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Introduction We quantified the linear trend in combustible tobacco smoking among adolescents in the United States from 2014 to 2020, and then compared these trends across racial and ethnic categories. We also tested the effect of e-cigarette use on these trends for all-youth and across racial and ethnic categories. Aims and Methods We pooled and analyzed seven years of National Youth Tobacco Survey data for n  = 124 151 middle and high school students from 2014 to 2020. Weighted logistic regression analyses calculated the annual change in combustible tobacco smoking (ie cigarettes, cigars, and hookah) from 2014 to 2020. Stratified analyses examined linear trends for non-Hispanic White (NHW), NH-Black (NHB), Hispanic/Latino, and NH-Other (NHO) youth. All-models controlled for sex, grade level, and past 30-day e-cigarette use. Results Combustible tobacco smoking from 2014 to 2020 dropped by more than 50% for NHW youth, more than 40% for Latino and NHO youth, compared to just 16% among NHB youth. From 2014 to 2020, the odds of combustible tobacco smoking declined by 21.5% per year for NHWs, which was significantly greater than Hispanic/Latinos (17% per year; p  = .025), NHOs (15.4% per year; p  = .01), and NHBs (5.1% per year; p  < .001), adjusting for sex, grade, and e-cigarette use. Trends and disparities in trends by race and ethnicity were observed independent of e-cigarette use. Conclusions Combustible tobacco smoking declined for all-youth but at significantly different rates across races and ethnicities. Notably, declines in combustible tobacco smoking are lagging among NHB youth. Interventions are critically needed to address this disparity. Implications A direct, evidence-based intervention to reduce combustible tobacco smoking among NHB youth is critically needed. Such tobacco control initiatives should follow the Best Practices for Comprehensive Tobacco Control Framework, incorporating sustainable funding for school-based intervention, public health education, and adult cessation. [ABSTRACT FROM AUTHOR]

Introduction: There is an established link between tobacco use and adverse oral health outcomes. However, there is a paucity of research exploring the effect of various tobacco products on clinically diagnosed adverse oral health outcomes.Methods: Data were pooled from three cycles of the National Health and Nutrition Examination Survey: 2009-2010; 2011-2012; and 2013-2014 (n = 11,453). Multivariable logistic regressions examined the associations between periodontitis and dental caries with the type of tobacco product used (combustible, non-combustible or both).Results: Overall, 42.3% of the study sample had any periodontitis, 7.8% had severe periodontitis and 21.7% had dental caries. There was a higher prevalence of periodontitis and caries among combustible tobacco users than non-combustible tobacco use; 62.1% of combustible tobacco smokers had any periodontitis, 17.1% had severe periodontitis, while 39.4% of adults with dental caries were dual users. Compared to non-smokers, combustible tobacco use increased the odds of any periodontitis (adjusted odds ratio [aOR] 2.81, 95% confidence interval [CI] 2.28, 3.45) and severe periodontitis (aOR 2.62, 95% CI 1.90, 3.61). Compared to non-smokers, both combustible tobacco (aOR 2.11, 95% CI 1.61, 2.76) and non-combustible tobacco use (aOR 2.09, 95% CI 1.19, 3.66) increased the odds of dental caries.Discussion and Conclusions: In this study of US adults, combustible tobacco use was associated with periodontitis and dental caries, while non-combustible tobacco use was associated with dental caries. In addition to conducting extensive oral health screening among all smokers, oral health-care providers should counsel smokers on the need for smoking cessation. [ABSTRACT FROM AUTHOR]

Background In response to SARS-CoV2 (COVID-19), school districts incorporated remote learning as a mitigation strategy. This study examines the association between classroom setting (ie, on-campus versus remote) and e-cigarette susceptibility or ever use among a sample of Texas public middle school students. Methods Data from n = 985 students enrolled in the CATCH My Breath E-Cigarette Prevention Program trial were collected in Spring 2021. Participants were 6th-grade students in urban Texas. E-cigarette use was examined using the "at-risk" definition described by FDA, indicating either: (1) susceptible never user; or (2) experimental ever use. A multilevel, logistic regression model examined the association between classroom setting and e-cigarette susceptibility/ever use. Covariates included sex, race/ethnicity, academic achievement, household e-cigarette use, perceived school connectedness, and school-level economic status. Models account for nesting within school district. Analyses stratified by race/ethnicity were also conducted. Results Overall, 36.3% of the sample were susceptible never users or ever e-cigarette users. The sample was comprised of 55.0% on-campus and 45.0% remote learners. On-campus learners had greater odds of reporting e-cigarette susceptibility or ever use (aOR: 1.45; p =.014). These findings were observed among Latino (aOR: 1.77; p =.026) and White (aOR: 2.10; p =.099) but not African American/Black (aOR: 0.86; p =.728) youth. Conclusions On-campus learning during the Spring 2021 semester was associated with greater risk for e-cigarette susceptibility or ever use among a diverse sample of 6th-grade students. E-cigarette susceptibility and ever use is a risk factor for progression to long-term e-cigarette use in later adolescence. Implications As school districts prepare to return to on-campus learning in 2022, a focused approach to e-cigarette prevention may be needed to prevent widespread e-cigarette initiation and continued use. Further, study findings demonstrate a need for further research on the school environment as a determinant of e-cigarette use. [ABSTRACT FROM AUTHOR]

Introduction: Secondhand smoke exposure during adolescence is linked to increased risk for cigarette smoking susceptibility and initiation. Non-urban youth may encounter a disproportionate number social and environmental risk factors for secondhand smoke exposure. Research is needed to explore geographic disparities in secondhand smoke exposure.Aims and Methods: Four years of National Youth Tobacco Survey (2015-2018) data were pooled. Participants were 69 249 middle and high school students. Multivariable logistic regression examined the relationship between geographic region and secondhand smoke exposure (1) at home and (2) in a vehicle. A multivariable, multinomial logistic regression examined the relationship between geographic region and number of sources of secondhand smoke exposure (ie, 0, 1 source, 2 sources). Covariates included sex, race/ethnicity, grade level, past 30-day tobacco use, and living with a tobacco user.Results: From 2015 to 2018, ~28.4% of middle and high school students reported secondhand smoke exposure either at home, in a vehicle, or both. Non-urban youth had greater odds of reporting secondhand smoke exposure at home (Adj OR: 1.26; 95% CI: 1.15 to 1.38) and in a vehicle (Adj OR: 1.50; 95% CI: 1.35 to 1.65), compared with urban youth. Similarly, non-urban youth had greater odds of reporting secondhand smoke exposure via one source (RRR: 1.21; 95% CI: 1.11 to 1.31) and two sources (RRR: 1.61; 95% CI: 1.42 to 1.82), relative to no exposure, than urban youth.Conclusion: Secondhand smoke exposure at home and/or in a vehicle varies across geographic region. Targeted interventions should be developed and implemented to reduce secondhand smoke exposure among at-risk youth.Implications: Findings showcase the need to address secondhand smoke exposure in non-urban areas and how it impacts adolescents. Public health interventions and regulatory policies aimed at improving social norms and expanding health infrastructure in rural communities should be designed and implemented in order to prevent and reduce secondhand smoke exposure among non-urban youth. [ABSTRACT FROM AUTHOR]

Introduction: Recent literature has demonstrated individuals may be using electronic cigarettes (e-cigarettes) as a method of weight loss and/or management. Furthermore, e-cigarette companies are developing and patenting technologies related to e-cigarettes and weight loss. This study aims to determine the association between intentions to lose weight and e-cigarette use behaviors among a nationally representative sample of high school students.Methods: Data were obtained from the 2015 Youth Risk Behavior Surveillance survey. Participants were 12 847 students in grades 9-12 in the United States. Multivariate multinomial logistic regression models assessed the association between past 30-day e-cigarette use and weight loss intentions among 9-12 grade students. Subsample analyses were conducted, stratified by sex. Covariates included perceived weight, sex, race/ethnicity, grade, and past 30-day tobacco use.Results: Overall, 23.7% of the sample used e-cigarettes in the past 30 days. E-cigarette use was associated with 1.38 (95% CI = 1.07% to 1.78%) greater risk of intentions to lose weight among the full sample, controlling for covariates. Among girls, e-cigarette use was associated with 1.44 (95% CI = 1.05% to 1.97%) greater risk of intentions to lose weight, controlling for covariates. Among boys, e-cigarette use was associated with 1.40 (95% CI = 1.04% to 1.88%) greater odds of intentions to gain weight, controlling for covariates.Conclusion: Findings show a significant association between e-cigarette use and intentions to lose weight among high school students, among the full sample. Interestingly, e-cigarette use was statistically associated with intentions to gain weight among boys. Longitudinal study is needed to further examine this relationship.Implications and Contribution: This is the one of the first studies reporting on e-cigarette use and weight loss intentions among adolescents, both highly prevalent among this population. These findings are an important development in the study of e-cigarette use given the established link between conventional cigarette smoking and weight loss and/or management. [ABSTRACT FROM AUTHOR]

Objectives: We examined the association between school connectedness (SC) and e-cigarette susceptibility/ ever use in a diverse sample of Texas 6 th graders, with a secondary aim to explore the association stratified by gender and classroom setting (in-person vs remote). Methods: A cross-sectional analysis was conducted of CATCH My Breath baseline data, representing 985 6 th -graders from 21 public schools. SC was based on National Longitudinal Study of Adolescent Health measures; e-cigarette susceptibility/ever use was based on the FDA's definition of "at-risk" for long-term use. We conducted multi-level logistic regression analyses. Results: Over half the sample was Hispanic (57.6%), with 36.2% reporting susceptibility/ever use. Lower SC was associated with increased odds of e-cigarette susceptibility/ever use (low SC: aOR: 5.17, 95% CI: 3.54, 7.55; medium SC: aOR: 2.15, 95% CI: 1.44, 2.91; high SC= referent). The association held across gender groups, with low SC girls reporting the highest odds of susceptibility/ever use (aOR: 7.83, 95% CI: 4.51, 13.61). Low SC in- person and remote students were 6 and 4 times, respectively, more likely to report susceptibility/ever use as high SC students (p<.05). Conclusion: SC protected against e-cigarette susceptibility/ever use in this sample.