The Usage and Associated Factors of Alternative Tobacco Products among School-going Youth in Central Appalachia

Owusu, Daniel; Mamudu, Hadii M.; Collins, Candice; Robertson, Crystal; Wang, Liang; Rafie, Boghozian; Littleton, Mary Ann

doi:10.1353/hpu.2019.0019

Cited by 7 publications

(5 citation statements)

References 30 publications

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“…ENDS use among USA youths has surpassed all CTPs since 2014 [2,19,28]. However, studies involving youth in high-risk environments such as distressed rural areas that predispose youth to tobacco use and make them vulnerable to initiate ENDS use are sparse [10,[55][56][57][58]83]. This study explored the use of ENDS among students in an ARC-designated, distressed, rural county in Appalachian Tennessee in 2019.…”

Section: Discussionmentioning

confidence: 99%

Exploring Associations between Susceptibility to the Use of Electronic Nicotine Delivery Systems and E-Cigarette Use among School-Going Adolescents in Rural Appalachia

Mamudu

Nwabueze

Weierbach

et al. 2020

IJERPH

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Electronic nicotine delivery systems (ENDS) use, including e-cigarettes, has surpassed the use of conventional tobacco products. Emerging research suggests that susceptibility to e-cigarette use is associated with actual use among adolescents. However, few studies exist involving adolescents in high-risk, rural, socioeconomically distressed environments. This study examines susceptibility to and subsequent usage in school-going adolescents in a rural distressed county in Appalachian Tennessee using data from an online survey (N = 399). Relying on bivariate analyses and logistic regression, this study finds that while 30.6% of adolescents are ever e-cigarette users, 15.5% are current users. Approximately one in three adolescents are susceptible to e-cigarettes use, and susceptibility is associated with lower odds of being a current e-cigarette user (OR = 0.03; CI: 0.01–0.12; p < 0.00). The age of tobacco use initiation was significantly associated with decreased current use of e-cigarettes (OR = 0.89; CI: 0.83–0.0.97; p < 0.01). Overall, the results of this exploratory study suggest the need for larger studies to identify unique and generalizable factors that predispose adolescents in this high-risk rural, socioeconomically disadvantaged region to ENDS use. Nevertheless, this study offers insight into e-cigarette usage among U.S adolescents in rural, socioeconomically disadvantaged environments and provides a foundation for a closer examination of this vulnerable population.

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Section: Discussionmentioning

confidence: 99%

Exploring Associations between Susceptibility to the Use of Electronic Nicotine Delivery Systems and E-Cigarette Use among School-Going Adolescents in Rural Appalachia

Mamudu

Nwabueze

Weierbach

et al. 2020

IJERPH

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“…Despite high Appalachian youth tobacco use rates, few studies have examined patterns of use and associated factors. One study, using data collected in the Central Appalachian region in 2015–2016, reported that over 10% of middle schoolers had used alternative tobacco products, such as hookah and cigarillos 30 . Another, using data from 2016 in the same region, found that e-cigarettes were the most commonly used product among high schoolers and that many e-cigarette users also consumed one or more additional tobacco products 31 .…”

Section: Discussionmentioning

confidence: 99%

Sex differences in associations between receiving and sharing tobacco-related information and tobacco product use among Appalachian Youth

Mattingly¹,

Pfeiffer²,

Walker³

et al. 2020

Popul. Med.

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INTRODUCTION Given that Appalachian youth tobacco use rates are higher than the US national average, it is important to understand whether sex differences shape associations between receiving and sharing product information and using tobacco. METHODS Middle and high school students in rural Appalachia (n=1038) were surveyed about tobacco-related perceptions and behaviors, including ways youth receive and share conventional tobacco-related and e-cigarette-related information. Youth were characterized as tobacco users (i.e. ever or current users of cigarettes, smokeless tobacco, or e-cigarettes) or never users. Descriptive characteristics were compared by tobacco use and sex. Adjusted logistic regression models evaluated associations between communication channels and tobacco use. Models were stratified by sex to examine effect modification. RESULTS Approximately one-third of Appalachian youth (33.8%) were tobacco users and use varied by sex (males: 54.4%; females: 45.6%). Male (OR=1.75; 95% CI: 1.18-2.60) and female (OR=2.30; 95% CI: 1.53-3.47) youth who received e-cigarette-related information through friends and family (FF) had higher odds of tobacco use. Additionally, females who received e-cigarette-related information through public displays and digital media had nearly twofold increased odds of tobacco use. Although sharing conventional tobacco-related and e-cigarette-related information through FF was associated with increased odds of tobacco use among both sexes, these relationships were stronger among females. CONCLUSIONS Although specific communication channels were associated with tobacco use, associations involving receiving and sharing e-cigarette information were more pronounced in female tobacco users. Consideration of sex differences in how youth receive and share tobacco-related information may benefit tobacco prevention interventions.

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“…The rate of tobacco use among Appalachian Tennessee residents is higher than that of the State of Tennessee and the entire nation [47,48], which is why the region is part of Truth Initiative-designated "Tobacco Nation" [22]. The participants in the study were generally aware of these disparities in the usage of tobacco products across demographic subgroups and geographic areas.…”

Section: The Burden Of Tobacco Use In Appalachian Tennessee Comparedmentioning

confidence: 99%

A Qualitative Study to Explore Perception of Impacts of Preemption of Tobacco Regulation on Counties in Appalachian Tennessee

Mamudu

Osedeme

Robertson

et al. 2020

IJERPH

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Bottom-up processes, starting at the local government level, are valuable for more-stringent tobacco control measures. The existence of industry-backed state-level tobacco control preemption in states has impeded policy progress within the state and localities/communities. A national public health goal under Healthy People 2020 is to eliminate state-level preemption across the United States. This study explored individual-level perceptions of the impact of state-level preemption in Appalachian Tennessee—a high-smoking, low-income region. During 2015–2016, a community-engagement project to develop a Population Health Improvement Plan (PHIP) involving over 200 stakeholders and 90 organizations was conducted in Appalachian Tennessee to identify policies/programs to address tobacco use. Using a multifaceted framework approach that focused on prevention, protection, and cessation, interviews and meeting discussions were audio-recorded and transcribed. Content analysis using NVivo 11 was conducted to generate themes. Although the central focus of the PHIP was not preemption, the issue emerged naturally in the discussions as a major concern among participants. Cultural and normative factors in Appalachian Tennessee were identified as key rationales for participants’ aversion to state preemption. Thus, repealing preemption would facilitate culturally tailored and region-specific policies/programs to the high tobacco use among Appalachian Tennessee communities where statewide/nationwide policies/programs have not had the intended impacts.

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The Usage and Associated Factors of Alternative Tobacco Products among School-going Youth in Central Appalachia

Cited by 7 publications

References 30 publications

Exploring Associations between Susceptibility to the Use of Electronic Nicotine Delivery Systems and E-Cigarette Use among School-Going Adolescents in Rural Appalachia

Exploring Associations between Susceptibility to the Use of Electronic Nicotine Delivery Systems and E-Cigarette Use among School-Going Adolescents in Rural Appalachia

Sex differences in associations between receiving and sharing tobacco-related information and tobacco product use among Appalachian Youth

A Qualitative Study to Explore Perception of Impacts of Preemption of Tobacco Regulation on Counties in Appalachian Tennessee

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