Dual Use of E-Cigarettes and Cannabis Among Young People in America: A New Public Health Hurdle?

Roberts, Megan E.; Tackett, Alayna P.; Singer, Jill M.; Wagner, Dylan D.; Lü, Bo; Wagener, Theodore L.; Brinkman, Marielle C.; Klein, Elizabeth G.; Vickerman, Katrina A.; Wold, Loren E.; Gumina, Richard J.; Mohler, Peter J.

doi:10.15288/jsad.2022.83.768

Cited by 9 publications

(4 citation statements)

References 14 publications

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“…39 Thus adolescent vaping may be an early indicator of those at risk for cannabis adoption. This has been described as a "looming public health emergency" 40 and further examination of this issue is needed.…”

Section: Discussionmentioning

confidence: 99%

Adolescents Who Vape Nicotine and Their Experiences Vaping: A Qualitative Study

et al. 2023

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Introduction: Understanding adolescent perceptions of vaping and roles it plays in their lives is needed to design effective interventions to help adolescents quit. We explored vaping experiences of 11 adolescents from initiation through quit attempts. Methods: A convenience sample of students who vaped in the last 90 days was recruited from one suburban high school in Massachusetts. Qualitative interviews were transcribed and coded. An inductive thematic analysis approach was employed. Areas of agreement and range of responses in code reports were summarized. Results: Eleven open-ended semi-structured interviews were conducted (mean = 32.5 minutes each). Vaping initiation often occurred when socializing with friends who also supplied vaping devices. Vaping was “something to do” and new flavors engaged adolescents further. Solitary activities coupled with vaping included video gaming, getting ready for school, talking on the phone, or studying. Peak hours for vaping included morning, before and after school, before parents returned from work, and after parents went to bed. Several vaped to address anxiety/stress. For some, anxiety control was a main reason for vaping. Participants were concerned about health effects and nicotine dependence. Cost and health effects were drivers of quitting. Quit strategies relied on willpower and distraction. Conclusions: Peers have powerful influences on the initiation and maintenance of adolescent vaping. Vaping habits can become routinized into adolescent lives. Addiction is a concern although nicotine’s anxiolytic effects were valued by many. Social connection was enhanced by communal vaping, sharing, and common vernacular, secrecy and rule-breaking. We describe the context in which adolescents vape nicotine, their reasons for vaping, and reasons to quit. This information can inform the development of interventions to better address adolescents’ triggers to vape, and social and psychosocial barriers to quitting. Our findings suggest a desire to quit vaping but a limited awareness of quitting strategies.

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Section: Discussionmentioning

confidence: 99%

Adolescents Who Vape Nicotine and Their Experiences Vaping: A Qualitative Study

et al. 2023

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“…High rates of EC, tobacco, and cannabis co-use in younger populations have also been highlighted in other samples [ 40 , 41 ], with calls for more holistically addressing substance use among youth and YAs. Considering the overall health and wellbeing of this YA population, consideration must be given in intervention development to support individuals using ECs to cope with distress, and to avoid increasing rates of cannabis or risky alcohol use when quitting nicotine [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

A Randomized Clinical Trial of a Quitline Vaping Cessation Intervention: Baseline Characteristics of Young Adult Exclusive E-Cigarette Users Seeking Treatment

Klein,

Shoben,

Carpenter

et al. 2024

IJERPH

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Despite interest in quitting vaping among young adults (YAs), little is known about characteristics of e-cigarette (EC) users seeking treatment. In this study, YAs aged 18–24 living in the United States interested in vaping cessation treatment were recruited to complete an online survey regarding demographics and EC use. Primary eligibility criteria were EC use on at least 20 days per month (no other tobacco use), and interest in quitting in the next month. We report descriptive statistics for those who did and did not complete a mandatory coaching call (n = 981). In this sample, most EC users reported high nicotine dependence, a history of unsuccessful quit attempts (including 29.4% with previous NRT use), along with stress, anxiety, and depression. There were few meaningful differences in demographics, EC use behaviors, or behavioral health factors between those who engaged with a phone coaching call (fully enrolled in study; n = 508), and those who did not (n = 473). YAs demonstrated interest in vaping cessation support, but there were no clear characteristics for the half who did not complete a coaching call. Vaping cessation program designers should consider tailoring for the self-reported behavioral health concerns present in this population.

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“…However, these data from the NSDUH do not capture the use of newer products (eg, e-cigarettes and vaporized cannabis) among youths. Given the current context of increasing use of vaporized products for tobacco and cannabis among youths, 4 more recent data are critical to inform the surveillance of concurrent use of tobacco and cannabis in this age group. Depression, anxiety, and behavioral disorders are among the leading causes of illness and disability among youth.…”

Section: Introductionmentioning

confidence: 99%

Concurrent Use of Tobacco and Cannabis and Internalizing and Externalizing Problems in US Youths

Do,

Ling,

Chaffee

et al. 2024

JAMA Netw Open

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ImportanceLittle is known about whether concurrent use of tobacco and cannabis is associated with higher or lower levels of mental health problems than use of either substance alone among youths.ObjectiveTo examine the association between concurrent use of tobacco and cannabis and mental health problems in a national sample of US youths.Design, Setting, and ParticipantsThis cross-sectional study analyzed publicly available wave 6 data within the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative cohort study of US youths aged 14 to 17 years, collected from March to November 2021. This analysis used wave 6 single-wave weights to obtain statistically valid estimates for cross-sectional analyses generalizable to the wave 4 cohort sample. Data were analyzed from November 15, 2023, to April 20, 2024.ExposurePast 30-day use of any tobacco and cannabis products was self-reported and categorized into 4 exclusive patterns: concurrent, tobacco only, cannabis only, and nonuse.Main Outcomes and MeasuresSelf-reported past-year internalizing and externalizing mental health problems were measured using the modified version of the Global Appraisal of Individual Needs–Short Screener and separately categorized into 3 levels: low (0-1 symptoms), moderate (2-3 symptoms), and high (≥4 symptoms).ResultsA total of 5585 youths were included in the study, with a weighted proportion of 51.3% being male and 72.5% aged 15 to 17 years. In terms of race and ethnicity, 1606 youths (25.7%) were Hispanic, 626 (12.7%) were non-Hispanic Black, 2481 (50.5%) were non-Hispanic White, and 555 (11.0%) were non-Hispanic other. The prevalence of concurrent use (3.4% [95% CI, 2.9%-4.0%]) was comparable to tobacco-only use (3.9% [95% CI, 3.2%-4.6%]), but greater than cannabis-only use (2.5% [95% CI, 2.1%-2.9%]). High levels of internalizing and externalizing problems were most common for the concurrent use group (internalizing: 47.4% [95% CI, 39.2%-55.9%]; externalizing: 61.6% [95% CI, 54.1%-68.7%]), followed by the cannabis-only use group (internalizing: 44.8% [95% CI, 35.7%-54.1%]; externalizing: 48.5% [95% CI, 39.1%-57.9%]), the tobacco-only use group (internalizing: 41.4% [95% CI, 33.7%-49.5%]; externalizing: 46.3% [95% CI, 38.3%-54.5%]), and the nonuse group (internalizing: 22.4% [95% CI, 21.1%-23.8%]; externalizing: 30.4% [95% CI, 28.9%-31.9%]). After controlling for covariates in ordinal logistic regression models, concurrent use of tobacco and cannabis was associated with greater odds of reporting higher levels of externalizing problems compared with tobacco-only use (adjusted odds ratio [AOR], 1.83 [95% CI, 1.15-2.91]) and cannabis-only use (AOR, 1.85 [95% CI, 1.11-3.06]). However, there were no statistically significant differences in the odds of internalizing problems between concurrent use and use of tobacco or cannabis alone.Conclusions and RelevanceIn this cross-sectional study of the PATH Study wave 6 youth data, concurrent use of tobacco and cannabis was linked to higher levels of externalizing mental health problems than use of single substances, indicating a potential need to combine mental health support with tobacco and cannabis cessation interventions for youths.

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Dual Use of E-Cigarettes and Cannabis Among Young People in America: A New Public Health Hurdle?

Cited by 9 publications

References 14 publications

Adolescents Who Vape Nicotine and Their Experiences Vaping: A Qualitative Study

Adolescents Who Vape Nicotine and Their Experiences Vaping: A Qualitative Study

A Randomized Clinical Trial of a Quitline Vaping Cessation Intervention: Baseline Characteristics of Young Adult Exclusive E-Cigarette Users Seeking Treatment

Concurrent Use of Tobacco and Cannabis and Internalizing and Externalizing Problems in US Youths

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