Exposure to ENDS advertising and use of marijuana in ENDS among college students

Abstract

Background-Factors associated with marijuana use in electronic nicotine delivery systems (ENDS) are largely unknown. ENDS advertising, through subtle normative cues as well as explicit and implicit messages suggesting ENDS products are socially condoned and healthier alternatives, may influence the use of marijuana in ENDS. The aim of our study was to examine the association between exposure to ENDS advertising and subsequent use of ENDS with marijuana among college students. Methods-Data for this study were from waves 2 and 4 of the Marketing and Promotions across Colleges in Texas (M-PACT) study. Participants included 3720 college students (mean age = 21.4, SD = 2.3; 35.78% white; 35.7% male) across 24 colleges in Texas who completed online tobacco behavior surveys one year apart. Multilevel logistic regression was conducted to examine the association between ENDS advertising exposure at wave 2 (spring 2015) and use of marijuana in ENDS one year later at wave 4 (spring 2016), controlling for age, sex, race/ethnicity, and wave 2 sensation-seeking, impulsivity, current tobacco use, current marijuana use, and ever use of ENDS with marijuana. Use of ENDS to consume marijuana in the past six months was the outcome variable and ENDS advertising exposure was the independent variable. Results-Nearly half of participants reported ever ENDS use at waves 2 and 4, and 10% used marijuana in ENDS in the past 6-months at wave 4. Multilevel logistic regression analyses indicated that for every unit increase in ENDS advertising exposure, the odds of subsequently using ENDS with marijuana one year later were 1.08 times (95% CI = 1.01-1.14) greater. Conclusions-ENDS advertising uniquely contributed to the subsequent use of marijuana in an ENDS, over and above the effects of other risk factors.

Cannabis Vaping Among Youth and Young Adults: a Scoping Review

“…Consistent findings are summarized here. Across studies, cannabis vaping was more common among males than females [ 21 , 24 , 28 , 29 , 47 , 170 , 173 , 178 , 179 , 182 , 185 , 198 , 200 ], and among older youth (e.g., high school compared to middle school students) in most studies [ 21 , 29 , 47 , 163 , 167 , 198 ], and among young adults compared to older adults [ 31 , 50 ]. Cannabis vaping was also more common among Hispanic youth compared with non-Hispanic White [ 28 , 163 , 167 , 190 ] or Black [ 21 , 28 , 167 , 190 , 198 ] youth.…”

“…Studies showed greater socio-economic status (SES) may be a risk factor for cannabis vaping [ 24 , 47 , 64 , 170 , 182 ]. E-cigarette use with nicotine only or flavors [ 28 , 29 , 163 , 166 , 172 – 174 , 180 , 186 , 197 •, 198 , 200 ], as well as use of cigarettes, cigars, hookah, and smokeless tobacco [ 21 , 28 , 29 , 50 , 163 , 166 , 174 , 178 , 179 , 186 , 195 , 197 •, 199 ] is associated with greater odds of cannabis vaping. Former cannabis use, susceptibility to use cannabis, and peer use of cannabis, via vaping and other forms of cannabis consumption (e.g., ingesting, smoking), have also been shown to be related to greater odds of cannabis vaping [ 21 , 169 , 170 , 173 , 175 , 179 , 180 , 184 , 200 ].…”

“…E-cigarette use with nicotine only or flavors [ 28 , 29 , 163 , 166 , 172 – 174 , 180 , 186 , 197 •, 198 , 200 ], as well as use of cigarettes, cigars, hookah, and smokeless tobacco [ 21 , 28 , 29 , 50 , 163 , 166 , 174 , 178 , 179 , 186 , 195 , 197 •, 199 ] is associated with greater odds of cannabis vaping. Former cannabis use, susceptibility to use cannabis, and peer use of cannabis, via vaping and other forms of cannabis consumption (e.g., ingesting, smoking), have also been shown to be related to greater odds of cannabis vaping [ 21 , 169 , 170 , 173 , 175 , 179 , 180 , 184 , 200 ]. Greater access to both e-cigarettes [ 33 , 167 , 197 •] and cannabis [ 167 ]; and parent, sibling, and peer cannabis vaping [ 28 , 64 , 166 , 180 , 197 •] are associated with cannabis vaping.…”

“…Other less studied correlates of cannabis vaping included alcohol use [ 170 , 174 , 197 •, 198 , 200 ], non-medical prescription use [ 174 ], and illicit drug use [ 170 , 188 ]; greater impulsivity [ 174 , 179 ] and attention-related factors (e.g., inattention, perseverance) [ 174 ]; openness to new experiences [ 182 ] and sensation seeking [ 170 , 189 ]; psychiatric symptoms (e.g., depressive symptoms, conduct problems) [ 174 , 182 ]; delinquent behavior [ 196 ]; low grade point average and skipping class [ 167 ]; internalizing and externalizing problems [ 197 •, 198 ]; more exposure to e-cigarette marketing (see “ Marketing ” section, below) [ 179 ]; school urbanicity (urban and suburban being greater risk versus rural) [ 24 , 198 ]; using cannabis in a vehicle [ 170 ]; obtaining cannabis from dispensaries or recreational retailers versus from friends and family [ 171 ]; low disapproval of nicotine vaping [ 167 ] and of smoking cannabis regularly, [ 182 ] lower perceived risk of cannabis use [ 167 ]; lower perceived addictiveness of e-cigarettes [ 163 ]; and earlier age of initiation of cannabis use, in any form [ 170 , 200 ].…”

Sociodemographic differences in patterns of nicotine and cannabis vaping among US adults

“…For example, a cohort study found that the trajectories of nicotine and cannabis vaping frequencies increased similarly over time in youth aging up into adulthood ( Lanza et al, 2020 ). These similarities in use patterns may derive from common risk factors such as EVP marketing/advertising strategies that may promote cannabis vaping in addition to nicotine ( Kreitzberg et al, 2019 ). While studies have evaluated cannabis vaping among adult populations, they often do not consider the possible intersection between nicotine and cannabis vaping ( Baldassarri et al, 2020 , Braymiller et al, 2020 , Pokhrel et al, 2020 ).…”