182 results on '"James D. Sargent"'
Search Results
2. Alcohol Marketing and Youth Drinking: Is There a Causal Relationship, and Why Does It Matter?
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Thomas F. Babor, James D. Sargent, and Samantha Cukier
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Marketing ,Adolescent ,business.industry ,Alcoholic Beverages ,MEDLINE ,Human factors and ergonomics ,Poison control ,General Medicine ,Underage Drinking ,Consumer Behavior ,Suicide prevention ,Occupational safety and health ,Introduction and Overview ,Adolescent Behavior ,Environmental health ,Youth Drinking ,Injury prevention ,Medicine ,Humans ,business ,Consumer behaviour - Published
- 2020
3. Concurrent Use of E-cigarettes, Combustible Cigarettes, and Marijuana
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Ian Pagano, James D. Sargent, Adam M. Leventhal, and Thomas A. Wills
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Male ,medicine.medical_specialty ,Adolescent ,business.industry ,Vaping ,Smoking ,Marijuana Smoking ,Youth Risk Behavior Survey ,Cross classified ,Risk profile ,Article ,Health Risk Behaviors ,Marijuana use ,Adolescent Behavior ,Pediatrics, Perinatology and Child Health ,User group ,Epidemiology ,Humans ,Medicine ,Female ,business ,Psychosocial ,Demography - Abstract
OBJECTIVE Subgroups of adolescent single and dual e-cigarette and cigarette users have been identified, but usage patterns have changed in recent years, and there has been an increase in marijuana use. Research is needed with current data to identify subgroups of use including marijuana and determine their behavioral correlates. METHODS We cross classified ever and recent use of e-cigarettes, combustible cigarettes, and marijuana among US high school students in the 2019 Youth Risk Behavior Survey (YRBS), providing 8 different groups. Levels of 14 risk and protective factors were compared across groups in general linear models with demographic covariates using omnibus tests, pairwise comparisons, and planned contrasts. Replicability was tested through identical analyses for 2017 YRBS data. RESULTS The nonuser group was 43.9% of the sample. The most frequent user groups were triple users (ever-use proportion: 16.9%), dual (e-cigarette and marijuana) users (15.8%), and exclusive e-cigarette users (13.2%). For risk profiles on levels of psychosocial variables, the triple-user group was typically elevated above all other groups. Exclusive e-cigarette users were above nonusers in risk profile but below dual users (both cigarettes and marijuana). Results were similar for ever use and recent use. The patterning of results in 2019 YRBS data were closely replicated in 2017 YRBS data. CONCLUSIONS Co-occurrence of e-cigarette, cigarette, and marijuana use is currently substantial among adolescents and is associated with an elevated psychosocial risk profile. This has implications for both epidemiology and prevention studies. Further research is needed to study prevalence and identify pathways to triple use.
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- 2021
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4. Validation of an Index for Functionally Important Respiratory Symptoms among Adults in the Nationally Representative Population Assessment of Tobacco and Health Study, 2014-2016
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Nicolette Borek, Steven Woloshin, Lisa M. Schwartz, Andrew Hyland, K. Michael Cummings, Lisa D. Gardner, Maciej L. Goniewicz, Kathryn C Edwards, Gabriella Anic, Kristin Lauten, Raymond Niaura, Priscilla Callahan-Lyon, Jennifer A. Emond, Michael J. Halenar, Yanling Chen, Theresa Thekkudan, Mary F. Brunette, John P. Pierce, Susanne E. Tanski, Kristie Taylor, Heather L. Kimmel, and James D. Sargent
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Adult ,medicine.medical_specialty ,Allergy ,Index (economics) ,respiratory health ,Health, Toxicology and Mutagenesis ,Population ,tobacco use ,Toxicology ,Article ,Cronbach's alpha ,Clinical Research ,Surveys and Questionnaires ,Internal medicine ,Wheeze ,Tobacco ,Prevalence ,medicine ,Humans ,Respiratory system ,Child ,education ,Lung ,Respiratory Sounds ,Asthma ,COPD ,education.field_of_study ,PATH Study ,Tobacco Smoke and Health ,business.industry ,Prevention ,Public Health, Environmental and Occupational Health ,Reproducibility of Results ,medicine.disease ,functional outcomes ,patient-reported outcomes ,wheeze ,Respiratory ,Medicine ,medicine.symptom ,business - Abstract
The purpose of this study is to validate the seven-item wheezing module from the International Study of Asthma and Allergies in Children (ISAAC) in the nationally representative Population Assessment of Tobacco and Health Study. Adult participants with complete Wave 2–3 data were selected, including those with asthma but excluding those with COPD and other respiratory diseases (n = 16,295). We created a nine-point respiratory symptom index from the ISAAC questions, assessed the reliability of the index, and examined associations with self-reported asthma diagnosis. Threshold values were assessed for association with functional outcomes. The weighted prevalence for one or more respiratory symptom was 18.0% (SE = 0.5) for adults without asthma, 70.1% (SE = 1.3) for those with lifetime asthma, 75.7% (SE = 3.7) for adults with past-year asthma not on medications, and 92.6% (SE = 1.6) for those on medications. Cronbach’s alpha for the respiratory symptom index was 0.86. Index scores of ≥2 or ≥3 yielded functionally important respiratory symptom prevalence of 7–10%, adequate sensitivity and specificity for identifying asthma, and consistent independent associations with all functional outcomes and tobacco use variables. Respiratory symptom index scores of ≥2 or ≥3 are indicative of functionally important respiratory symptoms and could be used to assess the relationship between tobacco use and respiratory health.
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- 2021
5. Waterpipe smoking and subsequent cigarette and e-cigarette use: a cohort study
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Michaela Goecke, James D. Sargent, Reiner Hanewinkel, Matthis Morgenstern, and Barbara Isensee
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Pulmonary and Respiratory Medicine ,business.industry ,Smoking ,Survey sampling ,Cigarette use ,Relative risk ,Waterpipe Smoking ,Original Research Articles ,Sensation seeking ,Medicine ,Risk factor ,Substance use ,business ,Demography ,Cohort study - Abstract
Aim We tested the hypothesis that waterpipe smoking increases the likelihood to try conventional and electronic cigarettes. Methods In 2017 and 2018, 2752 German adolescents (mean age: 14.9 years), who had never tried conventional cigarettes or e-cigarettes, took part in a longitudinal survey with a 6-month observational period. Multiple regression analyses tested the association between waterpipe use at baseline and first experimentation with e-cigarettes at follow-up. The models adjusted for risk-taking propensity (sensation seeking and experimentation with alcohol and marijuana), age, sex, migration background, type of school and peer substance use. Results Some 381 adolescents (12.5% of the survey population) reported waterpipe smoking at baseline. The overall initiation rate during the 6 months was 4.9% (n=134) for conventional cigarettes and 10.5% (n=288) for e-cigarettes. Prior waterpipe smoking significantly predicted cigarette use (adjusted relative risk (ARR)=1.81, 95% CI 1.19–2.76), as well as e-cigarette use (ARR=3.29, 95% CI 2.53–4.28). In addition, a significant interaction between waterpipe use and sensation seeking was found (ARR=0.56, 95% CI 0.33–0.95), with waterpipe use being more predictive of later e-cigarette initiation for lower sensation-seeking individuals. Discussion Waterpipe use predicted both later cigarette and e-cigarette use independent of all other assessed risk factors, indicating that waterpipe use might be a risk factor on its own. The results suggest that the association was stronger for adolescents with a lower risk-taking propensity, which brings this group into focus for prevention efforts. However, further research is needed to understand whether these associations are causal., In a large cohort of German adolescents, an association of prior hookah use with later use of cigarettes and e-cigarettes was found. Both associations were independent of adolescents’ propensity to seek risk. https://bit.ly/3lxY2bJ
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- 2021
6. First E-Cigarette Flavor and Device Type Used: Associations With Vaping Persistence, Frequency, and Dependence in Young Adults
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Adam M. Leventhal, Hongying Dai, Rob McConnell, Janet Audrain-McGovern, James D. Sargent, Jessica L. Barrington-Trimis, and Mike Stoolmiller
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Adult ,Adolescent ,Original Investigations ,Electronic Nicotine Delivery Systems ,Persistence (computer science) ,Nicotine ,chemistry.chemical_compound ,Young Adult ,Medicine ,Humans ,Prospective Studies ,Young adult ,Nicotine dependence ,Flavor ,Retrospective Studies ,business.industry ,Vaping ,Public Health, Environmental and Occupational Health ,Tobacco Products ,Device type ,Product characteristics ,medicine.disease ,Flavoring Agents ,Cross-Sectional Studies ,chemistry ,business ,Menthol ,Demography ,medicine.drug - Abstract
Introduction Type of e-cigarette flavoring and device during first use might differentiate later e-cigarette use and dependence. This retrospective cross-sectional study examined associations of recalled first nicotine vaping device and flavor used with current vaping frequency/dependence. Aims and Methods A young adult cohort from Los Angeles, California, USA completed web-based surveys (N = 2553). Using cross-sectional data from 971 reporting ever vaping nicotine, multivariable hurdle regressions tested associations between recalled first flavor (fruit/sweet, menthol/mint, other) and device (Juul, disposable, mod, box, pod, pen, other) vaped with past-30-day vaping status (yes/no) and frequency (1–30 days), and with any vaping dependence symptoms (yes/no) and count (1–10 symptoms). Results The most common first-flavor was sweet (71%); the most common first-device was a vape pen (37%), then Juul (22%). First-flavor of mint/menthol (vs. other; adjusted odds ratio [AOR]: 2.22[95% CI = 1.16 to 4.25]), and first-device mod (AOR = 2.40[95% CI = 1.34 to 4.31]) and non-Juul pod (2.64[95% CI = 1.41 to 4.92]) (vs. pen) were associated with past-30-day vaping, and twice as many vaping days (adjusted rate ratios [ARRs] range: 1.96–2.12; ps < .05). First flavor of mint/menthol (vs. other; AOR: 1.95[95% CI = 1.003 to 3.79) and first device mod, box, non-Juul pod, and other (AORs range: 2.36–4.01; ps < .05) were associated with nicotine dependence. First device Juul, mod, box, and non-Juul pod were also associated with more dependence symptoms (ARRs range:1.38–1.59; ps < .05). Conclusions Exposure to mint/menthol and certain devices (mod, box, Juul, and non-Juul pods) at first e-cigarette use may be associated with more frequent e-cigarette use and nicotine dependence symptoms in young adulthood. Mint/menthol and certain devices warrant consideration in regulation of e-cigarettes based on product characteristics. Implications Characteristics (flavor and device type) of first e-cigarette product used were associated with higher usage and more dependence. Pending replication with prospective designs, the findings suggest certain flavors (mint/menthol) and devices (pods, mods) merit consideration in regulation because of their possible link with continued use and dependence among young people.
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- 2021
7. Cardiovascular Risk Factor and Disease Measures from the Population Assessment of Tobacco and Health (PATH) Study
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Kristie Taylor, Hoda T. Hammad, Maciej L. Goniewicz, Nicolette Borek, Heather L. Kimmel, Baoguang Wang, Carlos Blanco, Martin C. Mahoney, Cheryl Rivard, Jueichuan Connie Kang, Kristin Lauten, Michael J. Halenar, Dorothy K. Hatsukami, K. Michael Cummings, Andrew Hyland, Eva Sharma, and James D. Sargent
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Adult ,validity ,National Health and Nutrition Examination Survey ,Heart disease ,Health, Toxicology and Mutagenesis ,Population ,Disease ,030204 cardiovascular system & hematology ,Article ,03 medical and health sciences ,0302 clinical medicine ,health behavior ,Risk Factors ,Diabetes mellitus ,Environmental health ,Tobacco ,medicine ,Prevalence ,Humans ,030212 general & internal medicine ,Prospective Studies ,Risk factor ,education ,Stroke ,education.field_of_study ,business.industry ,Public Health, Environmental and Occupational Health ,Reproducibility of Results ,medicine.disease ,Nutrition Surveys ,United States ,cardiovascular outcomes ,survey methods ,Cardiovascular Diseases ,Heart Disease Risk Factors ,Heart failure ,Medicine ,business - Abstract
Background: Cardiovascular disease is a key health condition associated with tobacco use, however, clinical measures are not typically possible in population-based studies. In this paper, we assess the reliability and validity of self-reported cardiovascular risk factors and diseases in a large nationally representative study of tobacco use and health outcomes. Methods: This paper analyzes self-reported cardiovascular risk factors and disease among adults age 40 years and older based on U.S. nationally representative data from the Population Assessment of Tobacco and Health (PATH) Study. Prevalence of cardiovascular risk factors (self-reported high blood pressure, high cholesterol, diabetes and family history of premature heart disease, BMI ≥ 35, and tobacco use) and cardiovascular disease (self-reported heart attack, stroke and/or congestive heart failure (CHF)) were considered along with ratings of physical functioning, fatigue, and general health. Results: Self-reported cardiovascular disease was found to be associated with functional health measures (walking up a flight of stairs) and general ratings of health. Prospective analyses found strong correlations between sequential data collection waves for history of hypertension, elevated cholesterol and CHF, while more modest correlations were noted for stroke and heart attack. The overall prevalence of cardiovascular disease and hypertension was comparable to those from the National Health and Nutrition Examination Survey (NHANES). Conclusions: These analyses suggest reliability and concurrent validity regarding self-reported cardiovascular risk factors and disease assessed in the PATH Study.
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- 2021
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8. Longitudinal e-Cigarette and Cigarette Use Among US Youth in the PATH Study (2013–2015)
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James D. Sargent, Maciej L. Goniewicz, Hannah Day, K. Michael Cummings, Mark J. Travers, Lauren Katz, Amanda L. Johnson, Marushka L. Silveira, Andrew Hyland, Jennifer L. Pearson, Jean Limpert, Eva Sharma, Maansi Bansal-Travers, Nicolette Borek, Bridget K. Ambrose, Sarah E. Johnson, Susanne E. Tanski, Wilson M. Compton, Annette R. Kaufman, Heather L. Kimmel, David B. Abrams, and Cassandra A. Stanton
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Male ,Cancer Research ,Adolescent ,Population ,Cigarette use ,Electronic Nicotine Delivery Systems ,Affect (psychology) ,History, 21st Century ,Odds ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Cigarette smoking ,030225 pediatrics ,Prevalence ,Humans ,Medicine ,Public Health Surveillance ,030212 general & internal medicine ,Child ,Propensity Score ,education ,Differential impact ,education.field_of_study ,business.industry ,Smoking ,Tobacco Products ,Articles ,United States ,Confidence interval ,Oncology ,Propensity score matching ,Female ,business ,Demography - Abstract
BackgroundEvidence is accumulating that youth who try Electronic Nicotine Delivery Systems (ENDS, e-cigarettes) may go on to try cigarettes. This analysis examines the bidirectional patterns of ENDS and cigarette use among US youth over one year and uses propensity score matching (PSM) to examine frequency of ENDS use on changes in cigarette smoking.MethodsOur analysis included 11 996 participants who had two waves of available data (Wave 1 [W1] 2013–2014; Wave 2 [W2] 2014–2015) drawn from the longitudinal Population Assessment of Tobacco and Health Study. Cross-sectional weighted prevalence estimates are reported for cigarettes and ENDS. We used PSM to estimate the likelihood of ENDS use at W1 and to draw matched analytic samples, then used regression (logistic or linear) models to examine the effect of W1 ENDS use on W2 cigarette smoking. All statistical tests were two-sided.ResultsIn weighted analyses, 69.3% of W1 past-30-day cigarette smokers exhibited past-30-day smoking at W2; 42.2% of W1 past-30-day ENDS users were using ENDS at W2. W1 ever use of either product was similarly associated with W2 new use of the other product. Unweighted PSM models indicated W1 cigarette-naïve ENDS use was associated with W2 ever-cigarette smoking (n = 676; adjusted odds ratio = 3.21, 95% confidence interval [CI] = 1.95 to 5.45, P ConclusionsEver-ENDS use predicts future cigarette smoking, and frequency of ENDS use has a differential impact on subsequent cigarette smoking uptake or reduction. These results suggest that both cigarettes and ENDS should be targeted in early tobacco prevention efforts with youth.
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- 2019
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9. Promotion of Meal Premiums in Child-Directed TV Advertising for Children’s Fast-food Meals
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James D. Sargent, Hannah Utter, Mark A. Gottlieb, Jennifer A. Emond, Vincent Chang, and Alec Eschholz
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Meal ,business.industry ,media_common.quotation_subject ,Word count ,digestive, oral, and skin physiology ,Advertising ,Obesity risk ,Articles ,Direct-to-Consumer Advertising ,medicine.disease ,Childhood obesity ,United States ,Promotion (rank) ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,medicine ,Fast Foods ,Humans ,Television ,business ,health care economics and organizations ,media_common - Abstract
BACKGROUND: Fast-food intake is a modifiable obesity risk factor in early childhood, and child-directed fast-food marketing is common. Per self-regulatory guidelines regarding deception, premiums (ie, incentives or toy giveaways) in child-directed advertisements must be secondary to the advertised product. METHODS: Content analyses were performed of all child-directed fast-food television (TV) advertisements aired on four national US children’s TV networks, February 1, 2019, through January 31, 2020, to assess the emphasis of premiums relative to food. We quantified the percent of the audio transcript (word count) and visual airtime (seconds) that included premiums or food and the on-screen size of premiums relative to food in randomly selected frames from each advertisement. RESULTS: There were 28 unique child-directed advertisements for children’s fast-food meals in the study year; 27 advertisements were from one restaurant and accounted for nearly all (99.8%) of the total airtime for the 28 advertisements. Premiums were present in 27 of the 28 unique advertisements. On average, premiums (versus food) accounted for 53.0% (vs 16.0%) of words in the audio transcript and 59.2% (vs 54.3%) of the visual airtime per advertisement. In the random subset of frames that includes both premiums and food imagery, imagery of premiums accounted for 9.7% (95% CI: 6.4%–13.0%) of the on-screen area, whereas imagery of food accounted for 5.7% (95% CI: 4.4%–7.0%), an average ratio of 1.9:1 within each frame when excluding one large outlier. CONCLUSIONS: Child-directed fast-food TV advertisements emphasize premiums over food in violation of self-regulatory guidelines, counter to childhood obesity prevention efforts.
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- 2021
10. Recommendations From the USPSTF for Prevention and Cessation of Tobacco Use in Children and Adolescents
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James D. Sargent, Adam M. Leventhal, and Jennifer B. Unger
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medicine.medical_specialty ,Tobacco use ,Adolescent ,Primary Health Care ,business.industry ,medicine.medical_treatment ,MEDLINE ,Primary health care ,General Medicine ,Article ,Tobacco Use ,Family medicine ,Medicine ,Smoking cessation ,Humans ,Smoking Cessation ,Tobacco Use Cessation ,business ,Child - Published
- 2020
11. U.S. cannabis legalization and use of vaping and edible products among youth
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Dustin C. Lee, James D. Sargent, Joy Gabrielli, Jacob T. Borodovsky, Benjamin S. Crosier, and Alan J. Budney
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Male ,medicine.medical_specialty ,Younger age ,Adolescent ,030508 substance abuse ,Marijuana Smoking ,Toxicology ,Article ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Environmental health ,Humans ,Medicine ,Pharmacology (medical) ,030212 general & internal medicine ,Psychiatry ,Cannabis ,Legalization ,Pharmacology ,Alternative methods ,biology ,business.industry ,Vaping ,Cannabis use ,Legislation, Drug ,biology.organism_classification ,United States ,Dispensary ,Psychiatry and Mental health ,Marijuana Use ,Age of onset ,0305 other medical science ,business ,Licensure - Abstract
Background Alternative methods for consuming cannabis (e.g., vaping and edibles) have become more popular in the wake of U.S. cannabis legalization. Specific provisions of legal cannabis laws (LCL) (e.g., dispensary regulations) may impact the likelihood that youth will use alternative methods and the age at which they first try the method – potentially magnifying or mitigating the developmental harms of cannabis use. Methods This study examined associations between LCL provisions and how youth consume cannabis. An online cannabis use survey was distributed using Facebook advertising, and data were collected from 2630 cannabis-using youth (ages 14–18). U.S. states were coded for LCL status and various LCL provisions. Regression analyses tested associations among lifetime use and age of onset of cannabis vaping and edibles and LCL provisions. Results Longer LCL duration (OR vaping : 2.82, 95% CI: 2.24, 3.55; OR edibles : 3.82, 95% CI: 2.96, 4.94), and higher dispensary density (OR vaping : 2.68, 95% CI: 2.12, 3.38; OR edibles : 3.31, 95% CI: 2.56, 4.26), were related to higher likelihood of trying vaping and edibles. Permitting home cultivation was related to higher likelihood (OR: 1.93, 95% CI: 1.50, 2.48) and younger age of onset (β: −0.30, 95% CI: −0.45, −0.15) of edibles. Conclusion Specific provisions of LCL appear to impact the likelihood, and age at which, youth use alternative methods to consume cannabis. These methods may carry differential risks for initiation and escalation of cannabis use. Understanding associations between LCL provisions and methods of administration can inform the design of effective cannabis regulatory strategies.
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- 2017
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12. Adolescent smoking experimentation as a predictor of daily cigarette smoking
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Joy Gabrielli, Alan J. Budney, Thomas A. Wills, James D. Sargent, and Samir Soneji
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Male ,Adolescent ,Early adolescence ,media_common.quotation_subject ,Toxicology ,Logistic regression ,Article ,Cigarette Smoking ,03 medical and health sciences ,0302 clinical medicine ,Cigarette smoking ,030225 pediatrics ,Humans ,Personality ,Medicine ,Pharmacology (medical) ,Longitudinal Studies ,030212 general & internal medicine ,Child ,media_common ,Pharmacology ,Academic Success ,business.industry ,Odds ratio ,United States ,Confidence interval ,Psychiatry and Mental health ,Adolescent Behavior ,Female ,Substance use ,business ,Social psychology ,Adolescent smoking ,Demography - Abstract
Objective The utility of studying substance use during early adolescence depends on how well indicies of lower-level experimentation predict the development of substance use problems. We examined associations between experimental cigarette use at T1, recanting of use 8 months later (T2), and daily smoking at 2 years (T4). Methods Longitudinal telephone survey of 6522 US youth aged 10–14, examining lifetime cigarette smoking (none, just puffing, 1–19, 20–100, >100) and recanting (i.e., reporting lifetime use at T1, denying ever using at T2) as predictors of T4 daily smoking using multivariable logistic regression. Covariates included sociodemographics, friend/family smoking, school performance, and personality characteristics. Results The sample was 51% male, 18% Black, 17% Hispanic, with 70% retained at T2. At T1, 407 (8.9%) adolescents reported some smoking, of whom 85 (20.9%) recanted at T2. At T4, 970 reported any smoking, of whom 88 (9.1%) were daily smokers. Any T1 experimentation identified two-thirds of T4 daily smokers (sensitivity = 66.7%) with a false positive rate of 7.8%. T1 lifetime smoking categories were associated with the following adjusted odds ratios for T4 daily smoking (vs. never smokers): 2.7 for recanters (95% confidence interval 0.82, 8.5), 3.5 for few puffs (1.7, 7.0), 9.6 for 1–19 cigarettes (4.1, 22.3), 3.8 for 20–100 cigarettes (1.0, 14.3), and 30.1 for >100 cigarettes (8.1, 111). Conclusions In this sample experimentation with cigarettes predicted future daily smoking with high utility. The findings provide a rationale for monitoring and reporting any experimentation cigarettes as a tobacco surveillance outcome.
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- 2017
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13. 195: Timing two doses of antenatal corticosteroid treatment for PPROM at 22 weeks: a decision analysis
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Aaron B. Caughey, Clarice G. Zhou, and James D. Sargent
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medicine.medical_specialty ,Obstetrics ,business.industry ,medicine ,Obstetrics and Gynecology ,Antenatal corticosteroid ,business ,Decision analysis - Published
- 2020
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14. 591: Timing rescue antenatal corticosteroid treatment for PPROM at the limit of viability: a decision analysis
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Aaron B. Caughey, James D. Sargent, and Clarice G. Zhou
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medicine.medical_specialty ,business.industry ,Obstetrics ,Obstetrics and Gynecology ,Medicine ,Limit (mathematics) ,Antenatal corticosteroid ,business ,Decision analysis - Published
- 2020
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15. Assessing data availability and quality within an electronic health record system through external validation against an external clinical data source
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John H. Higgins, Jennifer A. Doherty, Saeed Hassanpour, Ellen L. Palmer, Christina M. Robinson, Tracy Onega, and James D. Sargent
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Adult ,medicine.medical_specialty ,Lung Neoplasms ,Medical Records Systems, Computerized ,020205 medical informatics ,media_common.quotation_subject ,Smokers registry ,Information Storage and Retrieval ,Health Informatics ,02 engineering and technology ,lcsh:Computer applications to medicine. Medical informatics ,Health informatics ,Cigarette Smoking ,03 medical and health sciences ,0302 clinical medicine ,Electronic health record ,Surveys and Questionnaires ,0202 electrical engineering, electronic engineering, information engineering ,Humans ,Electronic health records ,Medicine ,Quality (business) ,Registries ,030212 general & internal medicine ,Pack-year ,Early Detection of Cancer ,media_common ,Data source ,business.industry ,Natural language processing ,Health Policy ,External validation ,Computer Science Applications ,Informatics ,Family medicine ,lcsh:R858-859.7 ,Informatics pipeline ,business ,Algorithms ,Lung cancer screening ,Research Article - Abstract
Background Approximately 20% of deaths in the US each year are attributable to smoking, yet current practices in the recording of this health risk in electronic health records (EHRs) have not led to discernable changes in health outcomes. Several groups have developed algorithms for extracting smoking behaviors from clinical notes, but none of these approaches were assessed with external data to report on anticipated clinical performance. Methods Previously, we developed an informatics pipeline that extracts smoking status, pack year history, and cessation date from clinical notes. Here we report on the clinical implementation performance of our pipeline using 1,504 clinical notes matched to an external questionnaire. Results We found that 73% of available notes contained no smoking behavior information. The weighted Cohen’s kappa between the external questionnaire and EHR smoking status was 0.62 (95% CI 0.56–0.69) for the clinical notes we were able to extract information from. The correlation between pack years reported by our pipeline and the external questionnaire was 0.39 on the 81 notes for which this information was present in both. We also assessed for lung cancer screening eligibility using notes from individuals identified as never smokers or smokers with pack year history extracted by our pipeline (n = 196). We found a positive predictive value of 85.4%, a negative predictive value of 83.8%, sensitivity of 63.1%, and specificity of 94.7%. Conclusions We have demonstrated that our pipeline can extract smoking behaviors from unannotated EHR notes when the information is present. This information is reliable enough to identify patients most likely to be eligible for smoking related services. Ensuring capture of smoking information during clinical encounters should continue to be a high priority.
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- 2019
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16. Portrayals of character smoking and drinking in Argentine-, Mexican- and US-produced films
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James D. Sargent, James F. Thrasher, Rosaura Pérez-Hernández, Christy Kollath-Cattano, Raul Mejia, and Erika N. Abad-Vivero
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Adolescent ,Alcohol Drinking ,Epidemiology ,Motion Pictures ,Population ,Argentina ,Poison control ,Suicide prevention ,Article ,Gee ,03 medical and health sciences ,Risk-Taking ,Sex Factors ,0302 clinical medicine ,030225 pediatrics ,Injury prevention ,Prevalence ,Humans ,Medicine ,030212 general & internal medicine ,education ,Mexico ,Generalized estimating equation ,education.field_of_study ,business.industry ,Smoking ,Public Health, Environmental and Occupational Health ,Human factors and ergonomics ,United States ,Character (mathematics) ,business ,Demography - Abstract
The aim of this study was to assess film character portrayals of tobacco and alcohol use in US and nationally-produced films that were popular in Argentina and Mexico from 2004–2012. We performed a content analysis of these films (n = 82 Argentine, 91 Mexican, and 908 US films, respectively). Chi-squares and t-tests were used to compare characteristics of characters who smoked or drank by country of movie production. Then data from all countries were pooled, and generalized estimating equation (GEE) models were used to determine independent correlates of character smoking or drinking. There were 480 major characters for Argentine-, 364 for Mexican-, and 4962 for US-produced films. Smoking prevalence among movie characters was similar to population smoking prevalence in Mexico (21%) and Argentina (26%), but about half in the US (11%), where movie product placements are restricted. Movie smoking declined over the period in all three countries. Movie alcohol prevalence was 40–50% across all countries and did not change with time. Demographic predictors of character smoking included: being male, 18 and older, having negative character valence. Movie smoking was not associated with lower SES. Predictors of character drinking included: being age 18 and older and positive character valence. Smoking and drinking predicted each other, illicit drug use, and higher scores for other risk behaviors. This suggests that policy development in Mexico and Argentina may be necessary to reduce the amount of character tobacco and alcohol use in films.
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- 2016
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17. Design and methods of the Population Assessment of Tobacco and Health (PATH) Study
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Andrew Hyland, Wilson M. Compton, Nahla Hilmi, Kevin P. Conway, Greta K. Tessman, Dana M. van Bemmel, Heather L. Kimmel, Andrea Piesse, James D. Sargent, Nick Pharris-Ciurej, Raymond Niaura, Bridget K. Ambrose, Barbara O'Brien, Nicolette Borek, Ben Blount, Derek Alberding, Jonathan Kwan, Geoffrey T. Fong, Elizabeth Lambert, Yu Ching Cheng, Cathy L. Backinger, David M Maklan, Scott Crosse, Annette R. Kaufman, K. Michael Cummings, Graham Kalton, Charles Carusi, John P. Pierce, Victoria Castleman, Victoria R. Green, Maansi Bansal-Travers, Karen Messer, David Hammond, David B. Abrams, Charles E. Lawrence, Donna Vallone, Kristie Taylor, Cindy Tworek, Sharon L. Lohr, Ling Yang, and Lynn C Hull
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Male ,Gerontology ,Health Knowledge, Attitudes, Practice ,and promotion of well-being ,Health (social science) ,Public policy ,030508 substance abuse ,Disease ,Cardiovascular ,Substance Misuse ,0302 clinical medicine ,Medicine ,Longitudinal Studies ,030212 general & internal medicine ,Longitudinal cohort ,Child ,Cancer ,Practice ,education.field_of_study ,Health Knowledge ,Smoking ,Tobacco control ,Substance Abuse ,3.5 Resources and infrastructure (prevention) ,Middle Aged ,Substance abuse ,Research Design ,Respiratory ,Female ,Public Health ,0305 other medical science ,Adult ,Pediatric Research Initiative ,Surveillance and monitoring ,Adolescent ,Population ,Health outcomes ,Basic Behavioral and Social Science ,Article ,Young Adult ,03 medical and health sciences ,Clinical Research ,Environmental health ,Behavioral and Social Science ,Tobacco ,Humans ,education ,Aged ,Data collection ,Tobacco Smoke and Health ,business.industry ,Prevention ,Public Health, Environmental and Occupational Health ,Prevention of disease and conditions ,medicine.disease ,United States ,Good Health and Well Being ,Conceptual framework ,Attitudes ,3.1 Primary prevention interventions to modify behaviours or promote wellbeing ,Drug Abuse (NIDA only) ,business - Abstract
Background This paper describes the methods and conceptual framework for Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study data collection. The National Institutes of Health, through the National Institute on Drug Abuse, is partnering with the Food and Drug Administration9s (FDA) Center for Tobacco Products to conduct the PATH Study under a contract with Westat. Methods The PATH Study is a nationally representative, longitudinal cohort study of 45 971 adults and youth in the USA, aged 12 years and older. Wave 1 was conducted from 12 September 2013 to 15 December 2014 using Audio Computer-Assisted Self-Interviewing to collect information on tobacco-use patterns, risk perceptions and attitudes towards current and newly emerging tobacco products, tobacco initiation, cessation, relapse behaviours and health outcomes. The PATH Study9s design allows for the longitudinal assessment of patterns of use of a spectrum of tobacco products, including initiation, cessation, relapse and transitions between products, as well as factors associated with use patterns. Additionally, the PATH Study collects biospecimens from consenting adults aged 18 years and older and measures biomarkers of exposure and potential harm related to tobacco use. Conclusions The cumulative, population-based data generated over time by the PATH Study will contribute to the evidence base to inform FDA9s regulatory mission under the Family Smoking Prevention and Tobacco Control Act and efforts to reduce the Nation9s burden of tobacco-related death and disease.
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- 2016
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18. Appeal of electronic cigarettes in smokers with serious mental illness
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Sarah I. Pratt, Luke Daniels, Meghan Santos, James D. Sargent, and Mary F. Brunette
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Adult ,Male ,medicine.medical_specialty ,Nausea ,Appeal ,Medicine (miscellaneous) ,Electronic Nicotine Delivery Systems ,Toxicology ,Nicotine ,Young Adult ,03 medical and health sciences ,High morbidity ,0302 clinical medicine ,medicine ,Sore throat ,Humans ,030212 general & internal medicine ,Nicotine dependence ,Psychiatry ,Aged ,Smokers ,business.industry ,Mental Disorders ,Tobacco Use Disorder ,Middle Aged ,medicine.disease ,Mental illness ,030227 psychiatry ,Psychiatry and Mental health ,Clinical Psychology ,Patient Satisfaction ,Female ,medicine.symptom ,business ,Breath carbon monoxide ,medicine.drug - Abstract
Introduction Up to 75% of people with serious mental illness (SMI) smoke, and most are highly dependent on nicotine, consuming more cigarettes per day than smokers without mental illness. Even with evidence-based treatment, relapses are common, resulting in high morbidity and early mortality from tobacco-related diseases. Electronic cigarettes (e-cigarettes) are theoretically safer because they deliver no tar or carbon monoxide; however, their appeal is largely untested in people with SMI. Methods We enrolled 21 chronic smokers with SMI who had failed a quit attempt and were not engaged in cessation treatment. Research staff provided e-cigarettes and instructions on how to use them, and assessed participants weekly for 4 weeks. Results Of the enrolled participants, 19 completed weekly assessments. From baseline to the final study visit, mean self-reported use of combustible tobacco declined from 192 to 67 cigarettes/week (t = 3.62, df = 17, p = 0.005), confirmed by reduction in breath carbon monoxide from 27 ppm to 15 ppm (t = 3.246, df = 18, p = 0.004). Use of e-cigarettes did not escalate over the 4 weeks. Temporary and mild side effects, including dry/sore throat, nausea, dizziness, and cough, were reported by 58% of participants. End of trial ratings of enjoyment, satisfaction compared to regular cigarettes, and willingness to buy e-cigarettes were high (ranging from 3.82–4.51 on a 5-point scale). Conclusions Results of this study suggest that people with SMI may find e-cigarettes an appealing substitute for combustible cigarettes. We found no evidence of increasing nicotine dependence. Further randomized studies are needed to better assess e-cigarette appeal and toxicity.
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- 2016
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19. Prevalence and Correlates of E-Cigarette Perceptions and Trial Among Early Adolescents in Mexico
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Erika N. Abad-Vivero, Raul Mejia, Inti Barrientos-Gutiérrez, James D. Sargent, James F. Thrasher, Edna Arillo-Santillán, Mauricio Hernández-Ávila, Luz Miriam Reynales-Shigematsu, and Rosaura Pérez-Hernández
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Technophilia ,030505 public health ,Cross-sectional study ,business.industry ,media_common.quotation_subject ,education ,Public Health, Environmental and Occupational Health ,Multilevel logistic regression ,03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,Perception ,Pediatrics, Perinatology and Child Health ,Medicine ,Early adolescents ,030212 general & internal medicine ,Substance use ,0305 other medical science ,business ,Social psychology ,Bedroom ,Demography ,media_common - Abstract
Purpose Assess the prevalence and correlates of e-cigarette perceptions and trial among adolescents in Mexico, where e-cigarettes are banned. Methods Cross-sectional data were collected in 2015 from a representative sample of middle-school students (n = 10,146). Prevalence of e-cigarette awareness, relative harm, and trial were estimated, adjusting for sampling weights and school-level clustering. Multilevel logistic regression models adjusted for school-level clustering to assess correlates of e-cigarette awareness and trial. Finally, students who had tried only e-cigarettes were compared with students who had tried: (1) conventional cigarettes only; (2) both e-cigarettes and conventional cigarettes (dual triers); and (3) neither cigarette type (never triers). Results Fifty-one percent of students had heard about e-cigarettes, 19% believed e-cigarettes were less harmful than conventional cigarettes, and 10% had tried them. Independent correlates of e-cigarette awareness and trial included established risk factors for smoking, as well as technophilia (i.e., use of more media technologies) and greater Internet tobacco advertising exposure. Exclusive e-cigarette triers (4%) had significantly higher technophilia, bedroom Internet access, and Internet tobacco advertising exposure compared to conventional cigarette triers (19%) and never triers (71%) but not compared to dual triers (6%), although dual triers had significantly stronger conventional cigarette risk factors. Conclusions This study suggests that adolescent e-cigarette awareness and use is high in Mexico, in spite of its e-cigarette ban. A significant number of medium-risk youth have tried e-cigarettes only, suggesting that e-cigarettes could lead to more intensive substance use. Strategies to reduce e-cigarette use should consider reducing exposures to Internet marketing.
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- 2016
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20. Trends in the Age of Cigarette Smoking Initiation Among Young Adults in the US From 2002 to 2018
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Jessica L. Barrington-Trimis, Adam M. Leventhal, Rob McConnell, Jennifer B. Unger, Jonathan M. Samet, James D. Sargent, Andrew Stokes, Renee D. Goodwin, and Jessica L. Braymiller
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education.field_of_study ,business.industry ,Population ,Prevalence ,General Medicine ,Daily smoking ,Smoking initiation ,Cigarette smoking ,Recall bias ,Medicine ,Young adult ,business ,education ,Adolescent smoking ,Demography - Abstract
Importance Success in reducing the prevalence of adolescent smoking could reflect complete prevention of smoking initiation or a shift in the age of cigarette smoking initiation from adolescence into early adulthood. Objective To assess trends in early adult (ages 18-23 years) vs adolescent (age
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- 2020
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21. Mental Health Problems and Onset of Tobacco Use among 12–24 year-olds in the PATH Study
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Cassandra A. Stanton, Victoria R. Green, Raymond Niaura, Priscilla Callahan-Lyon, Wilson M. Compton, K. Michael Cummings, Mary F. Brunette, Karin A. Kasza, Nicolette Borek, Kevin P. Conway, Chad J. Reissig, Izabella Zandberg, Marushka L. Silveira, Nahla Hilmi, Andrew Hyland, Elizabeth Lambert, Amy M. Cohn, Wendy I. Slavit, James D. Sargent, and Susanne E. Tanski
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Adult ,Male ,Adolescent ,Substance-Related Disorders ,Population ,Psychological intervention ,Electronic Nicotine Delivery Systems ,Article ,Cohort Studies ,03 medical and health sciences ,Tobacco Use ,Young Adult ,0302 clinical medicine ,Dissolvable tobacco ,Developmental and Educational Psychology ,Medicine ,Humans ,030212 general & internal medicine ,Longitudinal Studies ,education ,Child ,education.field_of_study ,business.industry ,Mental Disorders ,Cigarillo ,Age Factors ,Odds ratio ,Tobacco Products ,Mental health ,United States ,Psychiatry and Mental health ,Smokeless tobacco ,Snus ,Female ,Self Report ,business ,030217 neurology & neurosurgery ,Demography - Abstract
Objective To examine whether mental health problems predict incident use of 12 different tobacco products in a nationally representative sample of youth and young adults. Method This study analyzed Wave (W) 1 and W2 data from 10,533 12- to 24-year-old W1 never tobacco users in the Population Assessment of Tobacco and Health (PATH) Study. Self-reported lifetime internalizing and externalizing symptoms were assessed at W1. Past 12-month use of cigarettes, electronic nicotine delivery systems (ENDS), traditional cigars, cigarillos, filtered cigars, pipe, hookah, snus pouches, other smokeless tobacco, bidis and kreteks (youth only), and dissolvable tobacco was assessed at W2. Results In multivariable regression analyses, high-severity W1 internalizing (adjusted odds ratio [AOR] = 1.5, 95% CI = 1.3−1.8) and externalizing (AOR = 1.3, 95% CI = 1.1−1.5) problems predicted W2 onset of any tobacco use compared to no/low/moderate severity. High-severity W1 internalizing problems predicted W2 use onset across most tobacco products. High-severity W1 externalizing problems predicted onset of any tobacco (AOR = 1.6, 95% CI = 1.3−1.8), cigarettes (AOR = 1.4, 95% CI = 1.0−2.0), ENDS (AOR = 1.8, 95% CI = 1.5−2.1), and cigarillos (AOR = 1.5, 95% CI = 1.0−2.1) among youth only. Conclusion Internalizing and externalizing problems predicted onset of any tobacco use. However, findings differed for internalizing and externalizing problems across tobacco products, and by age, gender, and race/ethnicity. In addition to screening for tobacco product use, health care providers should screen for a range of mental health problems as a predictor of tobacco use. Interventions addressing mental health problems may prevent youth from initiating tobacco use.
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- 2018
22. Impact of exposure to alcohol marketing and subsequent drinking patterns among youth and young adults
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Samantha Cukier, James D. Sargent, Bruce D. Bartholow, Kristina M. Jackson, Mike Stoolmiller, Silvia Minozzi, and Ashley Wettlaufer
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Medicine General & Introductory Medical Sciences ,Adolescent ,Alcohol Drinking ,Injury control ,MEDLINE ,030508 substance abuse ,Poison control ,Suicide prevention ,Occupational safety and health ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Environmental health ,Injury prevention ,Humans ,Medicine ,Pharmacology (medical) ,030212 general & internal medicine ,Young adult ,Child ,Marketing ,business.industry ,Alcoholic Beverages ,Human factors and ergonomics ,0305 other medical science ,business ,Systematic Reviews as Topic - Abstract
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the impact of exposure to any form of alcohol marketing, compared to less exposure or no exposure, on alcohol consumption patterns among youth and young adults up to and including the age of 25 years (we want to be able to look at potential dose response relationships at different levels of exposure).
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- 2018
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23. Longitudinal associations between youth tobacco and substance use in waves 1 and 2 of the population assessment of tobacco and health (path) study
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Nicolette Borek, Cassandra A. Stanton, Chad J. Reissig, Nahla Hilmi, Izabella Zandberg, Susanne E. Tanski, James D. Sargent, Kevin P. Conway, Amy M. Cohn, Wilson M. Compton, Andrew Hyland, Priscilla Callahan-Lyon, Wendy I. Slavit, Karin A. Kasza, Raymond Niaura, Mary F. Brunette, K. Michael Cummings, Victoria R. Green, Marushka L. Silveira, and Elizabeth Lambert
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Drug ,Male ,Adolescent ,Substance-Related Disorders ,media_common.quotation_subject ,Population ,Electronic Nicotine Delivery Systems ,Toxicology ,Article ,Heroin ,03 medical and health sciences ,Tobacco Use ,0302 clinical medicine ,Dissolvable tobacco ,Risk Factors ,030225 pediatrics ,Environmental health ,medicine ,Sensation seeking ,Humans ,Pharmacology (medical) ,030212 general & internal medicine ,Longitudinal Studies ,education ,Child ,media_common ,Pharmacology ,education.field_of_study ,business.industry ,Cigarillo ,Tobacco Use Disorder ,United States ,Psychiatry and Mental health ,Smokeless tobacco ,Population Surveillance ,Snus ,Female ,business ,medicine.drug - Abstract
Background While evidence suggests bidirectional associations between cigarette use and substance (alcohol or drug) use, how these associations are reflected across the range of currently available tobacco products is unknown. This study examined whether ever tobacco use predicted subsequent substance use, and ever substance use predicted subsequent tobacco use among 11,996 U.S. youth (12–17 years) from Waves 1 (2013–2014) and 2 (2014–2015) of the Population Assessment of Tobacco and Health (PATH) Study. Methods Ever use of cigarettes, e-cigarettes, traditional cigars, cigarillos, filtered cigars, pipe, hookah, snus pouches, smokeless tobacco excluding snus pouches, dissolvable tobacco, bidis, kreteks, alcohol, marijuana, prescription drugs, and other drugs (cocaine and other stimulants, heroin, inhalants, solvents, and hallucinogens) was assessed at Wave 1 followed by past 12-month use assessments at Wave 2. The analyses included covariates (demographics, mental health, sensation seeking, prior use) to mitigate confounding. Results Ever tobacco use predicted subsequent substance use. The magnitude of the associations was lowest for alcohol, higher for marijuana, and highest for other drugs. Ever substance use also predicted subsequent tobacco use. Specifically, ever alcohol, marijuana, and non-prescribed Ritalin/Adderall use predicted tobacco-product use. Ever e-cigarette and cigarette use exclusively and concurrently predicted subsequent any drug (including and excluding alcohol) use. E-cigarette and cigarette use associations in the opposite direction were also significant; the strongest associations were observed for exclusive cigarette use. Conclusion Tobacco and substance use prevention efforts may benefit from comprehensive screening and interventions across tobacco products, alcohol, and drugs, and targeting risk factors shared across substances.
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- 2018
24. Aspirational Brand Choice and Underage Alcohol Use
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Joy Gabrielli, James D. Sargent, Auden C. McClure, and Susanne E. Tanski
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Male ,Health (social science) ,Adolescent ,Alcohol Drinking ,Commodity ,030508 substance abuse ,Underage Drinking ,Toxicology ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Surveys and Questionnaires ,Odds Ratio ,Prevalence ,Humans ,Adolescent Drinking and Drug Use ,030212 general & internal medicine ,Underage Alcohol Use ,health care economics and organizations ,Marketing ,Alcoholic Beverages ,technology, industry, and agriculture ,Advertising ,Allegiance ,United States ,Psychiatry and Mental health ,Logistic Models ,Aspirational brand ,Female ,Business ,0305 other medical science - Abstract
OBJECTIVE: Marketing aims to foster brand allegiance, and alcohol is a heavily marketed commodity. We hypothesize that exposed youth who are able to identify an aspirational alcohol brand will be at higher risk for underage drinking. METHOD: U.S. youth ages 15–20 (N = 2,012; 51% female) were surveyed twice in 2011–2013. Aspirational brand was assessed by asking, “If you could drink any brand you want, what is the name of the brand of alcohol you would choose?” Multivariable logistic regression tested associations between having an aspirational brand at baseline and onset of ever, binge (≥6 drinks/occasion), and hazardous drinking (Alcohol Use Disorders Identification Test–Consumption ≥ 4). RESULTS: Baseline ever, binge, and hazardous drinking prevalence was 55%, 26%, and 19%, respectively; 47% reported having an aspirational brand, of whom 20% were nondrinkers. Top five reported brands were Budweiser, Smirnoff, Corona, Jack Daniels, and Bacardi, all heavily advertised brands. Older age, male gender, sensation seeking, and peer/parent drinking were associated with having an aspirational brand. After we controlled for these confounders, having an aspirational brand was independently associated cross-sectionally with greater risk of ever, binge, and hazardous drinking (adjusted odds ratio = 4.47, 95% CI [3.33, 6.00], 4.84 [3.41, 6.86], and 5.46 [3.63, 8.23], respectively) and longitudinally with initiation of binge and hazardous drinking (1.80 [1.19, 2.73] and 2.02 [1.33, 3.06], respectively). CONCLUSIONS: Having an aspirational alcohol brand is both common and independently associated with subsequent underage alcohol use and misuse. Further studies examining how youth interact with and are affected by branded advertising are critical to guide development of effective education and policy interventions.
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- 2018
25. Association Between Receptivity to Tobacco Advertising and Progression to Tobacco Use in Youth and Young Adults in the PATH Study
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Cassandra A. Stanton, Annette R. Kaufman, David B. Portnoy, Nicolette Borek, Sheila Kealey, Eric C. Leas, James D. Sargent, Yuyan Shi, Madison Noble, Kelvin Choi, Charles Carusi, Martha White, Maansi Bansal-Travers, John P. Pierce, Susanne E. Tanski, Kimberly Snyder, Katherine A. Margolis, Victoria R. Green, Karen Messer, Marushka L. Silveira, Andrew Hyland, Dennis R. Trinidad, and M. Jane Lewis
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Male ,Tobacco, Smokeless ,Tobacco use ,Adolescent ,Population ,Receptivity ,Electronic Nicotine Delivery Systems ,Pediatrics ,Article ,Smokeless ,Paediatrics and Reproductive Medicine ,03 medical and health sciences ,Young Adult ,Tobacco Use ,0302 clinical medicine ,Advertising ,Clinical Research ,030225 pediatrics ,Tobacco ,Medicine ,Humans ,030212 general & internal medicine ,Young adult ,Tobacco Use Epidemiology ,education ,Child ,Cancer ,education.field_of_study ,Tobacco Smoke and Health ,business.industry ,Prevention ,Smoking ,Odds ratio ,Confidence interval ,United States ,Good Health and Well Being ,Smokeless tobacco ,Adolescent Behavior ,Pediatrics, Perinatology and Child Health ,Respiratory ,Female ,Disease Susceptibility ,business ,Follow-Up Studies - Abstract
© 2018 American Medical Association. All rights reserved. IMPORTANCE Cigarette marketing contributes to initiation of cigarette smoking among young people, which has led to restrictions on use of cigarette advertising. However, little is known about other tobacco advertising and progression to tobacco use in youth and young adults. OBJECTIVE To investigate whether receptivity to tobacco advertising among youth and young adults is associated with progression (being a susceptible never user or ever user) to use of the product advertised, as well as conventional cigarette smoking. DESIGN, SETTING, AND PARTICIPANTS The Population Assessment of Tobacco and Health (PATH) Study at wave 1 (2013-2014) and 1-year follow-up at wave 2 (2014-2015) was conducted in a US population-based sample of never tobacco users aged 12 to 24 years from wave 1 of the PATH Study (N = 10 989). Household interviews using audio computer-assisted self-interviews were conducted. EXPOSURES Advertising for conventional cigarettes, electronic cigarettes (e-cigarettes), cigars, and smokeless tobacco products at wave 1. MAIN OUTCOMES AND MEASURES Progression to susceptibility or ever tobacco use at 1-year follow-up in wave 2. RESULTS Of the 10 989 participants (5410 male [weighted percentage, 48.3%]; 5579 female [weighted percentage, 51.7%]), receptivity to any tobacco advertising at wave 1 was high for those aged 12 to 14 years (44.0%; 95%confidence limit [CL], 42.6%-45.4%) but highest for those aged 18 to 21 years (68.7%; 95%CL, 64.9%-72.2%). e-Cigarette advertising had the highest receptivity among all age groups. For those aged 12 to 17 years, susceptibility to use a product at wave 1 was significantly associated with product use at wave 2 for conventional cigarettes, e-cigarettes, cigars, and smokeless tobacco products. Among committed never users aged 12 to 17 years at wave 1, any receptivity was associated with progression toward use of the product at wave 2 (conventional cigarettes: adjusted odds ratio [AOR], 1.43; 95% CL, 1.23-1.65; e-cigarettes: AOR, 1.62; 95%CL, 1.41-1.85; cigars: AOR, 2.01; 95%CL, 1.62-2.49; and smokeless [males only]: AOR, 1.42; 95%CL, 1.07-1.89) and with use of the product (conventional cigarettes: AOR, 1.54; 95%CL, 1.03-2.32; e-cigarettes: AOR, 1.45; 95%CL, 1.19-1.75; cigars: AOR, 2.07; 95%CL, 1.26-3.40). Compared with those not receptive to any product advertising, receptivity to e-cigarette advertising, but not to cigarette advertising, was independently associated with those aged 12 to 21 years having used a cigarette at wave 2 (AOR, 1.60; 95%CL, 1.08-2.38). CONCLUSIONS AND RELEVANCE Receptivity to tobacco advertisingwas significantly associated with progression toward use in adolescents. Receptivity was highest for e-cigarette advertising and was associated with trying a cigarette.
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- 2018
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26. Exposure to advertising of tobacco products at points of sale and consumption of tobacco in adolescents from 3 large cities in Argentina. Cross-sectional study
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Adriana Ángel, Sandra Braun, Raul Mejia, James F. Thrasher, James D. Sargent, and Adriana Pérez
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lcsh:RC705-779 ,Consumption (economics) ,Health (social science) ,Cross-sectional study ,Environmental health ,Public Health, Environmental and Occupational Health ,Medicine (miscellaneous) ,lcsh:Diseases of the respiratory system ,Business ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,lcsh:RC254-282 ,WCTOH - Abstract
Background Several researches have demonstrated a strong association between exposure tobacco advertising at point of sale (PoS) and tobacco susceptibility, experimentation and adolescent uptake. However, there are no local studies demonstrating this association.Our objective was to explore the association between exposure to tobacco advertising in PoS located near secondary schools and smoking in early adolescents in 3 Argentinean cities: Córdoba, Tucumán and Buenos Aires Methods This is a cross-sectional study with two descriptive sources: information about tobacco consumption was obtained through a survey of adolescents from 33 secondary schools in Buenos Aires, Córdoba and Tucumán. In addition, data on cigarette advertising in the PoS were relayed within 300 meters of each selected school. An exposition index was derived by multiplying the frequency of going to tobacco shops and a marketing index of each PoS (obtained by adding the number of signs, visibility from outside and displaying tobacco less than 1m from children's products). We explored the association between exposure to PoS advertising and smoking at individual and school level through multilevel logistic regression, adjusting for sociodemographics, social network smoking, and sensation seeking. Results The questionnaire was completed by 1680 students, 158 (9.4%) smokers, 895 (53%) no susceptible non-smokers, 389 (23%) susceptible non-smokers and 274 (16.3%) experimenters. We surveyed 340 PoS, 88 (25.88%) in Tucumán, 80 (23.53%) in Córdoba and 170 (50%) in Buenos Aires. Exposure to PoS advertising was significantly associated with being an experimenter (OR = 1.58, 95% CI 1.16-2.14) and susceptible (OR = 1.65, 95% CI 1.2-2.25) in the highest quartile of exposure. Smokers OR (95% IC) Experimenters OR (95% IC) Susceptibles OR (95% IC) Quartile 2 1.19 (0.838 - 1.685) 1.16 (0.873 - 1.534) 1.33 (0.983 - 1.792) Quartile 3 1.32 (0.930 - 1.874) 1.32 (0.996 - 1.754) 1.15 (0.839 - 1.584) Quartile 4 1.22 (0.848 - 1.758) 1.58 (1.160 - 2.147)§ 1.65 (1.207 - 2.250)§ OR= Odds Ratio § p
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- 2018
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27. Online Tobacco Marketing and Subsequent Tobacco Use
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Kristin E. Knutzen, Samir Soneji, Andy S.L. Tan, Jaewon Yang, James D. Sargent, Meghan Bridgid Moran, and Kelvin Choi
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Male ,Tobacco use ,Adolescent ,Population ,Frequency of use ,Logistic regression ,Smoking Devices ,Article ,03 medical and health sciences ,Tobacco Use ,0302 clinical medicine ,030225 pediatrics ,Medicine ,Humans ,030212 general & internal medicine ,Longitudinal Studies ,Risk factor ,Tobacco Use Epidemiology ,Marketing ,education ,Child ,education.field_of_study ,Internet ,business.industry ,Odds ratio ,Confidence interval ,United States ,Logistic Models ,Socioeconomic Factors ,Adolescent Behavior ,Pediatrics, Perinatology and Child Health ,Female ,business - Abstract
BACKGROUND:Nearly 2.9 million US adolescents engaged with online tobacco marketing in 2013 to 2014. We assess whether engagement is a risk factor for tobacco use initiation, increased frequency of use, progression to poly-product use, and cessation.METHODS:We analyzed data from 11 996 adolescents sampled in the nationally representative, longitudinal Population Assessment for Tobacco and Health study. At baseline (2013–2014), we ascertained respondents’ engagement with online tobacco marketing. At follow-up (2014–2015), we determined if respondents had initiated tobacco use, increased frequency of use, progressed to poly-product use, or quit. Accounting for known risk factors, we fit a multivariable logistic regression model among never-users who engaged at baseline to predict initiation at follow-up. We fit similar models to predict increased frequency of use, progression to poly-product use, and cessation.RESULTS:Compared with adolescents who did not engage, those who engaged reported higher incidences of initiation (19.5% vs 11.9%), increased frequency of use (10.3% vs 4.4%), and progression to poly-product use (5.8% vs 2.4%), and lower incidence of cessation at follow-up (16.1% vs 21.5%). Accounting for other risk factors, engagement was positively associated with initiation (adjusted odds ratio [aOR] = 1.26; 95% confidence interval [CI]: 1.01–1.57), increased frequency of use (aOR = 1.58; 95% CI: 1.24–2.00), progression to poly-product use (aOR = 1.70; 95% CI: 1.20–2.43), and negatively associated with cessation (aOR = 0.71; 95% CI: 0.50–1.00).CONCLUSIONS:Engagement with online tobacco marketing represents a risk factor for adolescent tobacco use. FDA marketing regulation and cooperation of social-networking sites could limit engagement.
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- 2018
28. Quantifying population-level health benefits and harms of e-cigarette use in the United States
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Brian A. Primack, Samir Soneji, Hai-Yen Sung, John P. Pierce, James D. Sargent, and Pershouse, Mark Allen
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and promotion of well-being ,Statistical methods ,medicine.medical_treatment ,Anti-Addiction Drug Therapy ,Electronic Cigarettes ,lcsh:Medicine ,Social Sciences ,Electronic Nicotine Delivery Systems ,01 natural sciences ,Geographical locations ,Cohort Studies ,Nicotine ,Habits ,0302 clinical medicine ,Theoretical ,Models ,Medicine and Health Sciences ,Smoking Habits ,Psychology ,Public and Occupational Health ,030212 general & internal medicine ,lcsh:Science ,Child ,Cancer ,Multidisciplinary ,Pharmaceutics ,Substance Abuse ,Middle Aged ,Nicotine Addiction ,Monte Carlo method ,Chemistry ,Research Design ,Smoking and Health ,Physical Sciences ,Respiratory ,Monte Carlo Method ,Research Article ,medicine.drug ,Cohort study ,Neurological Drug Therapy ,Adult ,Adolescent ,Substance-Related Disorders ,General Science & Technology ,Addiction ,Statistics (mathematics) ,Research and Analysis Methods ,03 medical and health sciences ,Young Adult ,Alkaloids ,Life Expectancy ,Drug Therapy ,Nicotine Replacement Therapy ,Clinical Research ,Mental Health and Psychiatry ,Tobacco ,medicine ,Humans ,0101 mathematics ,Behavior ,Harm reduction ,Tobacco Smoke and Health ,business.industry ,Prevention ,lcsh:R ,010102 general mathematics ,Chemical Compounds ,Biology and Life Sciences ,Models, Theoretical ,Nicotine replacement therapy ,Prevention of disease and conditions ,United States ,Young Adults ,Harm ,Years of potential life lost ,Good Health and Well Being ,Age Groups ,People and Places ,North America ,Life expectancy ,Mathematical and statistical techniques ,Smoking cessation ,3.1 Primary prevention interventions to modify behaviours or promote wellbeing ,lcsh:Q ,Population Groupings ,Smoking Cessation ,business ,3.1 Primary prevention interventions to modify behaviours or promote well-being ,Mathematics ,Demography - Abstract
© 2018 Soneji et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background: Electronic cigarettes (e-cigarettes) may help cigarette smokers quit smoking, yet they may also facilitate cigarette smoking for never-smokers. We quantify the balance of health benefits and harms associated with e-cigarette use at the population level. Methods and findings: Monte Carlo stochastic simulation model. Model parameters were drawn from census counts, national health and tobacco use surveys, and published literature. We calculate the expected years of life gained or lost from the impact of e-cigarette use on smoking cessation among current smokers and transition to long-term cigarette smoking among never smokers for the 2014 US population cohort. Results: The model estimated that 2,070 additional current cigarette smoking adults aged 25-69 (95% CI: -42,900 to 46,200) would quit smoking in 2015 and remain continually abstinent from smoking for >7 years through the use of e-cigarettes in 2014. The model also estimated 168,000 additional never-cigarette smoking adolescents aged 12-17 and young adults aged 18-29 (95% CI: 114,000 to 229,000), would initiate cigarette smoking in 2015 and eventually become daily cigarette smokers at age 35-39 through the use of e-cigarettes in 2014. Overall, the model estimated that e-cigarette use in 2014 would lead to 1,510,000 years of life lost (95% CI: 920,000 to 2,160,000), assuming an optimistic 95% relative harm reduction of e-cigarette use compared to cigarette smoking. As the relative harm reduction decreased, the model estimated a greater number of years of life lost. For example, the model estimated-1,550,000 years of life lost (95% CI: -2,200,000 to -980,000) assuming an approximately 75% relative harm reduction and -1,600,000 years of life lost (95% CI: -2,290,000 to -1,030,000) assuming an approximately 50% relative harm reduction. Conclusions: Based on the existing scientific evidence related to e-cigarettes and optimistic assumptions about the relative harm of e-cigarette use compared to cigarette smoking, e-cigarette use currently represents more population-level harm than benefit. Effective national, state, and local efforts are needed to reduce e-cigarette use among youth and young adults if e-cigarettes are to confer a net population-level benefit in the future.
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- 2018
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29. Children’s Food and Beverage Promotion on Television to Parents
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Diane Gilbert-Diamond, Suman J. Mathur, Marietta E. Smith, James D. Sargent, and Jennifer A. Emond
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Male ,Parents ,media_common.quotation_subject ,Target audience ,Article ,Child health ,Beverages ,Promotion (rank) ,Advertising ,Humans ,Medicine ,Child ,media_common ,business.industry ,Extramural ,Child Health ,United States ,Product (business) ,Appeal to emotion ,Food ,Content analysis ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Female ,Television ,Child Nutritional Physiological Phenomena ,business - Abstract
BACKGROUND: Nutritionally poor foods are heavily advertised to children on television. Whether those same products are also advertised to parents on television has not been systematically examined. METHODS: This study is a content analysis of advertisements for children’s packaged foods and beverages aired over US network, cable, and syndicated television for 1 year (2012 to 2013). The target audience of each advertisement was defined as children or parents based on advertisement content, where parent-directed advertisements included emotional appeals related to family bonding and love. Advertisement characteristics and patterns of airtime were compared across target audience, and the proportion of total airtime devoted to advertisements targeting parents was computed. RESULTS: Fifty-one children’s food or beverage products were advertised over the study year, 25 (49%) of which were advertised directly to parents. Parent-directed advertisements more often featured nutrition and health messaging and an active lifestyle than child-directed advertisements, whereas child-directed advertisements more frequently highlighted fun and product taste. Over all products, 42.4% of total airtime was devoted to advertisements that targeted parents. The products with the most amount of airtime over the study year were ready-to-eat cereals, sugar-sweetened beverages, and children’s yogurt, and the proportion of total advertisement airtime for those products devoted to parents was 24.4%, 72.8%, and 25.8%, respectively. DISCUSSION: Television advertisements for children’s packaged foods and beverages frequently targeted parents with emotional appeals and messaging related to nutrition and health. Findings are of concern if exposure to such advertisements among parents may shape their beliefs about the appropriateness of nutritionally questionable children’s foods and beverages.
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- 2015
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30. Vaping cannabis (marijuana): parallel concerns to e‐cigs?
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Dustin C. Lee, James D. Sargent, and Alan J. Budney
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Risk ,Marijuana Abuse ,medicine.medical_specialty ,media_common.quotation_subject ,Internet privacy ,Alternative medicine ,Medicine (miscellaneous) ,Marijuana Smoking ,Recreational use ,Electronic Nicotine Delivery Systems ,Article ,SAFER ,medicine ,Humans ,Psychiatry ,media_common ,Marketing ,biology ,business.industry ,Vaping ,Public health ,Addiction ,biology.organism_classification ,Frequent use ,Psychiatry and Mental health ,Harm ,Perception ,Public Health ,Cannabis ,Safety ,business ,Attitude to Health - Abstract
The proliferation of vaporization ('vaping') as a method for administering cannabis raises many of the same public health issues being debated and investigated in relation to e-cigarettes (e-cigs). Good epidemiological data on the prevalence of vaping cannabis are not yet available, but with current trends towards societal approval of medicinal and recreational use of cannabis, the pros and cons of vaping cannabis warrant study. As with e-cigs, vaping cannabis portends putative health benefits by reducing harm from ingesting toxic smoke. Indeed, vaping is perceived and being sold as a safer way to use cannabis, despite the lack of data on the health effects of chronic vaping. Other perceived benefits include better taste, more efficient and intense effects and greater discretion which allows for use in more places. Unfortunately, these aspects of vaping could prompt an increased likelihood of trying cannabis, earlier age of onset, more positive initial experiences, and more frequent use, thereby increasing the probability of problematic use or addiction. Sales and marketing of vaping devices with no regulatory guidelines, especially related to advertising or product development targeting youth, parallels concerns under debate related to e-cigs and youth. Thus, the quandary of whether or not to promote vaping as a safer method of cannabis administration for those wishing to use cannabis, and how to regulate vaping and vaping devices, necessitates substantial investigation and discussion. Addressing these issues in concert with efforts directed towards e-cigs may save time and energy and result in a more comprehensive and effective public health policy on vaping.
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- 2015
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31. Alcohol Use in Films and Adolescent Alcohol Use
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Andy R Ness, James D. Sargent, Sam D Leary, and Andrea Waylen
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Male ,Longitudinal study ,Adolescent ,Alcohol Drinking ,Motion Pictures ,Binge drinking ,Poison control ,Alcohol ,Suicide prevention ,Article ,Binge Drinking ,chemistry.chemical_compound ,Environmental health ,Injury prevention ,Humans ,Medicine ,Longitudinal Studies ,Early childhood ,business.industry ,United Kingdom ,Confidence interval ,Cross-Sectional Studies ,chemistry ,Pediatrics, Perinatology and Child Health ,Female ,business - Abstract
OBJECTIVES: To investigate whether exposure to alcohol use in films (AUFs) is associated with early alcohol use, binge drinking, and alcohol-related problems in British adolescents. METHODS: Cross-sectional study with 5163 15-year-olds from the Avon Longitudinal Study of Parents and Children in the United Kingdom. We measured adolescent exposure to AUFs, age at onset of alcohol use, and binge-drinking behavior. We adjusted for early childhood social, family and behavioral factors, adolescent tobacco use, and peer drinking. RESULTS: After adjustment, adolescents with the highest exposure to AUFs were 1.2 (95% confidence interval [CI]: 1.1–1.3) times more likely to have tried alcohol compared with those least exposed and 1.7 (95% CI: 1.5–2.0) times more likely to binge drink. They were 2.4 (95% CI: 1.9–3.1) times more likely to drink weekly and 2.0 (95% CI: 1.7–2.4) times more likely to have alcohol-related problems than those least exposed. CONCLUSIONS: Exposure to AUFs is associated with higher risk of alcohol use and alcohol-related problems in UK adolescents. Our findings provide evidence to support the argument that a review of film-rating categories and alcohol ratings for all films may help reduce problem-related alcohol consumption in young people.
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- 2015
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32. Flavour capsule cigarette use among US adult cigarette smokers
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Mary F. Brunette, Jennifer A. Emond, James D. Sargent, and Samir Soneji
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Adult ,Male ,medicine.medical_specialty ,Health (social science) ,Adolescent ,media_common.quotation_subject ,Flavour ,Population ,Cigarette use ,White People ,Cigarette Smoking ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Environmental health ,Epidemiology ,Medicine ,Humans ,030212 general & internal medicine ,Young adult ,education ,media_common ,education.field_of_study ,030505 public health ,business.industry ,Addiction ,Public Health, Environmental and Occupational Health ,Age Factors ,Capsule ,Survey research ,Hispanic or Latino ,United States ,Flavoring Agents ,Menthol ,Female ,0305 other medical science ,business - Abstract
IntroductionFlavour capsule cigarettes are a recent product worldwide, and little is known about the epidemiology of their use. We used data from a nationally representative survey to understand the sociodemographic characteristics of flavour capsule cigarette smokers and reasons for flavour capsule use.MethodsData were from the nationally representative, U.S. Population Assessment of Tobacco and Health survey (2013–2014). Analyses included 7181 adults, aged 18–44 years, who were current or former established (≥100 lifetime cigarettes) cigarette smokers. Participants reported their usual brand of cigarettes which were classified as non-menthol, menthol or flavour capsule. Analyses assessed differences in participant demographics, smoking patterns and reasons for use by product type among those aged 18–24 years. Analyses were weighted to account for the survey design.ResultsFlavour capsule cigarettes were the usual cigarettes among 9.4% of smokers aged 18–24 years and 6.0%, 3.7% and ConclusionsFlavour capsule cigarettes use is highest in young adults, particularly Hispanics. Young adult predominance, lower level of addiction symptoms and emphasis on pack design by flavour capsule users suggest that these products may be positioned as starter products.
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- 2017
33. Longitudinal study of electronic cigarette use and outset of conventional cigarette smoking and marijuana use among Mexican adolescents*
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James D. Sargent, James F. Thrasher, Paula Lozano, Edna Arillo-Santillán, Raul Mejia, Paola Morello, and Inti Barrientos-Gutiérrez
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Longitudinal study ,medicine.medical_specialty ,Marijuana Abuse ,Adolescent ,030508 substance abuse ,Electronic Nicotine Delivery Systems ,Toxicology ,Article ,Cigarette Smoking ,03 medical and health sciences ,0302 clinical medicine ,Marijuana use ,Cigarette smoking ,Environmental health ,Surveys and Questionnaires ,Mexican Americans ,Medicine ,Humans ,Pharmacology (medical) ,030212 general & internal medicine ,Longitudinal Studies ,Students ,Generalized estimating equation ,Mexico ,Pharmacology ,Mexican adolescents ,business.industry ,Public health ,Electronic Cigarette Use ,Psychiatry and Mental health ,0305 other medical science ,business ,Tobacco product - Abstract
Purpose This study evaluated whether e-cigarette trial among Mexican adolescents increased the likelihood of trial and use of conventional cigarettes or marijuana use at follow-up. Method A school-based longitudinal survey was conducted in 60 public middle schools from the three largest cities in Mexico. Students (12–13 years old) were surveyed in 2015 and followed up 20 months later (n = 6574). Generalized estimating equations models were used to evaluate the association between e-cigarette trial at baseline and conventional cigarettes smoking and marijuana use at follow-up. Result Adolescents who had tried e-cigarettes (but not cigarettes) at baseline were more likely to have tried conventional cigarettes at followup compared to adolescents who had tried neither e-cigarettes nor cigarettes (43% vs. 24%, respectively; RR 1.41, 95% CI 1.18-1.70). We also found that adolescents who had tried both conventional cigarettes and e-cigarettes at baseline were more likely to have tried marijuana at follow-up compared to adolescents who had tried neither tobacco product (20% vs. 4%, respectively; RR 2.67, 95% CI 1.78–4.02). Trial of only e-cigarettes was not independently associated with marijuana use at followup. Conclusions Adolescents who had tried e-cigarettes were more likely to have tried conventional cigarettes and marijuana 20 months later. Although e-cigarettes have been banned in Mexico, it is likely that additional policies and public health campaigns are needed to reduce adolescent use of e-cigarettes and its consequences.
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- 2017
34. Susceptibility to tobacco product use among youth in wave 1 of the population Assessment of tobacco and health (PATH) study
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Maansi Bansal-Travers, Eric C. Leas, Kelvin Choi, Martha White, Nicolette Borek, James D. Sargent, Madison Noble, Jennifer L. Pearson, Victoria R. Green, Charles Carusi, Cassandra A. Stanton, David R. Strong, Andrew Hyland, David B. Portnoy, Yuyan Shi, Annette R. Kaufman, Sheila Kealey, Blair N. Coleman, John P. Pierce, Karen Messer, and Dennis R. Trinidad
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Male ,and promotion of well-being ,Epidemiology ,Electronic Nicotine Delivery Systems ,Substance Misuse ,0302 clinical medicine ,Tobacco users ,Parental education ,Medicine ,2.1 Biological and endogenous factors ,030212 general & internal medicine ,Young adult ,Aetiology ,Child ,Lung ,Cancer ,Tobacco products ,Pediatric ,education.field_of_study ,Smoking ,Substance Abuse ,Tobacco Products ,Smokeless tobacco ,Respiratory ,Public Health and Health Services ,Female ,Public Health ,Tobacco product ,Pediatric Research Initiative ,Adolescent ,Population ,Article ,03 medical and health sciences ,Young Adult ,Clinical Research ,030225 pediatrics ,Environmental health ,Tobacco ,Humans ,Youth and young adults ,education ,Tobacco Smoke and Health ,business.industry ,Prevention ,Public Health, Environmental and Occupational Health ,Odds ratio ,Human Movement and Sports Sciences ,Prevention of disease and conditions ,Health Surveys ,Confidence interval ,United States ,Cross-Sectional Studies ,Good Health and Well Being ,Adolescent Behavior ,Susceptibility ,3.1 Primary prevention interventions to modify behaviours or promote wellbeing ,business - Abstract
© 2017 Elsevier Inc. The purpose of this study was to investigate susceptibility and ever use of tobacco products among adolescents and young adults in the US. Cross-sectional analysis of Wave 1(2013–2014) adolescent (12–17 year-olds; n = 13,651) and young adult (18–24 year-olds; n = 9112) data from the nationally-representative Population Assessment of Tobacco and Health (PATH) Study was conducted. At 12 years, 5% were ever tobacco users and 36% were susceptible to use. Seventy percent were susceptible at age 17 years, and the same proportion were ever users at age 22 years. Susceptibility levels were comparable for cigarettes and e-cigarette (28.6% and 27.4%, respectively), followed by hookah (22.0%), pipes (17.5%), cigars (15.2%), and smokeless tobacco (9.7%). Non-Hispanic (NH) Black (Adjusted Odds Ratio [ORadj] = 1.36; 95% Confidence Limit [CL], 1.18–1.56) and Hispanic (ORadj = 1.34: 95% CL,1.19–1.49) adolescent never- users were more likely to be susceptible to future use of a tobacco product than NH Whites. Susceptibility was higher with age (15–17 yrs. vs 12–14 yrs.: ORadj = 1.69; 95% CL, 1.55–1.85) and parental education (college graduates vs less than HS education: ORadj = 1.22, 95% CL, 1.08–1.39). Compared to exclusive users of hookah, cigars, or smokeless products, larger proportions of exclusive e-cigarette ever users were also susceptible to cigarette use. Among adolescents, lower levels of ever use of tobacco products are often counterbalanced by higher levels of susceptibility for future use, which may suggest delayed initiation in some groups. Ever users of a given tobacco product were more susceptible to use other tobacco products, putting them at risk for future multiple tobacco product use.
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- 2017
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35. Association Between Initial Use of e-Cigarettes and Subsequent Cigarette Smoking Among Adolescents and Young Adults: A Systematic Review and Meta-analysis
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Danielle M. Dick, Judy A. Andrews, Rui Dang, Adam M. Leventhal, Jessica L. Barrington-Trimis, James D. Sargent, Jaewon Yang, Tory R. Spindle, Samir Soneji, Richard A. Miech, Thomas Eissenberg, Laura A. Gibson, Jennifer B. Unger, Thomas A. Wills, Brian A. Primack, and Robert C. Hornik
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Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,030508 substance abuse ,Cochrane Library ,Electronic Nicotine Delivery Systems ,Nicotine ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Risk Factors ,Environmental health ,Medicine ,Humans ,030212 general & internal medicine ,Young adult ,business.industry ,Public health ,Smoking ,Odds ratio ,Tobacco Use Disorder ,Adolescent Behavior ,Meta-analysis ,Pediatrics, Perinatology and Child Health ,Disease Progression ,Smoking cessation ,Female ,Smoking Cessation ,0305 other medical science ,business ,Psychosocial ,medicine.drug - Abstract
Importance The public health implications of e-cigarettes depend, in part, on whether e-cigarette use affects the risk of cigarette smoking. Objective To perform a systematic review and meta-analysis of longitudinal studies that assessed initial use of e-cigarettes and subsequent cigarette smoking. Data Sources PubMed, EMBASE, Cochrane Library, Web of Science, the 2016 Society for Research on Nicotine and Tobacco 22nd Annual Meeting abstracts, the 2016 Society of Behavioral Medicine 37th Annual Meeting & Scientific Sessions abstracts, and the 2016 National Institutes of Health Tobacco Regulatory Science Program Conference were searched between February 7 and February 17, 2017. The search included indexed terms and text words to capture concepts associated with e-cigarettes and traditional cigarettes in articles published from database inception to the date of the search. Study Selection Longitudinal studies reporting odds ratios for cigarette smoking initiation associated with ever use of e-cigarettes or past 30-day cigarette smoking associated with past 30-day e-cigarette use. Searches yielded 6959 unique studies, of which 9 met inclusion criteria (comprising 17 389 adolescents and young adults). Data Extraction and Synthesis Study quality and risk of bias were assessed using the Newcastle-Ottawa Scale and the Risk of Bias in Non-randomized Studies of Interventions tool, respectively. Data and estimates were pooled using random-effects meta-analysis. Main Outcomes and Measures Among baseline never cigarette smokers, cigarette smoking initiation between baseline and follow-up. Among baseline non–past 30-day cigarette smokers who were past 30-day e-cigarette users, past 30-day cigarette smoking at follow-up. Results Among 17 389 adolescents and young adults, the ages ranged between 14 and 30 years at baseline, and 56.0% were female. The pooled probabilities of cigarette smoking initiation were 23.2% for baseline ever e-cigarette users and 7.2% for baseline never e-cigarette users. The pooled probabilities of past 30-day cigarette smoking at follow-up were 21.5% for baseline past 30-day e-cigarette users and 4.6% for baseline non–past 30-day e-cigarette users. Adjusting for known demographic, psychosocial, and behavioral risk factors for cigarette smoking, the pooled odds ratio for subsequent cigarette smoking initiation was 3.50 (95% CI, 2.38-5.16) for ever vs never e-cigarette users, and the pooled odds ratio for past 30-day cigarette smoking at follow-up was 4.28 (95% CI, 2.52-7.27) for past 30-day e-cigarette vs non–past 30-day e-cigarette users at baseline. A moderate level of heterogeneity was observed among studies ( I2 = 56%). Conclusions and Relevance e-Cigarette use was associated with greater risk for subsequent cigarette smoking initiation and past 30-day cigarette smoking. Strong e-cigarette regulation could potentially curb use among youth and possibly limit the future population-level burden of cigarette smoking.
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- 2017
36. Receptivity to Tobacco Advertising and Susceptibility to Tobacco Products
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Cassandra A. Stanton, David B. Portnoy, Nicolette Borek, David R. Strong, Victoria R. Green, Annette R. Kaufman, Martha White, James D. Sargent, Andrew Hyland, Karen Messer, Blair N. Coleman, Eric C. Leas, Maansi Bansal-Travers, Meghan Bridgid Moran, John P. Pierce, Dennis R. Trinidad, Madison Noble, Jennifer L. Pearson, and Charles Carusi
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Male ,Adolescent ,Population ,Receptivity ,Odds ,03 medical and health sciences ,0302 clinical medicine ,Cigarette smoking ,Advertising ,030225 pediatrics ,Tobacco ,Humans ,Medicine ,030212 general & internal medicine ,Child ,education ,Smoke ,education.field_of_study ,business.industry ,Smoking ,Odds ratio ,United States ,Confidence interval ,Smokeless tobacco ,Pediatrics, Perinatology and Child Health ,Commentary ,Female ,Disease Susceptibility ,business - Abstract
BACKGROUND AND OBJECTIVES: Non–cigarette tobacco marketing is less regulated and may promote cigarette smoking among adolescents. We quantified receptivity to advertising for multiple tobacco products and hypothesized associations with susceptibility to cigarette smoking. METHODS: Wave 1 of the nationally representative PATH (Population Assessment of Tobacco and Health) study interviewed 10 751 adolescents who had never used tobacco. A stratified random selection of 5 advertisements for each of cigarettes, e-cigarettes, smokeless products, and cigars were shown from 959 recent tobacco advertisements. Aided recall was classified as low receptivity, and image-liking or favorite ad as higher receptivity. The main dependent variable was susceptibility to cigarette smoking. RESULTS: Among US youth, 41% of 12 to 13 year olds and half of older adolescents were receptive to at least 1 tobacco advertisement. Across each age group, receptivity to advertising was highest for e-cigarettes (28%–33%) followed by cigarettes (22%–25%), smokeless tobacco (15%–21%), and cigars (8%–13%). E-cigarette ads shown on television had the highest recall. Among cigarette-susceptible adolescents, receptivity to e-cigarette advertising (39.7%; 95% confidence interval [CI]: 37.9%–41.6%) was higher than for cigarette advertising (31.7%; 95% CI: 29.9%–33.6%). Receptivity to advertising for each tobacco product was associated with increased susceptibility to cigarette smoking, with no significant difference across products (similar odds for both cigarette and e-cigarette advertising; adjusted odds ratio = 1.22; 95% CI: 1.09–1.37). CONCLUSIONS: A large proportion of US adolescent never tobacco users are receptive to tobacco advertising, with television advertising for e-cigarettes having the highest recall. Receptivity to advertising for each non–cigarette tobacco product was associated with susceptibility to smoke cigarettes.
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- 2017
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37. Co-occurrence of tobacco product use, substance use, and mental health problems among adults: Findings from Wave 1 (2013–2014) of the Population Assessment of Tobacco and Health (PATH) Study*
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Wilson M. Compton, Karin A. Kasza, Victoria R. Green, Nicolette Borek, David M Maklan, Elizabeth Lambert, Cassandra A. Stanton, James D. Sargent, Marushka L. Silveira, Kia J. Jackson, Kevin P. Conway, Nahla Hilmi, Heather L. Kimmel, Susanne E. Tanski, Andrew Hyland, and Chad J. Reissig
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Adult ,Male ,medicine.medical_specialty ,Tobacco, Smokeless ,Adolescent ,Substance-Related Disorders ,Population ,Comorbidity ,Toxicology ,Article ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Environmental health ,medicine ,Humans ,Pharmacology (medical) ,030212 general & internal medicine ,Longitudinal Studies ,Young adult ,education ,Psychiatry ,Aged ,Pharmacology ,education.field_of_study ,biology ,business.industry ,Mental Disorders ,Co-occurrence ,Tobacco Products ,Tobacco Use Disorder ,Middle Aged ,medicine.disease ,biology.organism_classification ,Moderation ,Mental health ,Psychiatry and Mental health ,Mental Health ,Population Surveillance ,Female ,Cannabis ,Self Report ,Substance use ,business ,030217 neurology & neurosurgery - Abstract
Although non-cigarette tobacco product use is increasing among U.S. adults, their associations with substance use and mental health problems are unclear. This study examined co-occurrence of tobacco use, substance use, and mental health problems, and its moderation by gender, among 32,202U.S. adults from Wave 1 (2013-2014) of the nationally representative longitudinal Population Assessment of Tobacco and Health (PATH) Study.Participants self-reported current cigarette, e-cigarette, traditional cigar, cigarillo, filtered cigar, hookah, smokeless tobacco and other tobacco product use; past year alcohol, marijuana, and other drug use; and past year substance use, internalizing and externalizing problems.Compared to non-current tobacco users, current users were more likely to report alcohol or drug use (adjusted odds ratio (AOR)=2.6; 95% confidence interval (CI): 2.3, 2.9), with the strongest associations observed for cigarillo and hookah users. Across all tobacco product groups, users were more likely to report internalizing (AOR=1.9; 95% CI: 1.7, 2.1), externalizing (AOR=1.6; 95% CI: 1.5, 1.8), and substance use (AOR=3.4; 95% CI: 2.9, 4.1) problems than non-users. Gender moderated many of these associations and, of these, all non-cigarette tobacco product associations were stronger among females.This nationally representative study of U.S. adults is the first to comprehensively document tobacco use, substance use, and mental health comorbidities across the range of currently available tobacco products, while also demonstrating that female tobacco users are at increased risk for substance use and mental health problems. These findings may point to gender differences in vulnerability and suggest that interventions incorporate gender-specific approaches.
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- 2017
38. Do E-cigarettes reduce smoking?
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Thomas A. Wills and James D. Sargent
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Epidemiology ,business.industry ,Smoking ,Public Health, Environmental and Occupational Health ,MEDLINE ,Smoking Prevention ,Electronic Nicotine Delivery Systems ,03 medical and health sciences ,0302 clinical medicine ,Smoking epidemiology ,030225 pediatrics ,Environmental health ,Tobacco Smoking ,Medicine ,Humans ,Smoking Cessation ,030212 general & internal medicine ,Pack-year ,Young adult ,business - Published
- 2017
39. Re: Modeling the effects of e-cigarettes on smoking behavior: Implications for future adult smoking prevalence
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Samir Soneji, James D. Sargent, Brian A. Primack, John P. Pierce, and Hai-Yen Sung
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Adult ,Epidemiology ,medicine.medical_treatment ,MEDLINE ,Electronic Nicotine Delivery Systems ,Smoking prevalence ,01 natural sciences ,Article ,Smoking behavior ,03 medical and health sciences ,0302 clinical medicine ,Prevalence ,medicine ,Humans ,030212 general & internal medicine ,0101 mathematics ,Extramural ,business.industry ,Smoking ,Statistics ,010102 general mathematics ,Smoking epidemiology ,Public Health and Health Services ,Smoking cessation ,Smoking Cessation ,business ,Demography - Abstract
Author(s): Soneji, Samir; Primack, Brian A; Pierce, John P; Sung, Hai-Yen; Sargent, James D
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- 2017
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40. Multiple tobacco product use among US adolescents and young adults
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Samir Soneji, James D. Sargent, and Susanne E. Tanski
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Male ,Health Knowledge, Attitudes, Practice ,Health (social science) ,Public policy ,Health Behavior ,Smoking Prevention ,Electronic Nicotine Delivery Systems ,0302 clinical medicine ,Risk Factors ,Surveys and Questionnaires ,Odds Ratio ,Medicine ,030212 general & internal medicine ,Young adult ,Health Policy ,Smoking ,Age Factors ,Advertising ,Tobacco Products ,Health Services ,3. Good health ,Electronic nicotine delivery devices ,Snus ,Female ,0305 other medical science ,Tobacco product ,Research Paper ,Adult ,Tobacco, Smokeless ,Adolescent ,Young Adult ,03 medical and health sciences ,Sex Factors ,Environmental health ,Humans ,Sensation seeking ,Snuff ,Product (category theory) ,030505 public health ,United States Food and Drug Administration ,business.industry ,Public Health, Environmental and Occupational Health ,Cigarillo ,United States ,Logistic Models ,Adolescent Behavior ,Multivariate Analysis ,Non-cigarette tobacco products ,Government Regulation ,Ordered logit ,business - Abstract
Objective To assess the extent to which multiple tobacco product use among adolescents and young adults falls outside current Food and Drug Administration (FDA) regulatory authority. Methods We conducted a web-based survey of 1596 16–26-year-olds to assess use of 11 types of tobacco products. We ascertained current (past 30 days) tobacco product use among 927 respondents who ever used tobacco. Combustible tobacco products included cigarettes, cigars (little filtered, cigarillos, premium) and hookah; non-combustible tobacco products included chew, dip, dissolvables, e-cigarettes, snuff and snus. We then fitted an ordinal logistic regression model to assess demographic and behavioural associations with higher levels of current tobacco product use (single, dual and multiple product use). Results Among 448 current tobacco users, 54% were single product users, 25% dual users and 21% multiple users. The largest single use category was cigarettes (49%), followed by hookah (23%), little filtered cigars (17%) and e-cigarettes (5%). Most dual and multiple product users smoked cigarettes, along with little filtered cigars, hookah and e-cigarettes. Forty-six per cent of current single, 84% of dual and 85% of multiple tobacco product users consumed a tobacco product outside FDA regulatory authority. In multivariable analysis, the adjusted risk of multiple tobacco use was higher for males, first use of a non-combustible tobacco product, high sensation seeking respondents and declined for each additional year of age that tobacco initiation was delayed. Conclusions Nearly half of current adolescent and young adult tobacco users in this study engaged in dual and multiple tobacco product use; the majority of them used products that fall outside current FDA regulatory authority. This study supports FDA deeming of these products and their incorporation into the national media campaign to address youth tobacco use.
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- 2014
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41. The Relative Roles of Types of Extracurricular Activity on Smoking and Drinking Initiation Among Tweens
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Anna M. Adachi-Mejia, Zhigang Li, James D. Sargent, and Jennifer J. Gibson Chambers
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Male ,Extracurricular activity ,Adolescent ,Alcohol Drinking ,Team sport ,education ,Population ,Poison control ,Youth smoking ,Coaching ,Article ,Injury prevention ,Humans ,Medicine ,Dancing ,Child ,education.field_of_study ,business.industry ,Smoking ,Odds ratio ,United States ,Logistic Models ,Multivariate Analysis ,Pediatrics, Perinatology and Child Health ,Recreation ,Female ,business ,human activities ,Social psychology ,Music ,Sports ,Demography - Abstract
Objective Youth involvement in extracurricular activities may help prevent smoking and drinking initiation. However, the relative roles of types of extracurricular activity on these risks are unclear. Therefore, we examined the association between substance use and participation in team sports with a coach, other sports without a coach, music, school clubs, and other clubs in a nationally representative sample of US tweens. Methods We conducted telephone surveys with 6522 US students (ages 10 to 14 years) in 2003. We asked participants if they had ever tried smoking or drinking, and we asked them about their participation in extracurricular activities. We used sample weighting to produce response estimates that were representative of the population of adolescents aged 10 to 14 years at the time of data collection. Logistic regression models that adjusted for appropriate sampling weights using jackknife variance estimation tested associations with trying smoking and drinking, controlling for sociodemographics, child and parent characteristics, friend/sibling/parent substance use, and media use. Results A little over half of the students reported participating in team sports with a coach (55.5%) and without a coach (55.4%) a few times per week or more. Most had minimal to no participation in school clubs (74.2%); however, most reported being involved in other clubs (85.8%). A little less than half participated in music, choir, dance, and/or band lessons. Over half of participants involved in religious activity did those activities a few times per week or more. In the multiple regression analysis, team sport participation with a coach was the only extracurricular activity associated with lower risk of trying smoking (adjusted odds ratio 0.68, 95% confidence interval 0.49, 0.96) compared to none or minimal participation. Participating in other clubs was the only extracurricular activity associated with lower risk of trying drinking (adjusted odds ratio 0.56, 95% confidence interval 0.32, 0.99) compared to none or minimal participation. Conclusions Type of extracurricular involvement may be associated with risk of youth smoking and drinking initiation. Future research should seek to better understand the underlying reasons behind these differences.
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- 2014
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42. Receptivity to and Recall of Alcohol Brand Appearances in U.S. Popular Music and Alcohol-Related Behaviors
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Brian A. Primack, James D. Sargent, Zhigang Li, and Auden C. McClure
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Male ,Adolescent ,Alcohol Drinking ,Alcohol industry ,Medicine (miscellaneous) ,Binge drinking ,Poison control ,Toxicology ,Suicide prevention ,Article ,Binge Drinking ,Odds ,Young Adult ,Sex Factors ,Advertising ,Injury prevention ,Humans ,Sensation seeking ,Medicine ,Socioeconomic status ,business.industry ,Alcoholic Beverages ,Age Factors ,United States ,Psychiatry and Mental health ,Mental Recall ,Female ,business ,Social psychology ,Music ,Demography - Abstract
BACKGROUND: The average U.S. adolescent is exposed to about 2.5 hours of popular music and 8 mentions of alcohol brands every day. Alcohol brand mentions may function as advertising whether or not they are sanctioned by the alcohol industry. Our study aimed to determine associations between adolescents' involvement with music containing alcohol brand mentions and alcohol-related behaviors. METHODS: In 2010 to 2011, we conducted a random-digit-dial survey using national U.S. land line and cell phone frames. Through screening interviews, we identified 6,466 eligible households with subjects between 15 and 23 years of age, of whom 3,422 (53%) completed the telephone survey. Of these, 2,541 opted to participate in a subsequent web-based component. Independent variables included a composite score indicating owning and liking popular songs with alcohol brand mentions and correct recall of alcohol brands in songs. Outcome measures included ever having consumed a complete drink, ever bingeing, bingeing at least monthly, and having experienced problems from alcohol use. RESULTS: Among the 2,541 participants, compared with those in the lowest tertile on the receptivity scale, those in the highest tertile had higher odds of having had a complete drink (OR = 3.4; 95% CI = 2.2, 5.2) after adjusting for age, sex, race/ethnicity, socioeconomic status, sensation seeking, friend alcohol use, and parent alcohol use. Compared with those who did not identify at least 1 alcohol brand correctly, those who did had over twice the odds of having had a complete drink (OR = 2.1; 95% CI = 1.2, 3.8) after adjusting for all covariates. RESULTS were also significant for the outcome of ever bingeing, but not for bingeing at least monthly or having had problems due to drinking. CONCLUSIONS: In a national sample of U.S. adolescents and young adults, there were independent associations between involvement with popular music containing alcohol brand mentions and both having ever had a complete drink and having ever binged on alcohol. Language: en
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- 2014
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43. Are movies with tobacco, alcohol, drugs, sex, and violence rated for youth? A comparison of rating systems in Argentina, Brazil, Mexico, and the United States
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Deborah L. Billings, James F. Thrasher, James D. Sargent, Ashley Navarro, Sandra Braun, Eric L. Sevigny, Edna Arillo-Santillán, James W. Hardin, Rosa Vargas, and Tonatiuh Barrientos-Gutiérrez
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Adult ,Youth ,Latin Americans ,Adolescent ,Alcohol Drinking ,Sexual Behavior ,Motion Pictures ,Argentina ,Movie rating systems ,Poison control ,Medicine (miscellaneous) ,Violence ,Risk behaviors ,Suicide prevention ,Article ,Occupational safety and health ,Risk-Taking ,Environmental health ,Tobacco ,Injury prevention ,Humans ,Medicine ,Child ,Mexico ,Tobacco and other drugs ,Illicit Drugs ,business.industry ,Health Policy ,Human factors and ergonomics ,medicine.disease ,United States ,Substance abuse ,Policy ,business ,Cinema ,Brazil - Abstract
Background This study aimed to determine between-country differences and changes over time in the portrayal of youth risk behaviors in films rated for youth in Argentina, Brazil, Mexico and the United States. Methods Content and ratings were analyzed for 362 films that were popular across all four countries from 2002 to 2009. Country-specific ratings were classified as either youth or adult, and Generalized Estimating Equations were used to determine between-country differences in the presence of tobacco, alcohol, drugs, sexual content, and violence in youth-rated films. Within-country differences in this content over time were also assessed, comparing films released from 2002 to 2005 with those released from 2006 to 2009. Results In the US, films rated for youth were less likely to contain all five risk behaviors than in youth-rated films in Argentina, Brazil, and, when the "15 and older" rating was considered a youth rating, in Mexico. All three Latin American countries "downrated" films that received an adult rating in the US. Nevertheless, tobacco and drug use in youth-rated films declined over time in all countries, whereas moderate to extreme alcohol use and violence involving children or youth increased in all countries. Conclusions Tobacco and drug use have declined in popular US films, but these behaviors are still prevalent in films rated for youth across the Americas. The apparent success of advocacy efforts to reduce tobacco and other drugs in films suggests that similar efforts be directed to reduce alcohol portrayals.
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- 2014
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44. IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS FOR CHILDREN WITH CARDIAC CONDITIONS ASSOCIATED WITH HIGH RISK FOR SUDDEN CARDIAC DEATH: A COST-EFFECTIVENESS ANALYSIS
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Aaron B. Caughey, Seshadri Balaji, David E. Toffey, Meredith Boulos, Alyssa R. Hersh, Stephen B. Heitner, James D. Sargent, and Eric C. Stecker
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medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,Cardiology ,Cost-effectiveness analysis ,Cardiology and Cardiovascular Medicine ,business ,medicine.disease ,Sudden cardiac death - Published
- 2019
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45. Medical Journals and Free Speech
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James D. Sargent, Bruce P. Lanphear, and Joel Bakan
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Pediatrics ,medicine.medical_specialty ,business.industry ,media_common.quotation_subject ,Human factors and ergonomics ,Poison control ,Advertising ,Deception ,Suicide prevention ,Pediatrics Perspectives ,Occupational safety and health ,Test (assessment) ,Consistency (negotiation) ,Bibliometrics ,Pediatrics, Perinatology and Child Health ,Injury prevention ,medicine ,Humans ,Periodicals as Topic ,business ,Publication Bias ,media_common - Abstract
Does fear of libel lawsuits influence what gets published in medical journals? We suggest it may, especially when the conclusions run counter to corporate interests. A research team headed by Sargent probed children’s responses to televised fast-food ads. The study tested Children’s Advertising Review Unit (CARU) advertising self-regulation guidelines, in which the Better Business Bureau “evaluates child-directed advertising and promotional material in all media to advance truthfulness, accuracy and consistency with its Self-Regulatory Program for Children’s Advertising.”1 The study examined children’s responses to television ads from McDonald’s and Burger King, companies responsible for 99% of the child-directed fast-food advertising on television in the United States at that time.2 It tested whether children’s ads focused the child’s attention primarily on the product and made the premium message clearly secondary, as CARU guidelines on deception said they should.3 To test this hypothesis for each company, the investigators randomly selected 1 adult and 1 children’s ad from 2010–2011 national television ads ( n = 107) for children ages 3 to 7 years to watch. None of the adult ads and almost all of the children’s ads contained a premium message, typically showing the current toy giveaway. After each viewing, the children were asked, “What did you see?” Most (∼70%) reported the adult ad was about food. However, fewer than half reported the children’s ad was about food. For children’s ads alone and for both restaurants, recall frequency for food was not significantly different from premiums/tie-ins. The investigators concluded that the companies had failed to comply with CARU’s self-regulation requirements that they emphasize food over premiums. The manuscript was reviewed at Pediatrics and was … Address correspondence to James D. Sargent, MD, Norris Cotton Cancer Center, Rubin 8, One Medical Center Dr, Lebanon, NH 03756. E-mail: james.d.sargent{at}dartmouth.edu
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- 2015
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46. Smoking in Movies and Adolescent Smoking Initiation
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Ron H. J. Scholte, Kate Hunt, Helen Sweeting, Ewa Florek, Fabrizio Faggiano, James D. Sargent, Matthis Morgenstern, Rutger C. M. E. Engels, Reiner Hanewinkel, and Federica Mathis
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Pediatrics ,medicine.medical_specialty ,Longitudinal study ,Epidemiology ,business.industry ,media_common.quotation_subject ,Public Health, Environmental and Occupational Health ,Limiting ,Cross-cultural studies ,03 medical and health sciences ,Screen time ,0302 clinical medicine ,030225 pediatrics ,Relative risk ,medicine ,Personality ,030212 general & internal medicine ,Age of onset ,business ,Adolescent smoking ,Demography ,media_common - Abstract
Background Longitudinal studies from the U.S. suggest a causal relationship between exposure to images of smoking in movies and adolescent smoking onset. Purpose This study investigates whether adolescent smoking onset is predicted by the amount of exposure to smoking in movies across six European countries with various cultural and regulatory approaches to tobacco. Methods Longitudinal survey of 9987 adolescent never-smokers recruited in the years 2009–2010 (mean age=13.2 years) in 112 state-funded schools from Germany, Iceland, Italy, The Netherlands, Poland, and the United Kingdom (UK), and followed up in 2011. Exposure to movie smoking was estimated from 250 top-grossing movies in each country. Multilevel mixed-effects Poisson regressions were performed in 2012 to assess the relationship between exposure at baseline and smoking status at follow-up. Results During the observation period (M=12 months), 17% of the sample initiated smoking. The estimated mean exposure to on-screen tobacco was 1560 occurrences. Overall, and after controlling for age; gender; family affluence; school performance; TV screen time; personality characteristics; and smoking status of peers, parents, and siblings, exposure to each additional 1000 tobacco occurrences increased the adjusted relative risk for smoking onset by 13% (95% CI=8%, 17%, p Conclusions Seeing smoking in movies is a predictor of smoking onset in various cultural contexts. The results confirm that limiting young people's exposure to movie smoking might be an effective way to decrease adolescent smoking onset.
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- 2013
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47. Validation of commercial business lists as a proxy for licensed alcohol outlets
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Heather A. Carlos, James D. Sargent, and Joy Gabrielli
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Commercial business list validity ,Geospatial analysis ,Kernel density estimation ,Poison control ,030209 endocrinology & metabolism ,computer.software_genre ,Proxy (climate) ,California ,03 medical and health sciences ,0302 clinical medicine ,Cronbach's alpha ,11. Sustainability ,Statistics ,Alcohol outlet ,Medicine ,Humans ,030212 general & internal medicine ,License ,business.industry ,lcsh:Public aspects of medicine ,Alcoholic Beverages ,Data Collection ,Public Health, Environmental and Occupational Health ,Commerce ,lcsh:RA1-1270 ,Euclidean distance ,business ,computer ,Licensure ,Research Article - Abstract
Background Studies of retail alcohol outlets are restricted to regions due to lack of U.S. national data. Commercial business lists (BL) offer a possible solution, but no data exists to determine if BLs could serve as an adequate proxy for license data. This paper compares geospatial measures of alcohol outlets derived from a commercial BL with license data for a large US state. Methods We validated BL data as a measure of off-premise alcohol outlet density and proximity compared to license data for 5528 randomly selected California residential addresses. We calculated three proximity measures (Euclidean distance, road network travel time and distance) and two density measures (kernel density estimation and the count within a 2-mile radius) for each dataset. The data was acquired in 2015 and processed and analyzed in 2015 and 2016. Results Correlations and reliabilities between density (correlation 0.98; Cronbach’s α 0.97–0.99) and proximity (correlations 0.77–0.86; α 0.87–0.92) measures were high. For proximity, BL data matched license in 55–57% of addresses, overstated distance in 19%, and understated in 24–26%. Conclusions BL data can serve as a reliable proxy for licensed alcohol outlets, thus extending the work that can be performed in studies on associations between retail alcohol outlets and drinking outcomes.
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- 2016
48. Prevalence and predictors of e-cigarette trial among adolescents in Argentina
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Adriana Pérez, James F. Thrasher, Paola Morello, Raúl M Mejía, Paula Lozano, James D. Sargent, and Lorena Peña
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Longitudinal study ,medicine.medical_specialty ,Health (social science) ,Epidemiology ,Public policy ,school ,Population ,Protective factor ,Argentina ,e-cigarette ,Health Professions (miscellaneous) ,Article ,Smoking behavior ,03 medical and health sciences ,0302 clinical medicine ,Environmental health ,Sensation seeking ,Medicine ,030212 general & internal medicine ,adolescents ,education ,education.field_of_study ,030505 public health ,business.industry ,Public health ,lcsh:Public aspects of medicine ,Public Health, Environmental and Occupational Health ,lcsh:RA1-1270 ,adolescent health ,Early adolescents ,0305 other medical science ,business ,Adolescent health - Abstract
Introduction Over the last few years, the increasing use of electronic cigarettes has become a new public health problem. Since 2011, Argentina has had a complete ban on marketing and sale of e-cigarettes. However, e-cigarettes are marketed online and can be easily bought in stores. We conducted a longitudinal study to evaluate the determinants of e-cigarette trial among Argentinean early adolescents. Methods A school-based longitudinal study was conducted in 2014-15, in 3 large cities in Argentina. Among students who reported never smoking an e-cigarette at baseline, we assessed demographics, media use, sensation seeking, smoking behavior, network member smoking, use of other substances, and perception of e-cigarette risk as potential risk factors for e-cigarette trial at follow up (mean between-wave interval 17.1 months) using multilevel logistic regression models with random intercepts for schools. Results E-cigarette trial prevalence increased from baseline (1.8%; n=57) to follow up (7.1%; n=139). Independent predictors of e-cigarette use at follow up included: higher sensation seeking (OR: 1.49 95% CI 1.21-1.84); being a current smoker (OR: 2.58 95% CI 1.38-4.83); having close friends that smoke cigarettes (OR: 1.93 95% CI 1.25-2.99) and being highly exposed to tobacco product ads online (OR: 1.87 95% CI 1.04-3.36). Attending a public school was the only protective factor (OR: 0.40 95% CI 0.22-0.73). Conclusions In Argentina, illicit trial of e-cigarettes among early adolescents is low but appears to be rapidly increasing. Identifying students at risk could help identify policies and programs to prevent increasing use in this population.
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- 2016
49. Smoking in Movies and Adolescent Smoking Initiation: A Longitudinal Study among Argentinian Adolescents
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Sandra Braun, James F. Thrasher, Christy Kollath-Cattano, Lorena Peña, Paola Morello, James W. Hardin, Raul Mejia, James D. Sargent, and Adriana Pérez
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Male ,Longitudinal study ,Adolescent ,Motion Pictures ,Argentina ,030508 substance abuse ,Logistic regression ,Article ,Odds ,03 medical and health sciences ,0302 clinical medicine ,Cigarette smoking ,Medicine ,Humans ,030212 general & internal medicine ,Longitudinal Studies ,Child ,business.industry ,Smoking ,Never smokers ,Pediatrics, Perinatology and Child Health ,Early adolescents ,Female ,0305 other medical science ,business ,Adolescent smoking ,Demography - Abstract
Objective To assess whether exposure to movie smoking is associated with cigarette smoking among Argentinian adolescents. Study design A school-based longitudinal study involving 33 secondary schools in Argentina was performed. The sample included 2502 never smokers (average age at entry = 12.5 years), 1700 (67.9%) of whom completed follow-up surveys 17 months later. Exposure to the top 100 highest-grossing films for each year between 2009 and 2013 was assessed by content-coding films for tobacco and then by asking adolescents whether they had seen each of 50 titles, randomly selected from the larger pool, then parsing exposure into tertiles. Logistic regression models estimated aOR for the following transitions: nonsusceptible to susceptible never smoker, never smoker to ever smoker, and never smoker to current smoking (last 30 days). Results At follow-up, 34.4% of nonsusceptible never smokers became susceptible, 24.1% reported having tried smoking, and 9.4% were current smokers. Most exposure to movie smoking was from US-produced films (average 60.3 minutes compared with only 3.4 minutes from Argentine films). Greater exposure to smoking in movies was significantly associated with increased odds of becoming susceptible (aOR first vs third tertile 1.77, 95% CI 1.30-2.41), of trying smoking (aOR first vs third tertile 1.54, 1.14-2.08), and marginally associated with current smoking (AOR first vs third tertile 1.54, 0.99-2.40). Exposure to smoking in US- or Argentine-produced films had similar associations. Conclusion In Argentina, exposure to smoking in the movies predicted future smoking transitions among early adolescents, with most exposure coming from viewing US movies.
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- 2016
50. Industry Television Ratings for Violence, Sex, and Substance Use
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Elaina Bergamini, Aminata Traore, James D. Sargent, Joy Gabrielli, and Mike Stoolmiller
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Quality Control ,Alcohol Drinking ,Sexual Behavior ,Poison control ,Violence ,Suicide prevention ,Article ,Occupational safety and health ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Injury prevention ,Humans ,Industry ,Medicine ,030212 general & internal medicine ,Child ,Social Responsibility ,Salience (language) ,business.industry ,Smoking ,Multilevel model ,Human factors and ergonomics ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Television ,Substance use ,business ,Demography - Abstract
OBJECTIVE: To examine whether the industry-run television (TV) Parental Guidelines discriminate on violence, sexual behavior, alcohol use, and smoking in TV shows, to assess their usefulness for parents. METHODS: Seventeen TV shows (323 episodes and 9214 episode minutes) across several TV show rating categories (TVY7, TVPG, TV14, and TVMA) were evaluated. We content-coded the episodes, recording seconds of each risk behavior, and we rated the salience of violence in each one. Multilevel models were used to test for associations between TV rating categories and prevalence of risk behaviors across and within episodes or salience of violence. RESULTS: Every show had at least 1 risk behavior. Violence was pervasive, occurring in 70% of episodes overall and for 2.3 seconds per episode minute. Alcohol was also common (58% of shows, 2.3 seconds per minute), followed by sex (53% of episodes, 0.26 seconds per minute), and smoking (31% of shows, 0.54 seconds per minute). TV Parental Guidelines did not discriminate prevalence estimates of TV episode violence. Although TV-Y7 shows had significantly less substance use, other categories were poor at discriminating substance use, which was as common in TV-14 as TV-MA shows. Sex and gory violence were the only behaviors demonstrating a graded increase in prevalence and salience for older-child rating categories. CONCLUSIONS: TV Parental Guidelines ratings were ineffective in discriminating shows for 3 out of 4 behaviors studied. Even in shows rated for children as young as 7 years, violence was prevalent, prominent, and salient. TV ratings were most effective for identification of sexual behavior and gory violence.
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- 2016
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