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ObjectiveTo determine if the declining trend in U.S. youth cigarette smoking changed after e-cigarettes were introduced, and if youth e-cigarette users would have been likely to smoke cigarettes based on psychosocial and demographic predictors of smoking.MethodsAn interrupted time series analysis was used for cross-sectional data from the 2004 to 2018 National Youth Tobacco Surveys (NYTS) to assess changes in cigarette and e-cigarette use over time. A multivariable logistic regression model used 2004-2009 NYTS data on psychosocial risk factors to predict individual-level cigarette smoking risk from 2011 to 2018. Model-predicted and actual cigarette smoking behavior were compared.ResultsThe decline in current cigarette smoking slowed in 2014 (-0.75 [95% CI: -0.81, -0.68] to -0.26 [95% CI: -0.40, -0.12] percentage points per year). The decline in ever cigarette smoking accelerated after 2012 (-1.45 [95% CI: -1.59, -1.31] to -1.71 [95% CI: -1.75, -1.66]). Ever and current combined cigarette and/or e-cigarette use declined during 2011-2013 and increased during 2013-2014 with no significant change during 2014-2018 for either variable. The psychosocial model estimated that 69.0% of current cigarette smokers and 9.3% of current e-cigarette users (who did not smoke cigarettes) would smoke cigarettes in 2018.ConclusionsThe introduction of e-cigarettes was followed by a slowing decline in current cigarette smoking, a stall in combined cigarette and e-cigarette use, and an accelerated decline in ever cigarette smoking. Traditional psychosocial risk factors for cigarette smoking suggest that e-cigarette users do not fit the traditional risk profile of cigarette smokers.

The Tobacco Regulatory Science Program is a collaborative research effort between the National Institutes of Health (NIH) and the Food and Drug Administration (FDA). In 2013, the NIH funded 14 Tobacco Centers of Regulatory Science (TCORS), which serve as partners in establishing research, training, and professional development programs to guide FDA. Each of the fourteen TCORS, and two other NIH-funded research programs, the Center for the Evaluation of Nicotine in Cigarettes (CENIC) and the Consortium on Methods Evaluating Tobacco (COMET), pursued specific research themes relevant to FDA's priorities. A key mandate for FDA is to reduce tobacco use among young people. This article is a review of the peer-reviewed research, including published and in-press manuscripts, from the TCORS, CENIC, and COMET, which provides specific data or other findings on youth (ages 10-18 years) and/or young adults (ages 18-34 years), from 2013 to 2018. Citations of all TCORS, CENIC, and COMET articles from September 2013 to December 2017 were collected by the TCORS coordinating center, the Center for Evaluation and Coordination of Training and Research. Additional citations up to April 30, 2018 were requested from the principal investigators. A scoring rubric was developed and implemented to assess study type, primary theme, and FDA priority area addressed by each article. The major subareas and findings from each priority area are presented. There were 766 articles in total, with 258 (34%) focusing on youth and/or young adults. Findings relevant to FDA from this review concern impact analysis, toxicity, health effects, addiction, marketing influences, communications, and behavior.ImplicationsThe Tobacco Centers of Regulatory Science, CENIC, and COMET have had a high output of scientific articles since 2013. These Centers are unique in that the FDA supports science specifically to guide future regulatory actions. The 258 articles that have focused on youth and/or young adults are providing data for regulatory actions by the FDA related to the key priority areas such as the addictiveness of non-cigarette products, the effects of exposure to electronic cigarette marketing on initiation and cessation, and the impact of flavored products on youth and young adult tobacco use. Future regulations to reduce tobacco use will be guided by the cumulative evidence. These Centers are one innovative mechanism to promote important outcomes to advance tobacco regulatory science.

Objective: The purpose of this study is to examine differences between current and non-current cigarette users, focusing on sociodemographic factors, non-cigarette tobacco product use, parental and friend use, and alcohol and marijuana use; and to identify predictors of cigarette use six months later. Participants: Participants included young adults (n = 4,296) from 24 Texas colleges, participating in a young adult cohort study, beginning in fall 2014. Methods: Mixed effects logistic regressions were conducted accounting for school-level variability. Results: Cigarette users were older, more likely to report use of non-cigarette tobacco products and peer use of cigarettes than non-current users. Wave 1 cigarette and non-cigarette tobacco product use, marijuana use and binge drinking, and peer use all uniquely predicted cigarette use at wave 2. Conclusions: Colleges need prevention programs targeting multiple tobacco products, because non-cigarette tobacco use and other risky behaviors appear to be independent risk factors for cigarette use in young adults.

Objective: To examine the associations between sensation seeking and ever and current e-cigarette use in Texas young adults (18-29 years old). Current cigarette use was examined as a potential effect modifier of the associations. Participants: Participants included college students enrolled in four-year and two-year colleges in four metropolitan areas in Texas (n = 5,418) who completed the survey between November 2014 and February 2015. Methods: This cross-sectional study utilized mixed effects logistic regression to determine the associations between mean sensation seeking scores and ever and current e-cigarette use after controlling for covariates. Results: After controlling for covariates, significant associations between sensation seeking and both ever and current e-cigarette use were observed; however, these associations were significant for noncurrent smokers only (adjusted odds rations [AOR] = 1.55, 95% confidence interval (CI) = 1.39, 1.73; AOR = 1.82, 95% CI = 1.54, 2.15, respectively). Conclusions: Sensation seeking is an important factor in identifying college students who may be at increased risk for e-cigarette use behaviors.

Background: Being a victim of bullying is associated with greater risk of youth substance use; however, research specifically examining whether tobacco use behaviors differ among adolescents who were bullied at school only, electronically only, or both at school and electronically is limited. Methods: We examined the associations between being a victim of bullying (at school only, electronically only, or both at school and electronically) and use of tobacco products using data from the 2013 national Youth Risk Behavior Survey. Results: Girls who were bullied both at school and electronically reported the highest odds of all tobacco use behaviors (ever use of cigarettes, current use of cigarettes, and current use of any tobacco product) as compared with girls who were not bullied after adjusting for covariates. Conversely, for boys, only the association between being bullied electronically only and ever use of cigarettes remained significant after adjusting for covariates. Conclusions: Results from this study indicate that electronic bullying may differentially influence the odds of tobacco use in high school students as compared with bullying that occurs at school only. Confirmation of these findings could inform interventions to reduce both bullying and tobacco use in high school.

Background: Narrative communication is gaining attention in the health education literature. In this article, we evaluate the acceptability and psychosocial impact of a book of role model stories presenting low-income women's success stories in changing diet and physical activity. Methods: Free copies of the "Be Well" book were distributed through organizations, and recipients were asked to fill out a paper or online questionnaire on completion of the book. Of the 317 recipients who returned valid questionnaires, 62.5% indicated that they had read at least one story in the book. Regression models were run to examine the strength of change in psychosocial and cognitive measures by degree of exposure; that is, number of stories read. Results: Overall, exposed respondents reported significantly greater self-efficacy and slightly greater knowledge and intent to change than unexposed respondents. Among exposed respondents, reported knowledge and intent to change behaviors varied directly with number of stories read. Discussion: The role model stories presented in the "Be Well" book were acceptable to the participants and successful in increasing readiness for behavior change. Translation to Health Education Practice: A narrative communication approach presented as a book of role model stories can bring about positive change in lifestyle behaviors and associated cognitions.

Introduction Understanding the characteristics of premium cigar use patterns is essential for minimizing public health harms. Typically, premium cigars are handmade, larger, more expensive, and without the characterizing flavors that are present in other cigar types: Nonpremium traditional cigars, cigarillos, and filtered cigars. Aims and Methods Self-reported brand and price data were used from Wave 6 of the Population Assessment of Tobacco and Health (PATH) Study to define and estimate premium versus nonpremium cigar use among U.S. adults, as well as to explore cigar smoking patterns, purchasing behavior, and reasons for use by cigar type. Results In 2021, 0.9% (95% CI = 0.7–1.0) of adults were premium cigar users, compared to 0.4% of nonpremium traditional cigar users (95% CI = 0.3–0.5), 1.1% of cigarillo users (95% CI = 1.0–1.2), and 0.6% filtered cigar users (95% CI = 0.5–0.7). Premium cigar users were overwhelmingly male (97.7%), and 35.8% were aged ≥55 years. The average premium cigar price/stick was $8.67, $5.50–7.00 more than other cigar types. Compared to other cigar types, significantly fewer premium cigar users had a regular brand with a flavor other than tobacco (~15% vs. 38%–53%). Though flavors remained the top reason for premium cigar use, they were less likely to endorse flavors as a reason for use than other cigar users (~40% vs. 68–74%). Premium cigar users had a lower prevalence (aRR: 0.37, 95% CI = 0.25–0.55) of dual use of cigars and cigarettes. Conclusions Although <1% of U.S. adults use premium cigars, their use and purchasing characteristics continue to differ from other cigar types, highlighting the importance of capturing data specific to premium cigar use. Implications This manuscript extends previous research from the National Academies of Science, Engineering, and Medicine report, "Premium cigars: Patterns of use, marketing, and health effects" by utilizing the most recent PATH Study data (Wave 6) to examine patterns of cigar use, including purchasing behavior and reasons for use, by cigar type (eg, premium traditional cigars, nonpremium traditional cigars, cigarillos, and filtered cigars). The findings support continued research on patterns of premium cigar use, which differ from use patterns of other cigar types. [ABSTRACT FROM AUTHOR]

Background: Computer-assisted techniques may be a useful way to enhance physical activity surveillance and increase accuracy of reported behaviors. Purpose: Evaluate the reliability and validity of a physical activity (PA) self-report instrument administered by telephone and internet. Methods: The telephone-administered Active Australia Survey was adapted into 2 forms for internet self-administration: survey questions only (internet-text) and with videos demonstrating intensity (internet-video). Data were collected from 158 adults (20-69 years, 61% female) assigned to telephone (telephone-interview) (n = 56), internet-text (n = 51), or internet-video (n = 51). Participants wore an accelerometer and completed a logbook for 7 days. Test-retest reliability was assessed using intraclass correlation coefficients (ICC). Convergent validity was assessed using Spearman correlations. Results: Strong test-retest reliability was observed for PA variables in the internet-text (ICC = 0.69 to 0.88), internet-video (ICC = 0.66 to 0.79), and telephone-interview (ICC = 0.69 to 0.92) groups (P-values < 0.001). For total PA, correlations (ρ) between the survey and Actigraph+logbook were ρ = 0.47 for the internet-text group, ρ = 0.57 for the internet-video group, and ρ = 0.65 for the telephone-interview group. For vigorous-intensity activity, the correlations between the survey and Actigraph+logbook were 0.52 for internet-text, 0.57 for internet-video, and 0.65 for telephone-interview (P < .05). Conclusions: Internet-video of the survey had similar test-retest reliability and convergent validity when compared with the telephone-interview, and should continue to be developed. [ABSTRACT FROM AUTHOR]