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Objective: To examine the relationship between demographics, other tobacco use, and JUUL dependency on combustible cigarette use among college JUUL users. Participants: Undergraduates (n = 595) at a large southwestern university who used JUUL weekly completed a cross-sectional online survey in March 2019. Methods: Logistic regressions examined associations between covariates and ever use/past 30-day use of cigarettes. Results: As age increased, odds of ever trying a cigarette increased (AOR = 1.87; 95% CI = 1.45-2.41); however, as age of JUUL initiation increased, odds of ever (AOR = 0.80; 95% CI = 0.65-0.99) or past 30-day (AOR = 0.78; 95% CI = 0.63-0.97) cigarette use decreased. Those moderately (AOR = 2.03; 95% CI = 1.07-3.82) or highly (AOR = 8.01; 95% CI = 3.08-20.83) dependent on JUUL were more likely to have tried cigarettes than those not dependent. However, dependence was not associated with past 30-day use. Conclusions: JUUL users may not transition to combustible cigarettes during college. Longitudinal studies are needed to examine transitions in JUUL users' tobacco product use after college.

Objective: This convergent mixed methods study examined how information sources influence college students' beliefs and knowledge about vaping. Participants: College students either completed a survey (n = 522; January-April, 2016) or were interviewed (n = 33; 2015-2016). Methods: College students completed an online survey asking 'where' students had heard about e-cigarette and 'what' they had heard. Responses were quantified and a chi-square analysis was conducted. Additional college student e-cigarette users were interviewed about the credibility of information sources. Thematic analysis was conducted with the coded interviews. Results: There was a significant relationship between information sources for e-cigarettes (social sources, media, advertising, education/research) and the messages they recalled. Friends who vaped and e-cigarette users were the most credible information sources. Confirmation bias and scientific impotence bias characterized assessment of e-cigarette information. Conclusions: Health education specialists working on college campuses should provide accurate information via communication channels most unitized by college students.

Dear Editor, While tobacco use is restricted in public spaces such as workplaces, restaurants, and public housing, non-smokers' exposure to environmental tobacco smoke (ETS) can happen in the home, especially [...]

Background: Young adults are adopting wearables ahead of research. Purpose: The purpose of this study was to explore the use of trackers through Social Cognitive Theory (SCT). Methods: SCT-guided individual interviews were conducted with young adults (n = 57). Typical case sampling was used to recruit college students (n = 35) and straight-to-work (STW) young adults (n = 22) for in-person/online interviews. Interviews were recorded, transcribed, and analyzed using NVivo. Results: There were few differences between the two groups. Most reported little knowledge of the benefits/risks associated with their health behavior (eg, physical activity) but high expectations of how devices would assist them in developing/maintaining behavior. Self-regulatory aspects were seen as benefits. Many reported not setting goals other than those set by their device. Most reported increased self-efficacy and viewed their device as positive, nonjudgmental social support. Discussion: Young adult device use can be health directed or health related. Utilizing devices and SCT-based education may increase young adults' knowledge, self-efficacy, and self-regulation while managing expectations. Translation to Health Education Practice: Health Educators should focus on increasing health knowledge, managing expectations, and setting goals. Building on the increased self-efficacy and social support that young adults reported as part of their wearable activity tracker use could provide a solid foundation for Health Education efforts. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI)http://portal.shapeamerica.org/trn-Webinars

Formation is an important stage of partnership development. Purpose: To describe the systematic approach to process evaluation of a Turning Point initiative in central Oklahoma during the formation stage. The nine-month collaborative effort aimed to develop an action plan to promote health. Methods: A sound planning framework was used in the design of a systematic approach to process evaluation. Mixed (qualitative and quantitative) methodology was used, including stakeholder interviews, surveys, and attendance logs. Results: Reach to the meetings ranged from 38% to 70%. "Collaboration membership" was statistically significantly associated with high attendance at the meetings. Strengths of the collaborative process included stakeholder diversity, a strong organizational structure and the use of a democratic collaborative process. Discussion: Building effective collaborative skills among the stakeholders early in the planning phase can be instrumental in promoting participation during the formation stage. In addition, emphasis should be given in strengthening/supporting of the coalition processes, coalition structures, leadership and staff. Translation to Health Education Practice: Process evaluation is a valuable tool for the continuous monitoring of the quality of the collaborative process during the formation stage, and therefore, minimum process evaluation measures should be incorporated at the early stages of the partnership development. (Contains 1 figure and 3 tables.)

The prospective associations between negative life events (NLEs) and adolescent alcohol use was examined using the Youth Asset Study. Participants (n = 1040 adolescents, mean age = 15.8 years) completed annual interviews which included a life events scale and alcohol use in the last 30 days. Family structure and parent education were assessed as confounders. For the youngest group, each NLE increased the odds of alcohol use the next year compared to those with no events (ORs 1.66, 2.43, 2.65). For the middle age group, one or more NLEs doubled the odds of alcohol use the next year (ORs 2.01, 2.03, 2.05). A simple life events checklist can be a useful tool to assess an increased risk of future alcohol use in adolescents.

Objective: The Ecological Model was used to examine the social and environmental influences of the college environment on e-cigarette use (vaping) among college students. Participants: Undergraduate college student e-cigarette users (vapers) across three large college campuses in the southwest US from Jan 2015-Aug 2016. Methods: Thirty-three interviews were conducted. Transcribed interviews were coded then analyzed for themes. Results: College student vapers report multiple levels of influence on their vaping beyond personal beliefs and peer influences, including parents, explicit campus and community messaging, community member requests, and respect for others. College student vapers also describe constant associations with smokers in allowable public places to vape. Conclusions: Parents, community members, campus policy, and the physical environment all influence where and when college students vape. Health communication messages to prevent college student vaping should incorporate alternative messages that are important to college students, such as respect for others and social image.

A systematic literature review was conducted to assess the utility of Positive Youth Development (PYD) concepts in promoting positive sexual health behaviors in young minority adolescents (n = 12 studies). Interventions reported significant associations between PYD-focused interventions and ever having sex, sexual partners in the last 30 days, using protection at the last sexual encounter, and decreased pregnancy rates. Outcomes were reviewed by age, gender, PYD constructs, cultural tailoring of interventions, and retention rates. Few interventions focused exclusively on young minority adolescents. PYD can be an effective tool in promoting sexual health in younger minority adolescents, but additional research is needed to determine beneficial strategies for this age group and timing of interventions. Recommendations for future studies include additional guidance on operationalization of PYD concepts, effective cultural tailoring methods, dosage of intervention components, and de-linking minority status from socioeconomic status (SES) and high-risk behaviors.

Objective: Fraternity and sorority members have one of the highest smoking rates among college students, yet little is known about the social influences on smoking within this subculture. The objective of this study was to examine sorority and fraternity member beliefs about smoking and alcohol use. Methods: In-depth individual interviews were conducted with active members of sororities (n = 16) and fraternities (n = 17). Members were recruited through posters and electronic postings using purposive sampling techniques and continued until saturation was reached. Interviews were conducted in community settings chosen by the participant. Transcribed interviews were coded and analyzed for themes. Results: Fraternity parties and bars/clubs provide a smoking-friendly environment where members expect to be offered both alcohol and cigarettes without negative evaluation from others. Fraternity members take on the role of providing cigarettes to others. Members discussed positive beliefs about smoking while using alcohol. Beliefs that smoking is an extension of drinking behaviors, smoking enhances the experience of alcohol, smoking while drunk does not lead to addiction and getting cigarettes from others is different than buying your own were examples of how members adopted beliefs that promote an addictive behavior. Conclusions: Fraternity and sorority member alcohol use may increase their risk for smoking because of their positive beliefs about smoking and alcohol use and smoking tolerant social environments. Increasing smoke-free perimeters at fraternity houses and bars/clubs and intervening with pledge classes to de-link smoking from alcohol use are needed to reduce non-daily smoking in members.

Objective: To understand how the Greek system uniquely influences smoking attitudes, beliefs, and behaviors among college students who belong to a social sorority or fraternity. Participants: Active members of sororities (n = 16) and fraternities (n = 17) were interviewed between February 2013 and October 2015. Methods: In-depth interviews were conducted examining the social influences of the Greek system on member smoking. Transcribed interviews were coded and analyzed for themes. Results: Sorority and fraternity members experienced different social influences on smoking. Sorority stigmatization of smoking outside bars or parties caused sorority members to hide their smoking. Fraternity members had no social penalties for smoking and allowed smoking at the fraternity house. Fraternity members influenced both fraternity members and sorority members to smoke by sharing cigarettes and smoking at parties. Conclusions: Sororities and fraternities have created social environments that both promote smoking and stigmatize it, presenting unique challenges in college student smoking prevention and cessation efforts.

Background: Youth assets protect adolescents from tobacco use, but their influence in young adulthood is unknown. Purpose: To determine the prospective influence of assets possessed in young adulthood with tobacco use the following year. Methods: Data from waves 4 and 5 from the Youth Asset Study (n = 450, ages 18-22 at wave 5) were used. Logistic regression was used to prospectively examine associations between 10 wave 4 assets with wave 5 tobacco use by gender. Results: Parental monitoring was significantly associated with wave 5 tobacco use in the youngest group of males (odds ratio [OR] = 10.00). The non-parental adult role model (OR = 2.57) and general self-confidence (OR = 2.41) assets were significantly associated with wave 5 tobacco use in females. Family communication (OR = 5.77) was significantly associated with wave 5 tobacco use for the oldest females, and positive peer role models (OR = 2.83) only for females in 2-parent homes. Discussion: Youth assets continue to positively influence health behavior decisions in emerging adulthood, but males and females also benefit from different assets. Translation to Health Education Practice: Understanding how youth assets impact tobacco use in young adults could lead to more effective tobacco use prevention programs and indicate where future efforts should be focused.

Objective: Fraternity and sorority members have higher rates of smoking than other college students. This systematic review examines studies that included fraternity/sorority membership in their investigation of smoking behaviors. Participants/Methods: Studies identified in MEDLINE, PsychInfo, JSTOR, CINAHL, ERIC, and Google Scholar published between 2003 and 2013 were included if they included fraternity and/or sorority membership, were written in English, published in a peer-reviewed journal, and had smoking as an outcome variable. Nineteen studies were identified for the review. Results: Fraternity/sorority members were more likely to be nondaily smokers. Members who lived in the fraternity/sorority house had higher rates of smoking than members who lived elsewhere. Fraternity/sorority member smoking was associated with alcohol and other substance use. The influence of no-smoking policies on fraternity/sorority member smoking was also examined. Conclusions: Fraternity/sorority membership was associated with higher rates of smoking, but this association was influenced by other substance use and environmental factors.

Background: African Americans have one of the lowest smoking rates as teens yet have one of the highest smoking rates as adults. Approximately 40% of African Americans who have ever smoked started smoking between the ages of 18 and 21. Purpose: This study aimed to identify why African American young adults began smoking in young adulthood and what personal, social, and environmental influences promoted the transition to regular smoking. Methods: Twelve focus groups were conducted with African American young adults (n = 99) between the ages of 18 and 29 who began smoking regularly after the age of 18. Results: Participants did not smoke while they were younger because of strong maternal antismoking messages, out of respect for elders, or because they smoked marijuana instead. Factors influencing smoking initiation were perceived smoking social norms, changing parental messages about smoking, believing that smoking was an adult coping strategy, and extending a marijuana high. Discussion: African American young adult smokers described multiple levels of influences on smoking initiation and the transition to regular smoking. Translation to Health Education Practice: Recommendations include continuing strong parental messages against smoking, preparing youth for the transition to young adulthood, targeting normative smoking beliefs, and delinking smoking from marijuana use.

Introduction E-cigarette advertising exposure is linked to e-cigarette initiation and use. Thus, monitoring trends in e-cigarette advertising practices is important to understand e-cigarette use patterns observed over recent years. Aims and Methods E-cigarette advertising expenditures (January 2016–July 2021; Numerator Ad Intel) for 154 U.S. market areas were harmonized with U.S. Census sociodemographic data through Nielsen zip code designations by market area. Descriptive statistics and multivariable linear regressions were used to examine trends in e-cigarette advertising expenditures across media outlets and associations between sociodemographic characteristics and e-cigarette advertising over time. Results E-cigarette advertising expenditures peaked in 2018/2019, followed by a sharp decline in 2020. Expenditures were concentrated primarily on print (58.9%), TV (20.6%), and radio (14.4%). Major print outlets were Sports Illustrated, Rolling Stone, and Star magazines. Top TV channels were AMC, Investigation Discovery, and TBS. TV advertisements were purchased commonly during popular movies and TV series (eg King of Queens, Everybody Loves Raymond, The Walking Dead). Higher expenditures were associated with U.S. market areas that had (1) a larger percentage of non-rural zip codes (radio), (2) smaller male populations (radio), and (3) larger White or Caucasian, Black or African American, American Indian or Alaska Native, Asian, and Other or Multiracial populations (radio, print, online display, and online video). Conclusions E-cigarette companies advertised in print magazines geared toward males and youth and young adults, radio commercials focused in urban areas with smaller male populations, and nationwide TV commercials. Declines in e-cigarette advertising expenditures in 2020 demonstrate the potential impact that federal policies may have on protecting populations who are at higher risk for tobacco use from predatory advertising practices. Implications E-cigarette advertising exposure is associated with the initiation and use of e-cigarettes. This study shows how e-cigarette marketing expenditures in the United States may have targeted specific consumers (eg youth and young adults) between 2016 and 2021. The precipitous drop in advertising expenditures across all outlets during early 2020 corresponds with the implementation of the Tobacco 21 federal policy, the federal enforcement policy to remove most unauthorized flavored e-cigarette cartridges from the U.S. market, preparations for FDA's premarket review of e-cigarette products, and the decision by several TV broadcast companies to stop showing e-cigarette ads. The potential impact of federal policies may have far-reaching implications for protecting populations who are at high risk for tobacco use and its health consequences. [ABSTRACT FROM AUTHOR]

Objective: To examine the relationship between demographics, other tobacco use, and JUUL dependency on combustible cigarette use among college JUUL users. Participants: Undergraduates (n = 595) at a large southwestern university who used JUUL weekly completed a cross-sectional online survey in March 2019. Methods: Logistic regressions examined associations between covariates and ever use/past 30-day use of cigarettes. Results: As age increased, odds of ever trying a cigarette increased (AOR = 1.87; 95% CI = 1.45–2.41); however, as age of JUUL initiation increased, odds of ever (AOR = 0.80; 95% CI = 0.65–0.99) or past 30-day (AOR = 0.78; 95% CI = 0.63–0.97) cigarette use decreased. Those moderately (AOR = 2.03; 95% CI = 1.07–3.82) or highly (AOR = 8.01; 95% CI = 3.08–20.83) dependent on JUUL were more likely to have tried cigarettes than those not dependent. However, dependence was not associated with past 30-day use. Conclusions: JUUL users may not transition to combustible cigarettes during college. Longitudinal studies are needed to examine transitions in JUUL users' tobacco product use after college. [ABSTRACT FROM AUTHOR]