Vaping is popular among adolescents. Previous research has explored sources of information and influence on youth vaping, including marketing, ads, family, peers, social media, and the internet. This research endeavors to expand understanding of peer influence. Our hypothesis is that friends’ influence on teen vapers’ first electronic nicotine delivery systems (ENDS) use varies by demographic variables and awareness of ENDS advertising. In August–October 2017, youth (n = 3174) aged 13–18 completed an online survey to quantify ENDS behaviors and attitudes and were invited to participate in follow-up online research in November-December 2017 to probe qualitative context around perceptions and motivations (n = 76). This analysis focused on the ENDS users, defined as having ever tried any ENDS product, from the survey (n = 1549) and the follow-up research (n = 39). Among survey respondents, friends were the most common source of vapers’ first ENDS product (60%). Most survey respondents tried their first ENDS product while “hanging out with friends” (54%). Among follow-up research participants, the theme of socializing was also prominent. ENDS advertising and marketing through social media had a strong association with friend networks; in fact, the odds of friends as source of the first vaping experience were 2 times higher for those who had seen ENDS ads on social media compared with other types of media. The influence of friends is particularly evident among non-Hispanic Whites, Hispanics/Latinos, those living in urban areas, those living in high-income households, those with higher self-esteem, and those who experiment with vaping. These findings support the premise that peer influence is a primary social influencer and reinforcer for vaping. Being included in a popular activity appears to be a strong driving force.
INTRODUCTION Exposure to green spaces is beneficial to mental health in a variety of ways, ranging from stress reduction to increased attentiveness and elevated selfesteem. The impact of views of greenness, as opposed to direct exposure, has been examined, but the association between self-reported views and depressive symptoms is not known. The purpose of this study is to examine the relationship between views of greenness and Patient Health Questionnaire-9 (PHQ-9) score. METHODS Questionnaire responses from 191 participants in the Health, Environment, and Action in Louisville (HEAL) study were examined. Univariate statistical analyses included Mann-Whitney U, Kruskal-Wallis, and Spearman rank tests. Inferential statistical analysis was linear regression.RESULTS Participant satisfaction with residential greenness was significantly associated with reduced PHQ-9 score (partially adjusted: linear coefficient = -0.42; 95% CI: -0.70 --0.14; fully adjusted: linear coefficient = -0.21; 95% CI: -0.44 -0.02). Additionally, being satisfied with local greenness was significantly associated with having views of greenness from home (linear coefficient = 1.97; 95% CI: 1.23-2.68). CONCLUSIONS Though views of greenness were not directly associated with depression, satisfaction with local greenness was associated with reduced PHQ-9 score, and having views of greenness from home was crudely associated with increased greenness satisfaction. The findings suggest urban greening interventions that focus on greenness satisfaction may be a strategy to reduce depression. Further research is necessary to better understand these relationships.
INTRODUCTION Patterns of youth tobacco use, including use of multiple products, have likely shifted as e-cigarettes have grown in popularity. However, there is limited understanding of dual and poly tobacco use and the associated disparities, especially among Appalachian youth. METHODS We analyzed Youth Appalachian Tobacco Study data (n=1116) to estimate prevalence of current (past-30 day) cigarette, e-cigarette, and smokeless tobacco use by gender, race/ethnicity, age, school type, state, smartphone use, and number of household tobacco users. We created a pattern of tobacco use variable (i.e. never, former, single, dual, poly) based on all possible combinations of the included products. Using multivariable multinomial logistic regression (outcome reference: never use), we evaluated associations between sociodemographic characteristics and patterns of tobacco use. RESULTS Former (16.2%) was the most common tobacco use group, followed by single (10.8%), dual (4.5%), and poly (2.4%) use. Dual and poly use were more prevalent among males, Whites/Caucasians, older participants, and participants living in households with tobacco users. Kentucky residents (vs New York) had higher odds of dual use (OR=5.15; 95% CI: 1.72-15.44), and youth who used smartphones for ≥20 hours/week (vs <20 hours/week) had greater odds of poly use (OR=3.02; 95% CI: 1.34-6.80). CONCLUSIONS Differences in single, dual, and poly tobacco use were evidenced by sociodemographic characteristics. Additional inquiry should further examine these disparities so that tobacco prevention interventions can be appropriately tailored.
INTRODUCTION Historically, lesbian, gay and bisexual (LGB) individuals have higher rates of cigarette smoking, often attributed to targeted tobacco advertising, exposure to stressors, and psychological distress. Elevated use of electronic nicotine delivery systems (ENDS) among LGB individuals has been documented recently. However, the LGB groups are not homogeneous and differences may exist between the use of tobacco by men and women within the LGB groups. The purpose of this research was to examine cigarette smoking, ENDS use and dual use (cigarettes plus ENDS) among LGB subgroups. METHODS We classified 2087 participants completing a national online survey based on tobacco-use status (i.e. cigarette only, ENDS only, dual use) and sexual orientation. Multinomial logistic regression was employed to assess group differences. RESULTS After adjusting for demographics and socioeconomic status, bisexual women were 1.85 times (95% CI: 1.19-2.87) more likely to report current dual use, in contrast to cigarette only use, compared to heterosexual women. No significant differences were found between lesbian and heterosexual women, or between gay or bisexual men and their heterosexual counterparts. CONCLUSIONS This study describes significantly greater dual use by bisexual women and is one of the first reports of elevated dual use in this group compared to heterosexual women. These findings suggest that targeted health messages may be needed to raise awareness of risk in specific LGB groups and that future research with these populations is necessary to better understand differences in tobacco perceptions and use. AFFILIATION
INTRODUCTION Youth are at risk for tobacco use, and previous research has pointed to increased vulnerabilities associated with sexual minority identity. For example, LGB youth have increased odds for using tobacco than their heterosexual peers, and bisexual youth have higher odds of smoking than other sexual identity groups. As new tobacco products proliferate and health risks from dual/poly use grow, increased understanding of tobacco use patterns by sexual minority youth is needed. METHODS For 3117 youth, aged 13–18 years, who completed an online questionnaire in 2017 and identified their sexual orientation [minority (e.g. lesbian/gay, bisexual, or pansexual) vs majority (heterosexual)] and gender, we classified current tobacco use into four categories: e-cigarette only, other product only (such as cigarette, cigar, or smokeless tobacco; not an e-cigarette), dual/poly use, and no use. Analyses were conducted separately for male and female participants. Multinomial logistic regression was employed. RESULTS Female sexual minority youth had nearly twofold odds of dual/ poly tobacco use (OR=1.95; 95% CI: 1.12–3.40), compared to their heterosexual counterparts. For male youth, sexual minority identification was not significantly associated with dual/poly use. No significant differences were found in sexual minority and heterosexual youth e-cigarette only or other tobacco only use groups. Tobacco use patterns also significantly differed by age, race, place of residence, and parental education level. CONCLUSIONS Study findings reveal greater odds of dual/poly tobacco use for female sexual minority youth. Tailored tobacco prevention and cessation programs or interventions are needed for sexual minority youth most at risk of tobacco use, especially multiple product use.
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