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Background: Australia introduced a prescription only policy for e‐cigarettes in 2011 to prevent uptake among youth while allowing smokers to access e‐cigarettes for cessation. This is one of the restrictive forms of regulation for e‐cigarettes recommended by the World Health Organisation. Aims: To assess whether the policy has prevented e‐cigarette youth uptake and facilitated smokers' access to e‐cigarettes for cessation; and to examine a proposed toughening of the policy. Methods: An analysis of survey and administrative data on e‐cigarette use and smoking and a critical analysis of the contents of submissions to parliamentary inquiries into the policy. Results: E‐cigarette use among youth and young adults has increased steeply since 2016 but very few of these products have been obtained through the prescription system, because medical authorities discourage their use. A policy change in 2021 to increase the prescription of e‐cigarettes has not reduced e‐cigarette use among youth and only marginally increased rates of prescribing. Australian policy makers have nonetheless tightened the prescription system by banning any use of e‐cigarettes unless prescribed by a doctor and dispensed by a pharmacist. Implications: Australia's tightened prescription policy for e‐cigarettes may reduce adolescent vaping but at the risk of reducing smokers' access to e‐cigarettes and increasing the size of the illicit market for combustible cigarettes and e‐cigarettes. A more effective policy would allow vapes to be sold as consumer products by licensed tobacconists under regulations that require prior product approval, plain packaging, bans on their promotion and enforced age restrictions on purchases. [ABSTRACT FROM AUTHOR]

Background: Past research indicates that young adult cigarette smokers are at risk of engaging in maladaptive eating behaviors (MEBs); however, whether this relationship extends to nicotine vaping is unclear. The current study assessed bidirectional associations between four types of MEBs and nicotine vaping among young adults. Methods: 1,303 young adults (20.5 ± 2.3 years; 63 % female) from a public, urban university were recruited and completed online surveys at six-month intervals from spring 2021 (W1) to spring 2023 (W5). Past 30-day nicotine vaping and four types of MEBs (susceptibility to external cues, emotional eating, routine restraint, and compensatory restraint) were evaluated. Results: Longitudinal cross-lagged models examined the bidirectional relationships between past 30-day nicotine vaping and each type of MEB across five waves. Nicotine vaping predicted both susceptibility to external cues (β = 0.10, p

The purpose was to assess clinical dental hygienists' knowledge, beliefs, and intentions regarding asking adolescents about electronic nicotine delivery systems (ENDS) use. Cross-sectional survey research was conducted with a convenience sample of dental hygienists using a validated instrument developed based on the theory of planned behavior (TPB) that contained the following sections: demographics, knowledge, behavioral belief (BB), normative beliefs, control beliefs, and behavioral intention. Outcomes were analyzed using descriptive statistics, correlations, and multivariate regression analysis. Of the 360 participants who opened the survey, 257 completed it for a completion rate of 71.4%. The knowledge score mean was 72%. BBs suggested that a majority (83%) of participants were likely to ask adolescent patient about ENDS use, however, normative beliefs showed that only about half had the support of their dentist/supervisor, and one-third (33%) felt they had sufficient tobacco/nicotine use and dependency guideline resources. This resulted in only half having the behavioral intention to ask adolescents about ENDS use. Demographic variables were not significantly correlated with the TPB subscales or intention. In the regression model all three TPB subscales predicted intention (F 3 , 251) = 46.1; p <.001). The coefficient of determination (R 2 = 0.35) suggested 35% of the variation in the intention to ask about ENDS use can be explained by the model. Most participants had favorable BBs toward asking about ENDS use among adolescents. However, adequate support from dentists/supervisors and training on guidelines for prevention and cessation of ENDS is needed to encourage dental hygienists to ask adolescents about ENDS use. [ABSTRACT FROM AUTHOR]

The effects of tobacco smoke and nicotine on the health of adults and children remain one of the most burning problem in our days. In 2019 the prevalence of active smoking in Ukraine reached 42.0 among men and 14.4% among women. The negative effects of second-hand tobacco smoke exposure are most significant in children under 5 years of life, especially in families with smoking mothers. The goal of the study was to assess the current smoking prevalence in families with children, including the use of modern electronic nicotine delivery devices. A self-reported survey of 414 families living in Odessa and Odessa region (Ukraine) was conducted. All questionnaires were divided into two groups depending on the presence of tobacco smoke exposure. To asses the factor's relevance the odds ratio (OR) and its 95% confidence interval (CI) were used. The prevalence of smoking in families was associated with the age of the father up to 30 years (16.13 [95% CI 11.54–22.09]%; OR 2.73 [1.42–5.25]), mother’s and father’s low education lever (OR 2.73 [1.42–5.25] and 2.70 [1.64–4.44]), as well as with the residence of the family in the city (OR 4.30). The prevalence of smoking exposure was not associated with the income level or number of household members. The prevalence of smoking in women before pregnancy was more than 20%, and during pregnancy – 10%. After delivery women smoked in 23.91 (95% CI 20.06-28.25)% of cases. Proportion of families where smoked someone other than the mother reached 42.75 (95% CI 38.08–47.56)%. Other family members smoking negatively affected mothers’ tobacco consumption, both before and after childbirth. After pregnancy, women used both smoked tobacco and noncombustible forms of nicotine (51.52 vs 48.48%) with the same frequency. Other family members consumed smoking tobacco more often than e-cigarettes. All smokers who used electronic nicotine delivery devices more likely smoked at home (OR 5.33 [95% CI 0.53–54.04]).

The author offers a response to commentaries on his article about Australia's regulation on selling electronic cigarettes (e-cigarettes). These include the agreement by Sharon Cox that Australia's prescription mode has not achieved its aims, the reason that Australia's prescription mode has not worked according to Sharon Gravely and Geoff Fong, and the support of Becky Freeman and Christina Watts to Australia's prescription model.

The effects of tobacco smoke and nicotine on the health of adults and children remain one of the most burning problem in our days. In 2019 the prevalence of active smoking in Ukraine reached 42.0 among men and 14.4% among women. The negative effects of second-hand tobacco smoke exposure are most significant in children under 5 years of life, especially in families with smoking mothers. The goal of the study was to assess the current smoking prevalence in families with children, including the use of modern electronic nicotine delivery devices. A self-reported survey of 414 families living in Odessa and Odessa region (Ukraine) was conducted. All questionnaires were divided into two groups depending on the presence of tobacco smoke exposure. To asses the factor's relevance the odds ratio (OR) and its 95% confidence interval (CI) were used. The prevalence of smoking in families was associated with the age of the father up to 30 years (16.13 [95% CI 11.54–22.09]%; OR 2.73 [1.42–5.25]), mother’s and father’s low education lever (OR 2.73 [1.42–5.25] and 2.70 [1.64–4.44]), as well as with the residence of the family in the city (OR 4.30). The prevalence of smoking exposure was not associated with the income level or number of household members. The prevalence of smoking in women before pregnancy was more than 20%, and during pregnancy – 10%. After delivery women smoked in 23.91 (95% CI 20.06-28.25)% of cases. Proportion of families where smoked someone other than the mother reached 42.75 (95% CI 38.08–47.56)%. Other family members smoking negatively affected mothers’ tobacco consumption, both before and after childbirth. After pregnancy, women used both smoked tobacco and noncombustible forms of nicotine (51.52 vs 48.48%) with the same frequency. Other family members consumed smoking tobacco more often than e-cigarettes. All smokers who used electronic nicotine delivery devices more likely smoked at home (OR 5.33 [95% CI 0.53–54.04]). [ABSTRACT FROM AUTHOR]

The prevalence of nicotine vaping is increasing among adolescents and emerging evidence suggests weight concerns may promote risk for vaping. The aims of this study were to investigate whether there is an association between attempting to lose weight and nicotine vaping during adolescence, when this association emerges and is strongest, and whether there are sex differences in this link. This study used time-varying effect modeling, an analytic method that estimates regression coefficients as a continuous function of age, to model dynamic associations between weight loss behavior and nicotine vaping across adolescence and sex differences in these links. Data were from 13,677 adolescents (aged 14–18 years, 49.4% female) who participated in the 2019 National Youth Risk Behavior Survey, a nationally representative U.S. sample. Results revealed an age-varying association that differed by sex. Girls who were trying to lose weight were at a higher risk for past 30-day vaping from ages 14.2–15.9 years, with the strongest association at 14.8 years (odds ratio [OR] = 1.92, 95% confidence interval [CI] [1.25, 2.95]). For boys, this association was nonsignificant across age (OR = 1.76, 95% CI [0.91, 3.41] at age 14.0 years). Girls who were trying to lose weight were at a higher risk for frequent vaping (vaping on 20–30 of the past 30 days) from ages 15.2–17.1 years, with the strongest association at 16.1 years (OR = 2.59, 95% CI [1.45, 4.62]). This link was not meaningfully significant at any age for boys (OR = 3.26, 95% CI [0.86, 12.33] at age 14.0 years). Girls, but not boys, who are trying to lose weight appear vulnerable to nicotine vaping during adolescence. [ABSTRACT FROM AUTHOR]

Background and Aims: Most population studies that evaluate the relationship between nicotine vaping and cigarette cessation focus on limited segments of the smoker population. We evaluated vaping uptake and smoking cessation considering differences in smokers' plans to quit. Design: Longitudinal International Tobacco Control (ITC) Four Country Smoking and Vaping Surveys were conducted in 2016, 2018 and 2020. Setting: This study was conducted in the United States, Canada, England and Australia. Participants: Participants of this study were adult daily cigarette smokers who had not vaped in the past 6 months at baseline and had participated in two or more consecutive waves of the ITC Four Country Smoking and Vaping Surveys (n = 2815). Measurements Plans to quit cigarette smoking was assessed at baseline (within 6 months, beyond 6 months, not planning to quit) and at follow‐up (within 6 months vs not within 6 months), cigarette smoking cessation was assessed at follow‐up (smoking less than monthly [including complete cessation] vs daily/weekly/monthly smoking) and inter‐wave vaping uptake was assesed between baseline and follow‐up (none, only non‐daily vaping and any daily vaping). Generalized estimating equations were used to evaluate whether inter‐wave vaping uptake was associated with smoking cessation at follow‐up and with planning to quit at follow‐up, each stratified by plans to quit smoking at baseline. Findings Overall, 12.7% of smokers quit smoking. Smokers not initially planning to quit within 6 months experienced higher odds of smoking cessation when they took up daily vaping (32.4%) versus no vaping (6.8%; adjusted odds ratio [AOR], 8.58; 95% CI, 5.06–14.54). Among smokers planning to quit, smoking cessation rates were similar between those who did and did not take up daily vaping (25.1% vs 16.8%; AOR, 1.91; 95% CI, 0.91–4.00), although we could not account for potential use of cessation aids. Daily vaping uptake was associated with planning to quit smoking at follow‐up among those initially not planning to quit (AOR,6.32; 95% CI, 4.17–9.59). Conclusions: Uptake of nicotine vaping appears to be strongly associated with cigarette smoking cessation among smokers with no initial plans to quit smoking. Excluding smokers not planning to quit from studies on vaping and smoking cessation may underestimate potential benefit of daily vaping for daily smokers. [ABSTRACT FROM AUTHOR]

Youth vaping is a public health concern in Canada. Researchers have explored factors associated with vape use, but rarely differentiated between types of use. This study estimates the prevalence and correlations among past-month nicotine vaping, nicotine-free vaping, and dual-use vaping (nicotine and nicotine-free) in grades 9–12 high school students. Data came from the 2019 Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS). The total sample consisted of 38,229 students. We used multinomial regression to assess for the correlations among different categories of vape use. Approximately 12% of the students reported past-month vape use exclusively with nicotine, 2.8% reported exclusively nicotine-free vape use, and 14% reported both nicotine vaping and nicotine-free vaping. Substance use (smoking, alcohol, cannabis) and being male were associated with membership in every category of vape use. Age was associated with vape use, but in different directions. Grade 10 and 11 students were more likely than grade 9 students to vape exclusively with nicotine (aOR 1.36; 95% CI: 1.05, 1.77 and aOR 1.46; 95% CI: 1.09, 1.97), while grade 9 students were more likely than grade 11 and 12 students to vape with both nicotine and nicotine-free vapes (aOR 0.82; 95% CI: 0.67, 0.99 and aOR 0.49; 95% CI: 0.37, 0.64). The prevalence of nicotine and nicotine-free vaping is high, with many students reporting the use of both. [ABSTRACT FROM AUTHOR]

• E-cigarette marketing exposure was associated with sole-cannabis vaping in adults. • It was also associated with dual-vaping of nicotine and cannabis. • Those associations were found for many marketing channels (e.g., retail stores). • These associations were found among young adults aged 18–24 and 25–34 years. • Those associations were not found for sole-nicotine vaping. Little is known about the influence of e-cigarette marketing on cannabis vaping behaviors. This study examined the associations between e-cigarette marketing exposure and nicotine and cannabis vaping among adults. This cross-sectional study included a U.S. nationally representative sample of adults from the Wave 6 survey of the Population Assessment of Tobacco and Health Study. We used multinomial logistic regressions to examine the associations between past 30-day e-cigarette marketing exposure and past 30-day vaping behavior (sole- and dual-vaping of nicotine and cannabis) overall and stratified by age. Overall, 52.0 % of respondents reported e-cigarette marketing exposure, and 89.8 %, 5.6 %, 3.2 %, and 1.4 % reported no vaping, sole-nicotine vaping, sole-cannabis vaping, and dual-vaping, respectively. E-cigarette marketing exposure was associated with increased odds of reporting sole-cannabis vaping versus no vaping (adjusted risk ratio [aRR], 1.31; 95 % confidence interval [CI], 1.09–1.57) and dual-vaping versus no vaping (aRR, 1.26; 95 % CI, 1.01–1.57). This association was found among those aged 18–24 and 25–34 years. It was also associated with increased odds of reporting sole-cannabis vaping versus sole-nicotine vaping (aRR, 1.28; 95 % CI, 1.04–1.58). This association was found among those aged 18–24 years. E-cigarette marketing exposure was associated with sole-cannabis vaping and dual-vaping, not sole-nicotine vaping among U.S. adults. Such associations were mainly driven by young adults aged 18–24 and 25–34 years. Greater restrictions on tobacco marketing may have reduced the influence of e-cigarette marketing on nicotine vaping, while gaps in marketing restrictions for cannabis may contribute to e-cigarette marketing influence on cannabis vaping. [ABSTRACT FROM AUTHOR]

Background Smoking among adolescents in schools is a major global public health concern. There is limited evidence regarding prevalence and associated factors in Vietnam. Objective To compare the prevalence of smoking and associated factors among in-school adolescents aged 13–17 years in Vietnam between 2013 and 2019. Methods Data were collected from two rounds of the national representative Vietnam Global School-based Student Health Survey (GSHS) conducted in 2013 (n = 3,331) and 2019 (n = 7,690). Logistic regression was used to identify the factors associated with tobacco and electronic cigarette smoking among in-school adolescents. Results There was a significant reduction in the prevalence of current smoking (water pipes and cigarettes) from 5.4% (95% CI: 4.0–7.2) in 2013 to 2.8% (95% CI: 2.2–3.6) in 2019. In 2019, 2.6% of the in-school adolescents reported having used electronic cigarette products 30 days prior to the survey. Factors associated with a significantly higher likelihood of current smoking status included gender, loneliness, suicidal ideation, sexual activity, truancy, and alcohol consumption. Similar patterns were observed for e-cigarettes. Conclusion Smoking among in-school adolescents in Vietnam decreased between 2013 and 2019. Follow-up studies are needed to further investigate causal factors so that future policies and communication programmes can be more effectively targeted to reduce smoking in adolescents.

Background: This study aimed to investigate whether perceived vaping addiction is a predictor of quitting nicotine vaping product (NVP) use among adults who have ever smoked and currently vape exclusively or predominantly in four countries: Australia, Canada, the US, and England., Method: Data analysed (n = 574) came from participants (aged 18 + ) who completed the International Tobacco Control (ITC) Four Country Smoking and Vaping survey in 2018 and again in 2020. Baseline inclusion criteria were: (1) currently not smoking or non-daily smoking; and (2) using NVPs daily/weekly for a period of at least 4 months. Association of self-reported baseline levels of perceived vaping addiction with making any attempts to quit vaping and successful attempts reported at follow-up were examined using logistic regression models, controlling for potential sociodemographic and smoking/vaping-related confounders., Results: Participants who perceived themselves as being addicted to vaping were less likely to attempt to quit vaping than those who perceived themselves as not addicted. Among those who tried, those who perceived themselves being addicted were also less likely to succeed than those who perceived themselves as not addicted. No significant country differences in associations were observed for both outcomes., Conclusions: Perceived vaping addiction was shown to have predictive utility for vaping cessation behaviours, possibly acting as an indicator of task difficulty, and thus may serve as a useful screening tool for identifying NVP users who may benefit from tailored cessation support programs if they want to stop using these products., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

We report a collection of lung findings in a patient with a remote history of cigarette smoking, but now engaged in heavy nicotine vaping with daily edible and combustible cannabis use. Computed tomography (CT) imaging demonstrated numerous, small, and bilateral nodules with ground-glass appearance. The largest nodule is demonstrated in the right upper lung lobe. Clinically the differential diagnosis at this time included hypersensitivity pneumonitis and sarcoidosis. Atypical infection, particularly of a fungal etiology, and metastatic malignancy were also considered. Initial pathology of the right lung needle biopsy revealed alveolar septal thickening with associated atypical pneumocyte proliferation, suggestive of atypical adenomatous hyperplasia (AAH). Subsequently the patient underwent wedge resection of the right upper, middle and lower lobes. Pathology examination revealed pulmonary Langerhans cell histiocytosis (PLCH) in the upper and lower lobes, with CD1a staining highlighting the aggregates of Langerhans cells. Vascular changes were also present including intimal thickening of muscular pulmonary arteries, consistent with pulmonary hypertensive changes. Background lung parenchyma demonstrated respiratory bronchiolitis, smoking-related interstitial fibrosis, an organizing thrombus in muscular artery and associated pneumocyte hyperplasia. [ABSTRACT FROM AUTHOR]

Smoking among adolescents in schools is a major global public health concern. There is limited evidence regarding prevalence and associated factors in Vietnam. To compare the prevalence of smoking and associated factors among in-school adolescents aged 13–17 years in Vietnam between 2013 and 2019. Data were collected from two rounds of the national representative Vietnam Global School-based Student Health Survey (GSHS) conducted in 2013 (n = 3,331) and 2019 (n = 7,690). Logistic regression was used to identify the factors associated with tobacco and electronic cigarette smoking among in-school adolescents. There was a significant reduction in the prevalence of current smoking (water pipes and cigarettes) from 5.4% (95% CI: 4.0–7.2) in 2013 to 2.8% (95% CI: 2.2–3.6) in 2019. In 2019, 2.6% of the in-school adolescents reported having used electronic cigarette products 30 days prior to the survey. Factors associated with a significantly higher likelihood of current smoking status included gender, loneliness, suicidal ideation, sexual activity, truancy, and alcohol consumption. Similar patterns were observed for e-cigarettes. Smoking among in-school adolescents in Vietnam decreased between 2013 and 2019. Follow-up studies are needed to further investigate causal factors so that future policies and communication programmes can be more effectively targeted to reduce smoking in adolescents. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to explore demographic and clinical characteristics of vaping-associated lung illness (VALI) cases reported in Canada from September 2019 to December 2020; compare the epidemiology of VALI cases in Canada to e-cigarette or vaping product use-associated lung injury (EVALI) cases in the US; and examine possible explanations for differences between the two countries. Methods: A federal/provincial/territorial task group developed a national outbreak definition, minimum dataset and case report form for identification and surveillance of VALI cases in Canada. Descriptive analysis explored the characteristics and epidemiology of reported VALI cases. Results: Of the 20 VALI cases reported, none resulted in a death. Of all cases, 5 (25%) involved youth aged 15 to 19 years, 10 (50%) adults aged 20 to 49 years and 5 (25%) aged 50 years and older. Sixty percent of patients were men. Half (50%) required breathing assistance. Three-quarters (75%) reported using nicotine-containing vaping products, and 40% reported use of cannabis-containing vaping products; of those who reported frequency of vaping, most (71%) reported vaping daily. VALI cases were reported at a lower prevalence (0.9 per million) than EVALI (8.5 per million). Demographics and vaping behaviour also differed. Conclusion: VALI cases were reported in Canada between September 2019 and December 2020; however, there was a much lower prevalence and they may have been caused by different factors from the EVALI outbreak in the US. The factors influencing VALI in Canada are complex and multifactorial. Research is needed to understand the short- and long-term health effects of nicotine and cannabis vaping. [ABSTRACT FROM AUTHOR]

Youth vaping is a public health concern in Canada. Researchers have explored factors associated with vape use, but rarely differentiated between types of use. This study estimates the prevalence and correlations among past-month nicotine vaping, nicotine-free vaping, and dual-use vaping (nicotine and nicotine-free) in grades 9–12 high school students. Data came from the 2019 Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS). The total sample consisted of 38,229 students. We used multinomial regression to assess for the correlations among different categories of vape use. Approximately 12% of the students reported past-month vape use exclusively with nicotine, 2.8% reported exclusively nicotine-free vape use, and 14% reported both nicotine vaping and nicotine-free vaping. Substance use (smoking, alcohol, cannabis) and being male were associated with membership in every category of vape use. Age was associated with vape use, but in different directions. Grade 10 and 11 students were more likely than grade 9 students to vape exclusively with nicotine (aOR 1.36; 95% CI: 1.05, 1.77 and aOR 1.46; 95% CI: 1.09, 1.97), while grade 9 students were more likely than grade 11 and 12 students to vape with both nicotine and nicotine-free vapes (aOR 0.82; 95% CI: 0.67, 0.99 and aOR 0.49; 95% CI: 0.37, 0.64). The prevalence of nicotine and nicotine-free vaping is high, with many students reporting the use of both.

• The study examined the association of disability and nicotine vaping among adolescents and young adults (AYAs) in 2021. • AYAs with disabilities had a higher prevalence of nicotine vaping compared to those without disabilities. • Major depressive episode (MDE) is strongly associated with nicotine vaping. Nicotine vaping is more prevalent among U.S. adults with disabilities compared to those without disabilities. However, less is known about nicotine vaping among adolescents (12–17 years) and young adults (18–25 years) by disability status. Using data from a sample of 24,722 adolescents and young adults (AYAs) from the 2021 National Survey on Drug Use and Health, we conducted descriptive and multivariable analyses to estimate the national prevalence of nicotine vaping by disability type and examined major depressive episodes (MDEs) as a risk factor for nicotine vaping. A greater proportion of AYAs with disabilities engaged in past-month nicotine vaping compared to those without a disability (13.9 % vs 9.6 %, p = 0.0001). Also, when MDE was excluded from the model, AYAs with any disability had higher odds of nicotine vaping (AOR = 1.41; 95 % CI 1.15, 1.74) than those without a disability. However, disability status was no longer significant when MDE was included (AOR = 1.16; 95 % CI 0.91, 1.46) in the model. The higher prevalence of nicotine vaping among AYAs with disabilities suggests that tailored messages may be needed to communicate health risks and adverse outcomes of e-cigarette use. Also, MDE is associated with nicotine vaping among AYA populations. This information can be helpful to school nurses, counselors, and mental health professionals in their screening of major depression as a risk factor for e-cigarette use. [ABSTRACT FROM AUTHOR]

Background: Past research indicates that young adult cigarette smokers are at risk of engaging in maladaptive eating behaviors (MEBs); however, whether this relationship extends to nicotine vaping is unclear. The current study assessed bidirectional associations between four types of MEBs and nicotine vaping among young adults., Methods: 1,303 young adults (20.5 ± 2.3 years; 63 % female) from a public, urban university were recruited and completed online surveys at six-month intervals from spring 2021 (W1) to spring 2023 (W5). Past 30-day nicotine vaping and four types of MEBs (susceptibility to external cues, emotional eating, routine restraint, and compensatory restraint) were evaluated., Results: Longitudinal cross-lagged models examined the bidirectional relationships between past 30-day nicotine vaping and each type of MEB across five waves. Nicotine vaping predicted both susceptibility to external cues (β = 0.10, p  <.05; Wave 2 to 3) and emotional eating (β = 0.08, p  <.05; Wave 1 to 2). A significant cross-lag regression (Wave 4 to 5) showed nicotine vaping predicted to routine restraint (β = 0.08, p  <.05), and routine restraint predicted to nicotine vaping (β = 0.12, p  <.05)., Conclusions: Results indicated that nicotine vaping predicted MEBs; however, the type of MEB differed across waves, which may have been due to the COVID-19 pandemic context. Nicotine vaping predicted to MEBs reflecting vulnerability to the external environment and emotion regulation during a period of heightened restrictions, whereas later when pandemic restrictions had ceased nicotine vaping predicted only to routine restraint. Integrating research and practice on nicotine vaping and MEBs may inform public health efforts to decrease co-occurring health-risks in young adulthood., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Simultaneous alcohol and marijuana (SAM) use is associated with adverse consequences for youth. While SAM use is overall declining among youth, prior studies indicate increasing marijuana use among US adolescents who ever used cigarettes, suggesting possible moderation of the alcohol-marijuana relationship by cigarette use. We included 43,845 12-th grade students participating in Monitoring the Future data (2000–2020). A 5-level alcohol/marijuana measure was used, including past-year SAM, alcohol-only, marijuana-only, non-simultaneous alcohol and marijuana, or no use. Multinomial logistic regressions estimated associations between time periods (categorized based on sample size: 2000–2005, 2006–2009, 2010–2014, 2015–2020) and the 5-level alcohol/marijuana measure. Models adjusted for sex, race, parental education and survey mode and included interactions of time periods and lifetime cigarette or vaped nicotine use. While overall SAM among 12th graders decreased from 23.65% to 18.31% between 2000 and 2020, SAM increased among students who never used cigarettes or vaped nicotine (from 5.42% to 7.03%). Among students who ever used cigarettes or vaped nicotine, SAM increased from 39.2% in 2000–2005–44.1% in 2010–2014 then declined to 37.8% in 2015–2020. Adjusted models controlling for demographics indicated that among students with no lifetime cigarette or vaped nicotine use, students in 2015–2020 had 1.40 (95% C.I. 1.15–1.71) times the odds of SAM, and 5.43 (95% C.I. 3.63–8.12) times the odds of marijuana-only (i.e., no alcohol use) compared to students who used neither in 2000–2005. Alcohol-only declined over time in both students who ever and never used cigarettes or nicotine vape products. Paradoxically, while SAM declined in the overall adolescent US population, the prevalence of SAM increased among students who have never smoked cigarettes or vaped nicotine. This effect arises because of a substantial decline in the prevalence of cigarette smoking; smoking is a risk factor for SAM, and fewer students smoke. Increases in vaping are offsetting these changes, however. Preventing adolescent use of cigarettes and nicotine vaped products could have extended benefits for other substance use, including SAM. • From 2000–2020, SAM increased among students who have never smoked cigarettes or vaped nicotine, despite declining overall. • Despite declines in smoking, increase in vaping may reverse declining trends in simultaneous alcohol and marijuana use. • Marijuana use is increasing in US adolescents, whereas alcohol‐use‐only is declining. [ABSTRACT FROM AUTHOR]

Introduction: Emerging research has found that some young adults report vaping nicotine to control appetite and lose weight. Yet, there is little research on how young adults use vaping to manage weight, where they learn about weight-motivated vaping, and the role that food and weight motivations play in decisions to vape.Methods: We conducted one-on-one qualitative interviews with young adults aged 18-25 years old in Los Angeles, California (N = 62) from June 2018 to June 2019, who self-reported using e-cigarettes on a weekly basis or more for at least 5 months prior to study enrollment. Interviews examined participants' thoughts, feelings, and experiences related to e-cigarette use, including their understanding of the relation of vaping with eating behaviors and weight management. We analyzed the interviews using the rigorous and accelerated data reduction (RADaR) technique.Results: Participants reported pairing nicotine vaping with caffeinated beverages like coffee, pop/soda, tea, and after every meal (like patterns of combustible cigarette use). Participants also reported vaping nicotine as a tool to avoid binge eating and increase concentration while studying. Reports of vaping effecting appetite and eating behaviors also emerged. Vaping nicotine to suppress appetite and/or achieve weight loss was often reported in conjunction with an eating disorder. Participants reported learning about weight-motivated vaping from peers or deducing from cigarette effects and their own experiences with nicotine. Others mentioned controlling food cravings by vaping a similar e-liquid flavor.Conclusion: Nicotine vaping was used as a tool to control weight and suppress appetite, paralleling food- and weight-related behaviors associated with cigarette use. Findings suggest a need for targeted interventions that address the role of nicotine vaping in eating/weight-related behaviors. [ABSTRACT FROM AUTHOR]

Background: How adolescent substance use and perceived availability of substances have changed during the COVID-19 pandemic remain largely unknown. Substantial reduction in availability of substances would present a unique opportunity to consider the supply-side hypothesis that reductions in drug availability will lead to reductions in drug prevalence.Methods: Longitudinal data come from Monitoring the Future and are based on responses from 582 adolescents who were originally surveyed as part of a national sample of 12th grade students in early 2020, one month before social distancing policies began. They were surveyed again after social distancing policies were implemented, in the summer of 2020.Results: Perceived availability of marijuana and alcohol declined across the two survey waves at the largest levels ever recorded in the 46 years of the project, by an absolute 17 %, p < .01 and 24 %, p < .01, respectively. Despite these declines, prevalence levels did not significantly change across the two waves for marijuana use in the past 30 days or for binge drinking in the past two weeks. Perceived availability of vaping devices significantly declined, from 73 % to 63 %, as did nicotine vaping prevalence in the past 30 days, from 24 % to 17 %.Conclusions: Perceived availability of marijuana, alcohol, and vaping devices declined at historic rates during the pandemic of 2020. Lack of accompanying reductions in prevalence for marijuana and binge drinking demonstrates the substantial challenges facing a supply-side approach to the reduction of adolescent use of these substances. [ABSTRACT FROM AUTHOR]

Objective: The myriad of e-cigarette devices and flavors used by young adults (YAs) complicates identification of the particular e-cigarette products that are associated with more frequent tobacco use and merit consideration for regulation. The current study used latent class analysis to identify distinct patterns of e-cigarette device and flavor use and evaluate their association with vaping and smoking frequency.Methods: Cross-sectional survey data (2018-2019) from a Southern California cohort were analyzed. YAs reporting past 30-day nicotine vaping (N = 550; M age = 19.2 years) self-reported e-cigarette device type/brand and flavor. Six device (e-cig/vape pen, mech mod, box mod, JUUL, non-JUUL pod, disposable) and three flavor (tobacco, mint/menthol, sweet/fruit) indicators were included in a latent class analysis. Past 30-day nicotine vaping and cigarette smoking frequency were assessed as correlates of device and flavor class membership.Results: Three classes were identified: Any Pod-Mint/Menthol or Sweet/Fruit Flavor Users (prevalance:47%); Non-JUUL-Sweet/Fruit Flavor Users (28%); and Poly-Device-Poly-Flavor Users (25%). Greater frequency of vaping and smoking were associated with higher odds of belonging to the Poly-Device-Poly-Flavor Users class vs. the Any Pod-Mint/Menthol or Sweet/Fruit Flavor Users (vaping: aOR[95%CI] = 1.36[1.16, 1.59], p < .001; smoking: aOR[95%CI] = 1.25[1.02, 1.54], p = .03) and Non-JUUL-Sweet/Fruit Flavor Users (vaping: aOR[95%CI] = 1.30[1.10, 1.53], p < .01; smoking: aOR[95%CI] = 1.42[1.07, 1.88], p = .02) classes.Conclusions: Although YAs that predominately used pod devices alongside non-tobacco flavors were most common, YAs characterized by a proclivity toward using many different devices and flavors were appreciably prevalent and smoked and vaped more frequently. Regulations targeting a wide spectrum of vaping products may be optimal in protecting YA health. [ABSTRACT FROM AUTHOR]

Introduction: Although a significant proportion of young adults report e-cigarette use (nicotine vaping), little is known about co-use with other substances, including correlates that predict co-use. The current study aimed to identify co-occurring substance use patterns and evaluate multiple correlates in a college student sample.Methods: 435 participants (21.4 ± 2.9 years; 57% women; 41% Hispanic/Latina/o, 29% Asian-American/Pacific Islander, 17% Caucasian/White, 6% Multiracial, and 5% African-American/Black) from a large, urban university were recruited in-person and completed an online survey in the fall of 2018 and the spring of 2019.Results: Using latent class analysis (LCA), four substance use patterns were identified: Binge Drinkers (7%); e-cigarette Users (8%); Cannabis Users (14%); and Low Substance Users (71%). The e-cigarette Users class was characterized by moderate or greater use (>5 days of nicotine vaping in past 30-days) as well as past 30-day binge drinking and cannabis use. Higher levels of deviant peer affiliation (aOR = 1.28[1.11-1.47], p < .01), impulsivity-lack of premeditation (aOR = 1.36[1.05-1.78], p < .05), and lower levels of social anxiety (aOR = 0.94[0.88-0.99], p < .05), predicted membership in the e-cigarette Users class.Conclusions: The most pervasive co-occurring substance use was observed among the e-cigarette Users class. Young adults reporting moderate or greater levels of nicotine vaping tended to engage in binge drinking and cannabis use, which may ultimately increase risk of deleterious health outcomes. Deviant peer affiliation and impulsivity-lack of premeditation (but not internalizing symptoms) predicted membership in the e-cigarette Users class; consequently, public health efforts may benefit from increased selectivity in targeting young adults for e-cigarette prevention and intervention services. [ABSTRACT FROM AUTHOR]