youth who vape infrequently merit greater attention in research and practice. [ABSTRACT FROM AUTHOR]

Examine trends in e-cigarette use, and Juul use specifically, among U.S. college students. In 2016, we established a cohort of 529 incoming first-year students to a large Midwestern University. In 2018, these students (now third-years) were re-contacted, and a new sample of 611 incoming first-year students was enrolled. First-year students in 2016 completed a survey assessing their e-cigarette use; in 2018, first- and second-year students reported on e-cigarette use, and use of Juul specifically. From 2016 to 2018, past 30-day e-cigarette use rose from 5.9% to 27.7%. In 2018, for Juul alone, ever use was above 35% and past 30-day use was above 20% for both cohorts. Juul use did not differ by gender, but was associated with higher socioeconomic status (SES) and being White. Findings present disturbing possibilities for long-term nicotine addiction among the next generation, and underscore the need for a rapid public health response. [ABSTRACT FROM AUTHOR]

Introduction: Tobacco 21 (T21), which sets the minimum legal sales age for tobacco to age 21, is now a national law in the United States. Although T21 is expected to help curb youth tobacco use, its impact may be dampened due to poor retailer compliance. Even within environments where enforcement is strong (ie, compliance checks are conducted with tough sanctions for violations), compliance might vary due to other factors.Aims and Methods: Three studies were conducted in Columbus, OH, where T21 became strongly enforced in 2018. These studies examined how retailer compliance related to features of the neighborhood in which a retailer was located (Study 1), features of the retailer (Study 2), and features of the retail cashier (Study 3).Results: Study 1 found that, after controlling for race- and age-based factors, retailers located in high (vs. low)-poverty neighborhoods had a lower likelihood of conducting identification (ID) checks. Study 2 found that ID checks were related to whether retailers displayed signage about T21, as required by the city law. Study 3 found that, among cashiers, T21 awareness (which was high) and perceptions about T21 (which were moderate) were not generally related to their retailer's compliance; having (vs. not having) scanners for ID checks was related to a higher likelihood of compliance.Conclusions: These studies emphasize the many, multilevel factors influencing T21 outcomes. Findings also indicate the potential for T21 to widen disparities in tobacco use, indicating the need for strategies to equitably improve T21 compliance.Implications: T21, which sets the minimum legal sales age for all tobacco products to age 21, is now a national law in the United States. Despite optimistic projections about what T21 could achieve, the ultimate impact may be dampened when it is applied in real-world settings. Our project revealed the many, multilevel factors influencing T21 compliance. Findings also indicate the potential for T21 to widen disparities in tobacco use if gaps in compliance persist. Strategies for equitably improving T21 compliance are discussed. This article is of relevance to areas interested in implementing or improving their local T21 enforcement. [ABSTRACT FROM AUTHOR]

Objective: There has been a growth in popularity of hookah (or waterpipes) among American college students, despite the health risks. This study investigated factors that predict hookah susceptibility and whether hookah susceptibility predicts hookah initiation and continued use.Method: The study established a cohort of 529 incoming college freshmen (51.6% female) who completed an online survey approximately 1 week before their arrival to a large U.S. university. Students were sent four follow-up surveys throughout the 2016-2017 academic year; 90.5% completed at least one follow-up survey.Results: A total of 13.2% of the sample had used hookah at baseline and 9.9% initiated hookah use over the course of their freshman year. Among the nonusers who had no hookah susceptibility at baseline, 30.0% came to indicate some susceptibility. Multivariable logistic regression indicated that the personality construct conscientiousness was protective against becoming susceptible, whereas coming from a rural part of the state was a risk factor. Susceptibility predicted both continued use among the baseline ever-users and initiation among the baseline never-users.Conclusions: These findings highlight the role of susceptibility in the trajectory of hookah use among U.S. college students. [ABSTRACT FROM AUTHOR]

Objectives: The tobacco industry has a history of making "natural" claims in advertisements. We report how viewing advertisements with such claims affected what adolescents found memorable. Methods: Adolescent boys (N = 1220; 11-16 years old) were randomly assigned to view a Natural American Spirit (NAS) or other brand cigarette advertisement, and were asked what they remembered about the advertisement. Survey-weighted logistic regression models assessed whether memorability of advertisement components differed by NAS advertisement exposure. Results: Adolescents viewing a NAS advertisement (vs another brand) had lower odds of finding memorable the advertisement's warning (OR = 0.58; 95% CI: [0.34, 0.98]) or brand (OR = 0.25; 95% CI: [0.11, 0.54]). They had higher odds of mentioning tobacco (OR = 2.33; 95% CI: [1.49, 3.63]) and packaging (OR = 2.57; 95% CI: [1.51, 4.37]). An estimated 6.7% of those viewing an NAS advertisement said the product was not addictive. Conclusions: Reduced-harm claims on cigarette advertisements may affect what adolescents find salient about the advertisement. As the FDA's agreement with Santa Fe Natural Tobacco Company to remove these claims is not inclusive of all reduced-harm claims and does not apply to other companies, findings underscore the need for prohibiting all reduced-harm claims from cigarette advertisements. [ABSTRACT FROM AUTHOR]

Purpose: Research indicates that tobacco marketing contributes to higher pro-tobacco attitudes and behaviors among adolescents, but no studies have been able to assess the impact of real-world tobacco marketing exposures in real-time. The purpose of this study was to examine the magnitude and impact of tobacco marketing exposure on adolescents using ecological momentary assessment (EMA). Our primary hypotheses were that (1) youth would most frequently report tobacco marketing at the retail points-of-sale and (2) greater exposures to tobacco marketing would be associated with more favorable tobacco-related attitudes, use, and expectancies.Methods: Participants were adolescent males from rural and urban Ohio (N = 176, ages 11-16). For ten days, these adolescents were prompted at two-three random times/day to complete a brief smartphone-based survey about their exposures and responses to tobacco-related advertising.Results: Adolescents reported exposures to tobacco marketing an average of 1.9 times over the 10-day EMA period, with over 10% seeing a tobacco advertisement 5 or more times. Reports of marketing exposures occurred most frequently at the point-of-sale; exposures were higher among tobacco users and rural adolescents. Consistent with hypotheses, marketing exposure was related to more positive attitudes to the tobacco advertisements, more tobacco use, and higher expectancies to use in the future.Conclusions: Overall, these findings signal the magnitude of tobacco marketing exposures and their pernicious impact on youth. Findings underscore the importance of federal, state, and local-level tobacco regulatory policies to protect youth from the marketing that puts them at risk for a lifetime of nicotine addiction and tobacco-related diseases. [ABSTRACT FROM AUTHOR]

Objectives: E-cigarettes are now the most commonly-used tobacco product among adolescents; yet, little work has examined how the appealing food and flavor cues used in their marketing might attract adolescents' attention, thereby increasing willingness to try these products. In the present study, we tested whether advertisements for fruit/sweet/savory-flavored ("flavored") e-cigarettes attracted adolescent attention in real-world scenes more than tobacco flavored ("unflavored") e-cigarettes. Additionally, we examined the relationship between adolescent attentional bias and willingness to try flavored e-cigarettes. Methods: Participants were 46 adolescents (age range: 16-18 years). All participants took part in an eye-tracking paradigm that examined attentional bias to flavored and unflavored e-cigarette advertisements embedded in pictures of real-world storefront scenes. Afterwards, participants' willingness to try flavored and unflavored e-cigarettes was assessed. Results: In support of our primary hypothesis, adolescents looked longer and fixated more frequently on flavored (vs unflavored) e-cigarette advertisements. Moreover, this attentional bias towards flavored e-cigarette advertisements predicted a greater willingness to try flavored vs unflavored e-cigarettes. Conclusions: These findings suggest that flavored e-cigarette marketing attracts the attention of adolescents, increases their willingness to try flavored e-cigarette products, and could, therefore, put them at greater risk for tobacco initiation. [ABSTRACT FROM AUTHOR]

Abstract The purpose of this study was to develop and test a new continuous measure for rural health disparities research that characterizes geographic areas according to a perspective of access to resources. We call the measure Isolation and anticipate it will be useful as an alternative to commonly used rural classification schemes (e.g., the Census Bureau's measure). Following the best known standards for measuring rurality, it captures the trade-off between access to resource-rich, high-population-density areas and the cost of travel to those areas; thus even intrinsically low-resource areas may have high access to nearby resources. Validity was tested with proxies such as distance to hospitals, physician availability, and access to high quality food. The Isolation scale demonstrated good construct validity (i.e., both convergent and criterion validity). Fit statistics indicated that, compared to other commonly-used urban/rural definitions, the Isolation scale was the best overall measure when predicting several proxies for rurality, even when categorized. We also show that the measure does a substantially better job at explaining national health outcome data at the state level. This new continuous Isolation scale shows considerable promise for improving our conceptualization, theorization, and measurement of the features of rurality that are pertinent to rural health disparities research, and can also be useful to policy makers who may find value in using isolation thresholds that are most relevant to their policy planning needs. Highlights • Existing US urban/rural measures are limited for health research use. • A new Isolation measure accounts for location and distance from population centers. • Isolation is superior for explaining actual access to health related resources. • Isolation is superior for explaining the distribution of health outcomes. • Isolation is a measurement step forward for rural health disparities research. [ABSTRACT FROM AUTHOR]

Background: Previous studies have examined what adolescents find appealing in tobacco and alcohol advertisements and how different themes in advertisements are used to manipulate consumer behaviors. Yet, we know little about the relationship between the themes portrayed in advertisements and youth attitudes towards those themes. Objectives: This study compared attitudes towards advertisements for different consumer products in a sample of urban and rural adolescent boys in order to examine how key marketing themes impact adolescent attitudes towards those advertisements. Methods: Participants were 11- to 16-year-old boys (N = 1220) residing in either urban or rural Ohio Appalachian counties. Each participant viewed five print advertisements (one each for cigarettes, electronic cigarettes (e-cigarettes), smokeless tobacco (SLT), non-alcoholic beverages, and alcohol), presented in a random order, for eight seconds each. All advertisements had appeared in magazines that adolescent males commonly read. Attitudes towards each of the five advertisements were assessed. The advertisements were then coded for the presence of various themes, including social acceptance and masculinity. Analyses were conducted to determine associations between advertisement type and the attitude measure, and between the presence of a theme and the attitude measure. Results: Overall, participants preferred non-tobacco advertisements to tobacco advertisements, rural participants had less positive attitudes and participants who had peers who used tobacco had more positive attitudes. Social acceptance and entertainment themes increased the appeal of SLT advertisements, and sex appeal increased the appeal of e-cigarette advertisements. Conclusions/Importance: Findings suggest that advertisements that promote the social nature of use in SLT advertisements may be of particular concern for their influence on adolescent boys. [ABSTRACT FROM AUTHOR]

Objective: We aimed to improve understanding of young adults' perceptions and interpretations of the contexts surrounding use. Methods: We conducted focus groups with young adult hookah users (ages 18-28) to examine hookah-use experiences and risk perceptions. Results: Two dominant themes that emerged from the discussions were the social aspects of use (eg, "ending up" at a hookah café while out with friends), and the mental and physiological reactions to use (eg, relaxation and a "high" feeling). Participants often argued that because they only used hookah every few weeks, hookah use was much less dangerous than cigarette use. Conclusions: Findings suggest that hookah research should account for heuristic processing and point to several areas where better health communication and stricter regulatory policies are needed. [ABSTRACT FROM AUTHOR]

Objectives: To examine urban-rural differences in US prevalences of traditional and emerging tobacco product use as well as dual or polytobacco use of these products. Methods: Our data were derived from wave 1 (2013-2014) of the Population Assessment of Tobacco and Health (PATH) Study. We estimated weighted prevalences of adult tobacco use across urban-rural geographies and examined prevalences classified by gender, poverty level, and region of the country. Results: Nationally, cigarette use and smokeless tobacco use, as well as dual or polytobacco use of traditional products, were more prevalent in rural than in urban areas. Conversely, cigarillo and hookah use and dual or polytobacco use of emerging products were higher in urban areas. There was no significant urban-rural difference in use of e-cigarettes. Gender, poverty, and region of the country did not seem to be driving most urban-rural differences, although differences related to cigarillo use and dual or polytobacco use of emerging products became nonsignificant after control for covariates. Conclusions: Our findings highlight important urban-rural differences in tobacco use. Whether the changing tobacco product landscape will contribute to a continuation of rural health disparities remains to be seen. [ABSTRACT FROM AUTHOR]

Background: Decades of research demonstrate the pernicious effects of targeted cigarette marketing on young people. Now, with tobacco marketing shifting toward greater incorporation of alternative products, it is critical to identify current attitudes toward the new landscape of tobacco advertisements. Objectives: The purpose of this study was to understand the present landscape of tobacco marketing to which young adults are exposed, and to assess how they respond to it. Method: During 2015–2016, we used ecological momentary assessment (EMA), in which 44 young adults (aged 18–28) carried smartphones equipped with a survey app. Seventy-seven percent were ever-users of tobacco and 29.5% were intermittent users of tobacco (someday users of cigarettes and/or those who used another tobacco product >5 times within the past year). For ten days, participants were prompted at three random times/day to complete a brief survey about their exposures and responses to tobacco-related advertising. Analyses used t-test and multilevel modeling. Results: Intermittent users reported greater exposure than non-intermittent users to tobacco advertising. Further, both intermittent and ever-users reported more positive attitudes toward the tobacco advertising. Of the tobacco advertisements reported, 22% were for products unregulated by the FDA at the time of data collection. Conclusions/Importance: These findings indicate that young adults, and especially young adults who use tobacco, are exposed to a fair amount of tobacco advertising on a weekly basis. As the tobacco users in our sample were largely experimental and occasional users, these marketing exposures could put young adults at risk for progression toward regular use. [ABSTRACT FROM AUTHOR]

The term situationism refers to an individual's belief about the importance of a behaviour's context. This study tested whether the degree of situationism expressed by individuals in various regions of Europe was consistent with self-regulation and cross-cultural theories. The English version of a Situationism Scale (measuring beliefs about the relation between the environment and one's own behaviour) was translated into five additional languages: Dutch, German, Hungarian, Italian and Slovenian. Young adults ( N = 1106, MAge = 22.9 years, 79% female) across Europe responded to one of the six language versions of the scale as part of a larger survey. Results indicated that: new language versions were psychometrically valid; there was a positive relation between situationism and the use of situation-control strategies; and situationism was higher for individuals from regions that are Eastern European and relatively more interdependent, compared with individuals from regions that are Western European and relatively less interdependent. As the first evaluation of the Situationism Scale outside America, this study supports the Scale's validity and suggests not only may some effects of situationism be universal, but between- and within-culture differences in situationism exist. Overall, when making judgments and decisions about the self, cultural background and individual differences in situationism may come into play. [ABSTRACT FROM AUTHOR]

Background: Married couples often share similar health-related characteristics and behaviors, including cigarette smoking status. Despite their rising popularity in the U.S., little research has examined the patterns of spousal concordance (SC) for alternative tobacco products (ATPs), such as e-cigarettes, cigars, and hookah.Methods: The purpose of this project was to examine the roles of age, gender, and culture in the strength of SC for these ATPs. Analyses focused on a diverse community sample of married individuals in Ohio, U.S. (N=278), but also examined patterns in Austria, Greece, Israel, the Netherlands, and Slovakia. All participants completed a survey in which they indicated both their own, and their spouse's ever-use of various tobacco products.Results: For the U.S. sample, SC was highest for e-cigarettes, flavored e-cigarettes, flavored cigarettes, and hookah (ϕs=0.48- 0.61); SC appeared to be stronger among younger couples, and when there was only a small female vs. male differences in use. Similar patterns were found in the other countries, with a few key exceptions. In particular, there was low SC for e-cigarettes and flavored e-cigarettes in the other countries, where e-cigarettes had been federally regulated by the time of data collection.Conclusion: Overall, these findings have implications for the continued spreading popularity of these tobacco use behaviors. [ABSTRACT FROM AUTHOR]

Purpose: Adolescents susceptible to late-onset smoking (becoming regular smokers at age 18 or later) are an understudied population. Social support is a promising target for intervention, but it is important to distinguish between implicit social support (reminders that one belongs to a network of valued others) and explicit social support (seeking and receiving advice and emotional solace). This study aimed to test the potential protective influence of implicit and explicit social support on reducing the risk of late-onset smoking.Methods: Fifty-eight smoking-susceptible youths (aged 16-18, 45% African American, 55% non-Hispanic White) completed an experimental session that included a video-recording task designed to elicit thoughts about implicit, explicit, or no social support. Youths reported their behavioral willingness and intentions (BW and BI) to smoke immediately following the social support manipulation; a random sample of 39 youths reported again at a 3-week follow-up.Results: Following the manipulation, BW and BI for cigarette smoking were significantly higher among youths assigned to the explicit-support condition, compared to those in the implicit-support or control conditions. At follow-up, BW and BI were highest in the explicit-support condition and lowest in the implicit-support condition, but the differences were not significant.Conclusions: Overall, findings indicated that for teens susceptible for late-onset smoking, eliciting thoughts about implicit social support produces lower risk for cigarette initiation than does eliciting thoughts about explicit social support. The present results and the video task that yielded them are important to researchers and practitioners interested in reducing the likelihood of late-onset smoking. [ABSTRACT FROM AUTHOR]

This project compared urban/rural differences in tobacco use, and examined how such differences vary across regions/divisions of the U.S. Using pooled 2012-2013 data from the National Survey on Drug Use and Health (NSDUH), we obtained weighted prevalence estimates for the use of cigarettes, menthol cigarettes, chewing tobacco, snuff, cigars, and pipes. NSDUH also provides information on participants' residence: rural vs. urban, and Census region and division. Overall, use of cigarettes, chew, and snuff were higher in rural, compared to urban areas. Across all tobacco products, urban/rural differences were particularly pronounced in certain divisions (e.g., the South Atlantic). Effects did not appear to be fully explained by differences in poverty. Going beyond previous research, these findings show that urban/rural differences vary across different types of tobacco products, as well as by division of the country. Results underscore the need for regulatory efforts that will reduce health disparities. [ABSTRACT FROM AUTHOR]

This study tested whether age is a factor in viewing time for tobacco warning labels. The approach drew from previous work demonstrating an age-related positivity effect, whereby older adults show preferences toward positive and away from negative stimuli. Methods: Participants were 295 daily smokers from Appalachian Ohio (age range: 21-68). All participants took part in an eye-tracking paradigm that captured the attention paid to elements of health warning labels in the context of magazine advertisements. Participants also reported on their past cessation attempts and their beliefs about the dangers of smoking. Results: Consistent with theory on age-related positivity, older age predicted weaker beliefs about smoking risks, but only among those with no past-year quit attempts. In support of our primary hypothesis, older age was also related to a lower percentage of time spent viewing tobacco warning labels, both overall (text + image) and for the graphic image alone. These associations remained after controlling for cigarettes smoked per day. Conclusions: Overall, findings suggest that age is an important consideration for the design of future graphic warning labels and other tobacco risk communications. For older adults, warning labels may need to be tailored to overcome the age-related positivity effect. [ABSTRACT FROM AUTHOR]

Introduction: Compared to the majority of non-Hispanic white ("white") cigarette smokers, many African American smokers demonstrate a later age of initiation. The goal of the present study was to examine African American late-onset smoking (ie, regular smoking beginning at age 18 or later) and determine whether late-onset (vs. early-onset) smoking is protective in terms of quit rates and health outcomes.Methods: We used data from the National Survey of Midlife Development in the United States (MIDUS) because the wide age range of participants (20-75 at baseline) allowed the examination of smoking cessation and mortality incidence across the lifespan.Results: Consistent with previous research, results indicated a later average age of smoking onset among African Americans, compared to whites. Disentangling effects of race from age-of-onset, we found that the cessation rate among late-onset African American smokers was 33%, whereas rates for early-onset African American smokers and early- and late-onset white smokers ranged from 52% to 57%. Finally, results showed that among white, low-socioeconomic status (SES) smokers, the hazard rate for mortality was greater among early- versus late-onset smokers; in contrast, among African American smokers (both low- and high-SES) hazard rates for mortality did not significantly differ among early- versus late-onset smokers.Conclusions: Although late (vs. early) smoking onset may be protective for whites, the present results suggest that late-onset may not be similarly protective for African Americans. Tobacco programs and regulatory policies focused on prevention should expand their perspective to include later ages of initiation, in order to avoid widening tobacco-related health disparities.Implications: This study indicates that late-onset smoking is not only the norm among African American adult smokers, but that late- versus early-onset smoking (ie, delaying onset) does not appear to afford any benefits for African Americans in terms of cessation or mortality. These results suggest that prevention and intervention efforts need to consider individual groups (not just overall averages) and that tobacco control efforts need to be targeted beyond the teenage years. Tobacco programs and regulatory policies focused on prevention should expand their perspective to include later ages of initiation, to avoid widening tobacco-related health disparities. [ABSTRACT FROM AUTHOR]

Considerable research has examined how cigarette point-of-sale advertising is closely related to smoking-related disparities across communities. Yet few studies have examined marketing of alternative tobacco products (e.g., e-cigarettes). The goal of the present study was to examine external point-of-sale marketing of various tobacco products and determine its association with community-level demographics (population density, economic-disadvantage, race/ethnicity) in urban and rural regions of Ohio. During the summer of 2014, fieldworkers collected comprehensive tobacco marketing data from 199 stores in Ohio (99 in Appalachia, 100 in Columbus), including information on external features. The address of each store was geocoded to its census tract, providing information about the community in which the store was located. Results indicated that promotions for e-cigarettes and advertising for menthol cigarettes, cigarillos, and cigars were more prevalent in communities with a higher percentage of African Americans. Cigarillos advertising was more likely in high-disadvantage and urban communities. A greater variety of products were also advertised outside retailers in urban, high-disadvantage, African American communities. Findings provide evidence of differential tobacco marketing at the external point-of-sale, which disproportionately targets urban, economically-disadvantaged, and African American communities. There is a need for tobacco control policies that will help improve equity and reduce health disparities. [ABSTRACT FROM AUTHOR]

Introduction: A growing body of evidence indicates that exposure to tobacco advertising among adolescents increases the likelihood of subsequent tobacco use. It is important to understand the process by which this occurs, in order to appropriately target factors for intervention. The objective of this study was to test whether attitudes towards tobacco advertising mediates the impact of advertising exposure on tobacco use.Methods: From an ongoing prospective cohort study of male adolescents (aged 11-16 at baseline), we recruited a subset of tobacco users and non-users to participate in an additional ecological momentary assessment (EMA) project (N = 164). Adolescents completed smartphone-based surveys 2-3 times/day over a 10-day period with items assessing their exposures and attitudes towards tobacco-related advertising. If participants reported exposure to tobacco advertising, they were asked about their attitudes toward it (how much they enjoyed it, liked it, and found it appealing).Results: Adolescents who reported a greater amount of advertising exposure during the EMA period were more likely to report past-30-day tobacco use at their next cohort follow-up (6-12 months later). Moreover, the impact of advertising exposure on subsequent use was mediated by attitudes toward the tobacco advertisements, as reported during the EMA. This effect remained after controlling for baseline tobacco use.Conclusions: By pairing EMA with long-term follow-up, we identified attitudes as a mediator between adolescent advertising exposure and subsequent tobacco use. Interventions to lessen adolescents' positive attitudes toward tobacco advertisements may help disrupt this impact. [ABSTRACT FROM AUTHOR]

Objectives. Adolescent smokers experience respiratory symptoms as a consequence of smoking, which may be impacted by harm-reduction products. We sought to validate the American Thoracic Society Questionnaire (ATSQ), a measure of respiratory symptoms, in adolescent smokers. Methods. Data were drawn from 2 studies of adolescents (ages 14 to 19). Study 1 (N = 118) comprised daily smokers. Study 2 (N = 216) comprised 118 smokers and 98 nonsmokers; a subset of the total sample comprised 70 matched pairs of smokers and non-smokers. Results. The ATSQ showed high internal consistency. In Study 1, ATSQ scores were positively correlated with dependence. In Study 2, scores were positively correlated with CO, cotinine, and cigarettes per day; and scores were significantly greater for smokers than non-smokers. Conclusions. The ATSQ offers a psychometrically valid method for measuring respiratory symptoms in adolescent smokers. [ABSTRACT FROM AUTHOR]

Objective: Converging lines of research suggest that adolescents' smoking behaviors are strongly influenced by the characteristics of their social network and the social processes their network facilitates. The primary goal of this study was to conduct a detailed comparison of the social networks of adolescent smokers and nonsmokers to determine what aspects relate the most to smoking status. A secondary goal was to conduct within-group analyses to examine relationships between key measures of behavior-specific social support and (a) smoking susceptibility among nonsmokers, and (b) readiness to quit smoking among smokers. Method: A matched sample of 190 adolescent smokers and nonsmokers (Mage = 16.8 years; 51% female) completed a questionnaire in which they nominated and reported on up to 10 important people in their lives. This measure allowed us to examine adolescents' overall networks (both peers and family) and to investigate numerous aspects, including general network characteristics (e.g., size of network, average contact with network members), social support (e.g., importance of people in the network), and the pervasiveness of smoking in the network (e.g., percentage of smoking peers). Results: The pervasiveness of smoking in adolescents' social network was the strongest distinguisher of smokers versus nonsmokers. In addition, behavior-specific social support was strongly associated with susceptibility to initiate smoking among nonsmokers and readiness to quit among smokers. Conclusions: This research offers insight into potential targets for prevention and early intervention by demonstrating how social networks can both promote and attenuate risk for smoking. [ABSTRACT FROM AUTHOR]

Objective: As many cigarette smokers begin experimenting before age 16, prevention efforts require a comprehensive understanding of smoking predictors during adolescence. Research has made many advances in understanding the predictors of smoking initiation, yet more precision is still needed to determine whether the patterns of prediction differ across early smoking milestones. The purpose of this study was to use a sample of young adolescents to examine the predictors of two key milestones in smoking initiation: first puff and first cigarette. Method: Data came from an ongoing, prospective project examining psychosocial factors related to adolescent substance use. At Time 1 (Tl), the sample was 1,023 Rhode Island middle school students (ages 10-15 years; M = 12.2). Tl measures included empirically supported risk and protective factors, as well as current smoking. Follow-up surveys assessed smoking behavior over the ensuing year (T2 smoking). Results: Cigarette availability was the most robust predictor of smoking milestones, increasing the likelihood of both first puff and first cigarette in cross-sectional and prospective analyses. Multivariable analyses also showed specificity, where some factors were only associated with one time point (e.g., age and Tl puff and cigarette), whereas others were only associated with one milestone (e.g., parental monitoring and whole cigarette at both time points). Conclusions: This study found different patterns of predictors for two early smoking milestones. Such findings are the first to suggest that puff and whole cigarette are distinct smoking milestones and reaffirm arguments that researchers should distinguish the various stages of smoking initiation when examining the broader period of onset/initiation. [ABSTRACT FROM AUTHOR]

This article concerns the construct oflay situationism—an individual’s belief in the importance of a behavior’s context. Study 1 identified a 13-item Situationism Scale, which demonstrated good reliability and validity. In particular, higher situationism was associated with greater situation-control (strategies to manipulate the environment in order to avoid temptation). Subsequent laboratory studies indicated that people higher on the situationism subscales used greater situation-control by sitting farther from junk food (Study 2) and choosing to drink non-alcoholic beverages before a cognitive task (Study 3). Overall, findings provide preliminary support for the psychometric validity and predictive utility of the Situationism Scale and offer this individual difference construct as a means to expand self-regulation theory. [ABSTRACT FROM AUTHOR]

Objectives This article investigates a potential mechanism underlying the 'sexually conservative puzzle' (the scenario where people reporting little to no casual sex intentions nevertheless go on to engage in casual sex). Methods In two experiments, we tested whether people reporting no behavioural intentions ( BI) for casual sex were nevertheless more responsive to risk-conducive cues, when compared to those with some BI. Responsiveness to cues was assessed in terms of increases in behavioural willingness ( BW) for casual sex. Results In Study 1, subliminal priming of sexual images (vs. control images) increased the casual sex BW of male undergraduates, but only among those who had previously reported no BI for casual sex in a baseline survey. In Study 2, these results were replicated using supraliminal priming with a more diverse online sample; effects were not moderated by age, education, or relationship status. Conclusions Overall, these findings suggest that although sexually conservative people often do not plan on having sex (i.e., they have no BI), for some, their reactive, context-sensitive decision-making (i.e., their BW) can be swayed in the presence of risk-conducive cues. Statement of contribution What is already known on this subject? The sexually conservative puzzle occurs when those with low casual sex intentions go on to have casual sex., When experience for a health-risk behaviour is low, behavioural willingness ( BW) tends to predict better than behavioural intentions ( BI)., Risk-inductive cues can increase risk cognitions and behaviour, but there are important individual differences., What does this study add? Among men with low BI for casual sex at baseline, sexual primes increased casual sex BW., It appears that more sexually conservative men are more swayed by sexual cues., Results highlight an interesting and rather unsuspected group of at-risk individuals. [ABSTRACT FROM AUTHOR]

The impact of 3 different sources of stress-environmental, familial (e.g., low parental investment), and interpersonal (i.e., racial discrimination)-on the life history strategies (LHS) and associated cognitions of African American adolescents were examined over an 11-year period (5 waves, from age 10.5 to 21.5). Analyses indicated that each one of the sources of stress was associated with faster LHS cognitions (e.g., tolerance of deviance, willingness to engage in risky sex), which, in turn, predicted faster LHS behaviors (e.g., frequent sexual behavior). LHS, then, negatively predicted outcome (resilience) at age 21.5 (i.e., faster LHS -» less resilience). In addition, presence of the risk ("sensitivity") alleles of 2 monoamine-regulating genes, the serotonin transporter gene (5HTTLPR) and the dopamine D4 receptor gene (DRD4), moderated the impact of perceived racial discrimination on LHS cognitions: Participants with more risk alleles (higher "sensitivity") reported faster LHS cognitions at age 18 and less resilience at age 21 if they had experienced higher amounts of discrimination and slower LHS and more resilience if they had experienced smaller amounts of discrimination. Implications for LHS theories are discussed. [ABSTRACT FROM AUTHOR]

This study investigated how early experience with racial discrimination affected the subsequent risky sexual behaviors of a diverse sample of African American youths (N = 745). The analyses focused on 3 risk-promoting factors thought to mediate the hypothesized discrimination → risky sex relation: negative affect, affiliation with deviant peers, and favorable attitudes toward risky sex. In addition, attentive parenting was examined as a protective factor. Analyses using structural equation modeling revealed that youths who perceived more racial discrimination at age 10 or 11 were engaging in more sexual risk taking at age 18 or 19. This relation was mediated by the hypothesized risk-promoting factors via pathways that were consistent with our conceptual model. Results also indicated a prospective reciprocal relation between parenting and children's deviant affiliations: deviant peer affiliations at age 10 or 11 predicted more attentive parenting behaviors by the parents; this response from the parents, in turn, predicted relatively fewer deviant affiliations when the youths were 15 or 16. Study findings are discussed in terms of their relevance to the disproportionately high rates of sexually transmitted infections among African Americans. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Although a human papillomavirus (HPV) vaccine has been available for more than 3 years, little research has documented the uptake and predictors of vaccination among older adolescents and young adult women. The purpose of this cross-sectional study was to examine the prevalence of HPV vaccination among college women across time and to explore the effect of mother-daughter communication on vaccination. METHODS: During the period of fall 2007 through fall 2009, a convenience sample of 972 female undergraduate students (aged 18-25) at a large Midwestern state university (89% white) completed a paper and-pencil or online anonymous questionnaire that assessed their sexual-risk behavior, knowledge of HPV, perceptions of KPV risk, communication from their mothers about sex-related topics (including HPV), and their current vaccination status. RESULTS: Sixty-five percent of the women reported being sexually active, and 49% reported having received at least the first of the 3-shot vaccine series. The mother's approval of HPV vaccination, motherdaughter communication about sex, and daughter's perceptions of vulnerabilityto HPV were positively associated with vaccination status. Among the women who had not received any of the HPV shots, the mother's approval of HPV vaccination, perceived vulnerability to HPV, and risky sexual behavior were predictive of interest in receiving the vaccine. Mother-daughter communication about values related to sex was negatively associated with interest. CONCLUSIONS: Although many of these young women were old enough to receive the vaccine without their parents' consent, perception of their mother's approval and mother-daughter communication about sex were important predictors of vaccination. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare prevalence of JUUL use and JUUL risk perceptions between adolescents living in an urban area versus Appalachian areas of the U.S. Data were drawn from a prospective cohort study of adolescent males (the Buckeye Teen Health Study, or BTHS); our cross-sectional analysis used data from one timepoint, collected between January and December 2019 (N = 873). Chi-square tests and multivariable logistic regression compared JUUL use prevalence and risk perceptions between participants in an urban Ohio county and nine predominantly rural Appalachian Ohio counties. Over a quarter of the sample (29.2%) had ever used JUUL. In the unadjusted model, prevalence of JUUL use was similar between regions but Appalachian participants perceived JUUL as more harmful (p <.001) and more addictive (p =.04) than urban participants. In the adjusted model, region was not significantly related to current JUUL use (OR: 1.20, 95% CI: 0.77, 1.87) or ever JUUL use (OR: 1.15, 95% CI: 0.83, 1.60). JUUL use was similar between urban and Appalachian participants despite regional differences in risk perceptions. Interventions that only target risk perceptions may not be sufficient to prevent adolescent e-cigarette use, particularly in rural communities. [ABSTRACT FROM AUTHOR]

Tobacco retailer density is consistently associated with poor tobacco-use outcomes. The aim of this review was to synthesize the international evidence on density reduction policies. Searches in multiple databases resulted in 31 studies covering various policy approaches evaluated for their impact on retailer density. Findings indicate that bans on tobacco sales in pharmacies reduced retailer density, but perhaps not equitably. Prohibiting sale of tobacco near schools produced greater density reductions in higher-risk neighborhoods. Policies in combination were most effective. Future studies should measure the impact of these policies on tobacco use. Density-reduction policies offer a promising approach to tobacco control. [ABSTRACT FROM AUTHOR]

Researchers have proposed numerous factors that may contribute to rural adolescents' heightened risk for tobacco use. Some of these include well-known risk factors for tobacco use, whereas others concern factors unique to rural populations, reflecting norms and values ("rural culture") that accept and encourage tobacco use. This study aimed to test a broad range of tobacco-use risk factors to determine which were a) universal risk factors for both urban and rural adolescents vs. b) unique risk factors for rural adolescents. Data came from a prospective cohort study of 1220 adolescent males in Ohio who were aged 11-16 (average = 14 years) when surveyed at baseline (2015-2016). Follow-up surveys occurred every 6 months. The present study examined tobacco-use outcomes-prevalent use and incident use-by the two-year follow-up (2017-2018). Findings indicated a higher prevalence of ever-use of cigarette and smokeless tobacco among rural, vs. urban, adolescents at baseline. By the two-year follow-up, the urban/rural difference was attenuated but remained. Stratified multivariable logistic regression indicated that some baseline risk factors were associated with subsequent tobacco use for both rural and urban adolescents. Having an adult tobacco user in the home (for prevalent use) and susceptibility to a male family member offer of tobacco products (for both prevalent and incident use) were associated with tobacco use only for rural adolescents. These findings align with qualitative work demonstrating that masculinity and an intergenerational tobacco culture are important to male adolescents. This unique rural profile should be considered when developing prevention efforts. [ABSTRACT FROM AUTHOR]

Aims Design, setting, participants Measurements Findings Conclusions To measure nicotine delivery, vaping topography and subjective effects of current generations of disposable, cartridge‐based and other types of electronic cigarettes (e‐cigarettes) among young adults.Observational, human laboratory assessment of e‐cigarette use in Columbus, Ohio, USA (July 2020 to June 2021). Participants (n = 96, 60.4% female, age mean = 21.7 [standard deviation = 1.7] years, 82.4% white race) were identified via their participation in a cohort study or other convenience sampling and were 18 to 25 years old, vaped ≥4 days/week for ≥4 weeks and used other tobacco products for ≤5 days of past 30 days. Participants completed a pre‐vaping questionnaire, vaped their usual brand of e‐cigarette ad libitum for 30 min and completed a post‐vaping questionnaire.Outcome variables included pre‐ and post‐vaping measures of plasma nicotine (t = 0 and t = 30, respectively) and craving and withdrawal symptoms, as well as vaping topography (e.g. flow rate and inter‐puff interval), pre‐vaping expectancies and post‐vaping product appeal. Variables used to characterize the sample included demographics, e‐cigarette and other tobacco use history, e‐cigarette dependence and e‐cigarette device characteristics (e.g. device type, flavor and nicotine form).Participants reported moderate nicotine dependence on average via the E‐Cigarette Dependence Scale (mean = 6.9 [standard deviation = 4.0]). Following 30 min of ad libitum vaping, participants achieved substantial plasma nicotine boost (mean = 18.8 [standard deviation = 14.5] ng/mL), corresponding with statistically significant decreases in withdrawal symptoms measured via the Minnesota Nicotine Withdrawal Scale (pre‐vaping mean = 9.0 [standard deviation = 5.1], post‐vaping mean = 4.3 [standard deviation = 3.9]; P‐value <0.0001). Pre‐vaping, participants reported moderate vaping expectancies (e.g. mean = 2.5 [standard deviation = 1.0] on a scale from 0 to 4 for smell and taste expectancies); post‐vaping, participants reported high satisfaction (mean = 4.6 [standard deviation = 1.2] on a scale from 1 to 7) and moderate reward (mean = 2.9 [standard deviation = 1.2]) and respiratory sensations (mean = 3.7 [standard deviation = 1.6]). Nearly half of participants (47.9%) used disposable e‐cigarettes, and most used a mint/menthol or fruit flavored (99.0%) and nicotine salt (98.9%) e‐liquid.Among young adults in the United States, the latest generations of e‐cigarettes appear to deliver large quantities of nicotine (similar to cigarettes) and significantly relieve withdrawal symptoms, and they are appealing. [ABSTRACT FROM AUTHOR]

AbstractObjectiveParticipantsMethodsResultsConclusionsThis study examined the relationship between use patterns of a popular e-cigarette brand using nicotine salts, JUUL, and symptoms of nicotine dependence in a college cohort.Data for this study came from a prospective cohort of undergraduate students at a large Midwestern university from 2018 to 2019.Among participants who had ever tried a JUUL (N = 411), univariate and multivariable logistic regression were used to test the associations between use frequency (past 30-day use) and quantity (time to finish a pod) and nicotine dependence at follow up.In the multivariable models, both frequency of use and quantity of use were associated with subsequent nicotine dependence, based on most indicators of dependence.As salt-based nicotine is now present in the most popular e-cigarette brands used by young people, such findings inform our contemporary understanding of e-cigarettes’ addictive potential and can help inform campus-based interventions. [ABSTRACT FROM AUTHOR]

Objective: In this study, we aimed to examine substance use among college students during the acute period of transition between high school and college. Methods: One week before coming to campus, participants completed an online survey assessing their alcohol, tobacco, and marijuana use. Next, beginning on the first Friday of the semester, they completed a 10-day experience sampling (ES) protocol, receiving one app-based survey each morning assessing recent substance use. Results: Among students who used any tobacco product prior to college, 70% or more reported alcohol use during ES. Among previous marijuana users, 85.7% reported alcohol use during ES. Baseline alcohol and tobacco use were not associated with subsequent marijuana use. Conclusions: Substance use prevention should target the transition to college. [ABSTRACT FROM AUTHOR]

Background: Oral nicotine pouches (ONPs) are novel products, gaining popularity and marketed as "tobacco-free" alternatives to cigarettes and smokeless tobacco (SLT), but their public health impact is unknown. This study qualitatively examined ONP appeal and perceptions among cigarette smokers and SLT users from Ohio Appalachia. Methods: In 2022, we conducted 10 virtual focus groups with smokers (n = 19) and smokeless tobacco users (n = 18) from Appalachia Ohio aged ≥21 to examine perceptions of risks and benefits, substitutability for cigarettes and SLT, and ONP marketing. We transcribed focus groups verbatim, thematically coded transcripts, and analyzed coded data for prominent themes. Results: Participants perceived ONPs to have similar or less risk than cigarettes/SLT but prominently discussed gastrointestinal and cardiovascular risks. Addiction risk was thought to be comparable to cigarettes/SLT, citing "nicotine is nicotine." Participants viewed ONPs to be situational rather than complete substitutes for cigarettes/SLT, viewing them as "cleaner," more socially acceptable, and discrete. Despite appealing features of ONP marketing, participants surmised ads would appeal to youth, new users, tobacco users seeking to cut down/quit, or to "high class," "white-collar" demographics. Conclusions: Participants' perceptions of ONPs and their marketing suggest ONPs are more likely to be used as situational versus complete substitutes for cigarettes and SLT. While situational substitution could exacerbate disparities in Appalachia by facilitating more frequent tobacco/nicotine use, complete substitution could reduce disparities. Research is needed to understand how perceptions, the appeal of ONP marketing, and novel product features translate to patterns of use to understand ONPs' potential impact. [ABSTRACT FROM AUTHOR]

U.S. smoking prevalence is declining at a slower rate in rural than urban settings and contributing to regional health disparities. Cigarette smoking among women of reproductive age is particularly concerning due to the potential for serious maternal and infant adverse health effects should a smoker become pregnant. The aim of the present study was to examine whether this rural-urban disparity impacts women of reproductive age (ages 15–44) including pregnant women. Data came from the ten most recent years of the U.S. National Survey on Drug Use and Health (2007–2016). We estimated prevalence of current smoking and nicotine dependence among women categorized by rural-urban residence, pregnancy status, and trends using chi-square testing and multivariable modeling while adjusting for common risk factors for smoking. Despite overall decreasing trends in smoking prevalence, prevalence was higher among rural than urban women of reproductive age overall (χ2(1) = 579.33, p < .0001) and among non-pregnant (χ2(1) = 578.0, p < .0001) and pregnant (χ2(1) = 79.69, p < .0001) women examined separately. An interaction between residence and pregnancy status showed adjusted odds of smoking among urban pregnant compared to non-pregnant women (AOR = .58, [.53 –.63]) were lower than those among rural pregnant compared to non-pregnant women (AOR = 0.75, [.62 –.92]), consistent with greater pregnancy-related smoking cessation among urban pregnant women. Prevalence of nicotine dependence was also higher in rural than urban smokers overall (χ2(2) = 790.42, p < .0001) and among non-pregnant (χ2(2) = 790.58, p < .0001) and pregnant women examined separately (χ2(2) = 63.69, p < .0001), with no significant changes over time. Associations involving residence and pregnancy status remained significant in models adjusting for covariates (ps < 0.05). Results document greater prevalence of smoking and nicotine dependence and suggest less pregnancy-related quitting among rural compared to urban women, disparities that have potential for direct, multi-generational adverse health impacts. [ABSTRACT FROM AUTHOR]

Spatial variability in early and late winter measures of whole body energy density of juvenile (age-0) Pacific herring ( Clupea pallasii ) of Prince William Sound (PWS), Alaska was examined over nine years of study. Pacific herring in this region remain considered as an injured resource over the 25 years following the Exxon Valdez oil spill, however factors responsible for the lack of recovery by herring in PWS are a source of ongoing debate. Given the species’ key ecological role in energy transfer to higher predators, and its economic role in a historical commercial fishery within the region, significant research effort has focused on understanding environmental factors that shape nutritional processes and the quality of these young forage fish. During November (early winter), factors such as juvenile herring body size, hydrological region of PWS, year, and the interaction between carbon (δ 13 C′) or nitrogen (δ 15 N) stable isotope signature and hydrological region were all important predictors of juvenile herring energy density. In particular, analyses indicated that in the northern and western regions of PWS, juvenile herring with more depleted δ 13 C′ values (which reflect a Gulf of Alaska carbon source) were more energy dense. Results suggest that intrusion of water derived from the Gulf of Alaska enhances the condition of age-0 herring possibly through alterations in zooplankton community structure and abundance, particularly in the northern and western regions of PWS in the fall, which is consistent with regional circulation. During March (late winter), factors such as juvenile herring body size, year, and the interaction between δ 13 C′ or δ 15 N isotope signature and year were all important predictors of juvenile herring energy density. Results differed for early and late winter regarding the interaction between stable isotope signatures and region or year, suggesting important seasonal aspects of circulation contribute to variation in PWS juvenile herring energy density. In addition, winter-feeding may enrich herring without considerable energy gain, removing any relationship between energy density and δ 13 C′ isotope signature in late winter. [ABSTRACT FROM AUTHOR]

Background: Adherence to COVID-19 protective measures is lowest for young people and males. The current study investigated characteristics associated with adherence to COVID-19 protective measures among male youth during the early months of the pandemic. Method: The study used data from a prospective cohort study among male youth with baseline assessment in 2015/2016 and follow-up measurements in 2019 and summer 2020. Attrition-weighted multivariable ordinal logistic and log-binomial regression models were used to assess factors associated with adherence to overall and specific adherence measures, respectively. Results: Among 571 male youth (mean age 18.5), overall adherence was higher for those who were older (OR: 1.15; 95% CI: 1.03–1.30), non-White (OR: 1.96; 95% CI: 1.20–3.32), and residing in an urban area (OR: 2.06; 95% CI: 1.46–3.01). Overall adherence was lower for those who had a history of being drunk (OR: 0.65; 95% CI: 0.42–0.99). For outdoor mask-wearing, adherence was higher for youth with attention-deficit disorder or attention-deficit/hyperactivity disorder (RR: 1.58; 95% CI: 1.16–1.97) and lower for youth who currently used tobacco products (RR: 0.42; 95% CI: 0.21–0.70). Before a statewide mask mandate was issued, non-White youth were more likely to report wearing masks in outdoor spaces than their non-Hispanic White peers (RR: 2.34; 95% CI: 1.75–3.23). Conclusion: The study identified demographic, psychosocial, and behavioral factors associated with adherence to COVID-19 protective behaviors among male youth. The findings illustrate characteristics that could be leveraged for targeted preventive efforts during the ongoing pandemic and future outbreaks in a low-compliance group. [ABSTRACT FROM AUTHOR]

Objectives. To conduct a content analysis of news articles to investigate the relationship between language used to describe e-cigarettes, how the news articles framed (conveyed information to influence a certain perception of the news read by its audience) e-cigarettes, and the Food and Drug Administration's (FDA's) oversight of e-cigarettes. Methods. We searched a database of articles published across the United States from February 1, 2016, to February 28, 2017, using the headline terms "e-cigarette," "e-cig," and "vape." We then dichotomized terms into 2 categories: technical ("e-cigarette" or "e-cig") and nontechnical ("vape"). We coded the frame of each article body as positive, negative, or neutral or mixed. Results. Articles containing the term "vape" in the headline were more likely to positively frame e-cigarettes (P ≤.001) and negatively frame FDA oversight (P ≤.001) in the body than were those with "e-cigarette" or "e-cig" in the headline. Conclusions. Omitting the word "cigarette" when describing tobacco products may reduce the negative perception associated with tobacco use, making it more appealing. It is important to know which terms are used to describe e-cigarettes and how these terms can make those products appear less harmful. [ABSTRACT FROM AUTHOR]

Introduction: Electronic cigarette (e-cigarette) use among adolescents is associated with increased risk of subsequent cigarette smoking initiation in observational research. However, the existing research was not designed to answer causal questions about whether adolescent e-cigarette users would have initiated cigarette smoking if they had never used e-cigarettes. The current study used a causal inference framework to identify whether male adolescent e-cigarette users were at increased risk of initiating cigarette smoking and smokeless tobacco (SLT) use, compared to similar boys who had never used e-cigarettes.Methods: Boys from urban and Appalachian Ohio (N = 1220; ages 11-16 years at enrollment) reported use of e-cigarettes, cigarettes, and SLT at baseline and every six months for two years. A propensity score matching design was implemented, matching one e-cigarette user to two similar e-cigarette non-users. This analysis was completed in 25 multiple imputed datasets to account for missing data. Risk ratios (RRs) comparing risk of initiating cigarettes and SLT for e-cigarette users and nonusers were estimated.Results: Compared to non-users, e-cigarette users were more than twice as likely to later initiate both cigarette smoking (RR = 2.71; 95% CI: 1.89, 3.87) and SLT (RR = 2.42; 95% CI: 1.73, 3.38). They were also more likely to become current (i.e., past 30-day) cigarette smokers (RR = 2.20; 95% CI: 1.33, 3.64) and SLT users (RR = 1.64; 95% CI: 1.01, 2.64).Conclusions: Adolescent boys who used e-cigarettes had increased risk of later initiating traditional tobacco products when compared to similar boys who had never used e-cigarettes. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to select a health warning message location on a waterpipe (WP) that both attracted visual attention and conveyed the risks associated with WP smoking. Methods: During June through November 2019, we conducted a within-subjects randomized experiment (N = 74) using eye tracking equipment to examine visual attention to 3 placements of a health warning on the WP (stem, water bowl, hose). We asked young adult ever WP users 3 questions about WP harm perceptions. We used generalized linear mixed models to examine the amount of fixation time spent on the placement locations; we used repeated measures ANOVA to model changes in harm perceptions. Results: There were statistically significant differences across all 3 placement locations; regardless of place, all HWLs attracted a comparable amount of visual attention. Absolute WP harm perceptions significantly increased following the experiment and remained significantly higher at the one-week follow-up, compared to baseline. Conclusions: Warnings on WPs attracted visual attention and increased harm perceptions, and those harm perceptions remained high one week after the experiment. Findings indicate the value of including a warning on the WP device, and underscore the necessity and effectiveness of those health warnings to combat WP harm misperceptions. [ABSTRACT FROM AUTHOR]

Objectives: Health warning messages could be an effective means of communicating the health risks associated with waterpipe (WP) smoking. The objective of this study was to select a message that conveyed the risks associated with WP smoking. Methods: A mixed-methods approach was used to explore the effectiveness of the Food and Drug Administration's (FDA's) mandated message, and others, among young adults using focus groups and surveys. Two focus group studies and one convenience survey were conducted to examine the FDA's mandated message and 11 other WP warning messages. The final study, conducted with a random sample of firstyear university students, examined the effectiveness and reactance of the chosen message using previously validated items (scored on a 1-5 scale). Results: The FDA's mandated message did not resonate well with focus group participants. In the random sample of students, the top message (WARNING: Hookah smoke contains poisons that cause lung and oral cancers) had high effectiveness (M = 4.49) and a low reactance (M = 2.12). Conclusions: Our studies suggest that other messages are more effective for communicating the risks associated with WP smoking than the FDA's message for WP tobacco. [ABSTRACT FROM AUTHOR]

Purpose: In autumn 2017, Columbus, Ohio, joined numerous other US locations in raising their legal sales age for purchasing tobacco to 21 (ie, becoming "T21"). The present study sought to establish a baseline for ID checks in Columbus prior to T21 enforcement and to examine whether store type and marketing were associated with better rates of ID checks.Design: Fieldworkers aged 20 to 21 years visited a random sample of 110 tobacco retailers during summer 2017 (drawn from >10 000 licensed retailers in the county). After collecting store-related information, they attempted to purchase cigarettes and recorded whether their ID was checked (federal law requires ID checks for anyone who looks younger than 27 years).Setting: Columbus, Ohio.Measures: Store type, external tobacco advertising, and ID check outcome.Analysis: Descriptive and inferential statistics.Results: Among stores where cigarettes were purchased, 61.1% did not conduct ID checks. Absent ID checks were associated with the store being a convenience store or tobacco shop, χ2(2) = 4.45, P = .035, and having a greater amount of external advertising, t(93) = 2.00, P = .049.Conclusion: Overall, the low rate of ID checks for young adults purchasing tobacco in Columbus is concerning. Continued monitoring of retailer compliance will be important as retailers adjust to the arrival of T21. Targeted enforcement and additional outreach with tobacco shops, convenience stores, and stores with a high amount of external advertising may be particularly needed. [ABSTRACT FROM AUTHOR]

Background: The tobacco industry spends billions on retail marketing and such marketing is associated with tobacco use. Previous research has not examined actual and potential exposures that adolescents have on a daily basis.Objective: The objective of this study was to determine whether both self-reported and geographically estimated tobacco retailer exposures differ by participant or neighborhood characteristics among urban and rural adolescents.Methods: The data for this study were part of a cohort study of 1220 adolescent males residing in urban and rural (Appalachian) regions in Ohio. The baseline survey asked participants how often they visited stores that typically sell tobacco in the past week (self-reported exposures). The number of tobacco retailers between home and school was determined using ArcGIS software (potential exposures). Adjusted regression models were fit to determine the characteristics that were associated with self-reported or potential exposures to retailers.Results: Adolescents who were non-Hispanic black or other racial/ethnic minority, had used tobacco in the past, and lived in rural areas had higher self-reported exposures. Urban adolescents, non-Hispanic black or other racial/ethnic minority, and those living in neighborhoods with a higher percentage of poverty had more potential exposures to tobacco retailers in their path between home and school.Conclusions: Rural adolescents had more self-reported marketing exposures than urban adolescents. However, urban adolescents had more potential tobacco exposures between home and school. Thus, point of sale marketing limitations might be a more effective policy intervention in rural areas whereas limits on tobacco retailers might be more effective for urban areas. [ABSTRACT FROM AUTHOR]

BACKGROUND: Researchers in several studies have examined correlations between tobacco harm perceptions and tobacco use in youth, but none have prospectively addressed the association between harm perceptions and subsequent new use across multiple noncigarette products. METHODS: Product-specific absolute and relative harm perceptions for cigarettes, electronic cigarettes (e-cigarettes), cigars, pipes, hookah, and smokeless tobacco were collected at wave 1 (W1) (2013-2014) among youth in the nationally representative US Population Assessment of Tobacco and Health Study (12-17 years of age; n = 10 081). At wave 2 (W2) (2014-2015), product-specific new use was calculated. Adjusted relative risks were used to estimate if harm perceptions at W1 predicted W2 new tobacco use. RESULTS: The proportion of youth who endorsed "a lot of harm" was highest for cigarettes (84.8%) and lowest for e-cigarettes (26.6%); the proportion of youth who thought products were "more harmful" than cigarettes was highest for cigars (30.6%) and lowest for e-cigarettes (5.1%). Among youth who had not used those products at W1, product-specific new use at W2 ranged from 9.1% (e-cigarettes) to 0.6% (pipes). Youth who believed that noncombustible tobacco products posed "no or little harm" at W1 were more likely to have tried those products at W2 (P < .05). Youth who viewed e-cigarettes, hookah, and smokeless tobacco as "less harmful" than cigarettes at W1 were more likely to try those tobacco products at W2 (P < .05). CONCLUSIONS: Low harm perceptions of noncigarette tobacco products predict new use of these products by youth within the next year. Targeting product-specific harm perceptions may prevent new tobacco use among youth. [ABSTRACT FROM AUTHOR]

This study examined quit rates longitudinally for cigarettes, e-cigarettes, hookah, cigars, and all tobacco products in a U.S. national sample of women aged 18-44 who completed both Wave 1 (W1) and Wave 2 (W2) of the Population Assessment of Tobacco and Health (PATH, 2013-2014, 2014-2015) study (N = 7814). Quit rates were examined among women who transitioned into pregnancy across survey waves, and among a comparable sample of non-pregnant women to provide contextual information about quitting among the broader population of reproductive-aged women. Multiple logistic regression modeling was used to estimate the associations of pregnancy and quitting adjusting for other demographic and psychosocial characteristics. Quit rates among women who were pregnant in W2 were highest for hookah (98.3%), followed by cigars (88.0%), e-cigarettes (81.3%), and lowest for tobacco cigarettes (53.4%). Slightly more than half (58.7%) of women reported quitting use all tobacco products while pregnant. Pregnancy was independently associated with increased odds of quitting hookah (AOR = 52.9, 95%CI = 3.4, 830.2), e-cigarettes (AOR = 21.0, 95%CI = 2.6, 170.3), all tobacco products (AOR = 9.6, 95%CI = 6.4, 14.5), and cigarettes (AOR = 6.5, 95%CI = 4.2, 10.1), although not cigars. Relative to other demographic and psychosocial characteristics, pregnancy was the strongest predictor of quitting use of each tobacco product. While these data indicate that pregnancy has strong, independent associations with quitting a variety of commercially available tobacco products, the comparatively lower quit rates for cigarettes versus other tobacco products underscores the long-standing need for more intensive, multipronged clinical and regulatory interventions to reduce cigarette use among reproductive-aged women. [ABSTRACT FROM AUTHOR]