Adolescent Cigarette Research Articles

Individual and joint association of adulthood experiences and parental or teacher smoking with adolescent cigarette smoking.

INTRODUCTIONOne limitation of the minimum legal age (MLA) law, the primary strategy for curbing youth smoking, is the rite-of-passage effect. Adulthood experiences and the behavior of surrounding adults help build ‘adult identity’ among adolescents. We examined the individual association of adulthood experience and joint association with significant adults who smoke with adolescent cigarette smoking.METHODSA nationally representative cross-sectional sample of 138542 South Korean adolescents aged 12–18 years (mean: 15 years) from the 2014 and 2015 Korea Youth Risk Behavior Survey was used. Adulthood markers used were tall stature, precocious sexual development, independent living, and job experience. Parents and teachers were considered significant adults. Logistic regression analyses and relative risk due to interaction (RERI) calculations were conducted.RESULTSTall stature (OR=1.19; 95% CI: 1.08–1.31), precocious sexual development (OR=1.51; 95% CI: 1.36–1.69), independent living (OR=1.24; 95% CI: 1.08– 1.43), and job experience (OR=4.38; 95% CI: 4.14–4.64) were associated with cigarette smoking among study participants. Statistically significant additive interactions were found for parental smoking and job experience (RERI=0.41; 95% CI: 0.06–0.76), teacher smoking and precocious development (RERI=0.71; 95% CI: 0.28–1.15), teacher smoking and independent living (RERI=0.68; 95% CI: 0.11–1.24), teacher smoking, and job experience (RERI=2.12; 95% CI: 1.66– 2.58).CONCLUSIONSThe association between adulthood experience and adolescent cigarette smoking suggests the rite-of-passage effect, which may be strengthened by the MLA law. Raising the MLA to an age much higher than the normative age of adulthood initiation is required. Additionally, targeted intervention for adolescents with both adulthood experience and exposure close to adult smoking are required to curb youth smoking.

Interparental Relationship Adjustment, Parenting, and Offspring's Cigarette Smoking at the 10-Year Follow-up.

Familial influences on children’s cigarette smoking have been established, yet little is known about whether these influences in childhood relate to offspring’s smoking behavior in adolescence. Drawing on prior work showing that children’s emotional and behavioral problems (i.e., internalizing and externalizing behavior problems) are influenced by both interparental and parent–child relationships, we examined whether children’s emotional and behavioral problems would further predict their smoking behavior in adolescence. Two hundred and twenty‐one families were followed from early childhood (M age = 4.05 years) to the 10‐year follow‐up. Interparental relationship adjustment and disagreement, dysfunctional parenting, and children’s emotional and behavioral problems were reported by both mothers and fathers. Adolescents’ self‐reported cigarette smoking status was assessed along with other demographic variables. Using structural equation modeling, the hypothesis was only supported based on mothers’ reports, suggesting that early couple relationship adjustment and parenting relate to children’s emotional and behavioral problems, which associate with smoking behavior in adolescence. When the hypothesized model was tested with emotional and behavioral problems separately, only behavioral problems were related to adolescent smoking for both parents. Findings from this study support models of family environment and children’s behavioral problems, providing evidence of the long‐term links with adolescent cigarette smoking behaviors. Further family‐focused research and preventive work, for instance, testing the combination of partner support and parent training, are needed.

Association between school-based tobacco retailer exposures and young adolescent cigarette, cigar and e-cigarette use

BackgroundAssociations between retail tobacco availability and tobacco use have been mixed. This study examined associations between school-based retail environment exposures and current use of cigarettes, cigar products and e-cigarettes among...

Natural Course of Nicotine Dependence Among Adolescent Waterpipe and Cigarette Smokers

PurposeWaterpipe (WP) smoking patterns and setting can result in a unique trajectory of nicotine dependence (ND) compared with cigarette smoking. This longitudinal study compared the development of ND symptoms among adolescent WP and cigarette smokers. MethodsA cohort of 647 eighth and ninth graders in Lebanon were followed over 5 years. This study was based on 283 current exclusive WP and 146 current exclusive cigarette smokers. Kaplan–Meier survival analyses were conducted to evaluate 50% cumulative probability for the development of initial Hooked on Nicotine Checklist symptoms and the International Classification of Diseases, 10th revision (ICD-10) ND. ResultsAn initial Hooked on Nicotine Checklist symptom was endorsed by 59% of WP and 50% of cigarette smokers after smoking onset. Among those, 50% of both WP and cigarette smokers did so within 9.7 and 18.5 months, respectively. Approximately 28% of WP smokers and 22% of cigarette smokers developed ICD-10 ND. Among those, 50% of both WP and cigarette smokers did so within 15 and 22 months, respectively. The most common first to fourth ICD-10 criteria reported by WP smokers were “a strong desire to use tobacco,” “difficulties in controlling tobacco taking behavior,” “neglect of alternative pleasure,” and “use despite harm.” The most common first to fourth ICD-10 criteria reported by cigarette smokers were “a strong desire to use tobacco,” “difficulties in controlling tobacco taking behavior,” “withdrawal,” and “tolerance”. ConclusionsCompared with adolescent cigarette smokers, initial ND symptoms and ICD-10 ND can develop sooner after starting to smoke and progress more rapidly among adolescent WP smokers. Developing, implementing, and evaluating intervention programs with adolescent WP smokers should be guided by the WP-specific trajectory of ND.

Evidence that an intervention weakens the relationship between adolescent electronic cigarette use and tobacco smoking: a 24-month prospective study

BackgroundThe electronic cigarette (e-cigarette) use to subsequent smoking relationship in adolescents has received much attention. Whether an intervention to reduce smoking initiation attenuated this relationship was assessed.MethodData were from 3994...

M90. CANNABIS USE, CIGARETTE SMOKING, AND PSYCHOTIC EXPERIENCES IN ADOLESCENCE AND DIAGNOSIS OF PSYCHOSIS IN EARLY ADULTHOOD. A BIRTH-COHORT STUDY

BackgroundRecent studies indicate that adolescent cannabis use (1) and cigarette smoking (2) increase the risk for psychosis. However, less is known about symptom profile associated with cannabis use and cigarette smoking prior to the psychotic episodes. Our aim was to study the associations between daily smoking, life-time cannabis use, and psychotic experiences in adolescence, and their relationship with psychotic disorders in early adulthood.MethodsThe Northern Finland Birth Cohort 1986 study includes 99% of all births (n=9432) in the region. At age 15–16, data on self-reported daily cigarette smoking and cannabis use was gathered using questionnaires. Psychotic experiences during past 6 months were evaluated using PROD-screen (3). Psychiatric diagnoses were collected from four Finnish nationwide health-care registers until year 2016, when participants were 30–31 years old. Individuals with information on daily smoking, cannabis use and psychotic experiences (n=6037, 47.7% male, 64.0% of the total cohort) were included. Associations were studied using multivariate logistic regression analysis.ResultsAt age 15–16, 12.5% (n=755) reported daily smoking, and 5.6% (n=340) reported lifetime cannabis use and 30.9% (n=1868) were PROD-screen positive, i.e. reporting ≥3 symptoms on the PROD-screen. At age 30–31, 1.8% (n=111) of the participants had a register-based psychosis diagnosis. Individuals with subsequent psychosis reported more daily smoking (24.3%), cannabis use (15.3%) and psychotic experiences (51.4%) in adolescence than did individuals without any psychiatric diagnosis (11.1%, 4.6% and 28.6%).The multivariate logistic regression analyses included sex, daily smoking, lifetime cannabis use, drug use other than cannabis and parental psychosis. Among those with psychosis during the follow-up, cannabis use at age 15–16 associated with positive PROD-screen (OR=5.0, 95%CI 1.1–22.1, p=0.033), ‘experience of thoughts running wild or difficulty in controlling the speed of thoughts’ (OR=5.0, 95%CI 1.2–20.9, p=0.026), and ‘depression, apathy, loss or energy or marked tiredness’ (OR 5.3, 95%CI 1.3–22.3, p=0.021). In the same group, daily smoking was inversely associated with ‘disorders in connection with vision, such as blurred vision, visual oversensitivity or changing visual perceptions’ (OR=0.1, 95%CI 0.02–0.8, p=0.028).Among those without later psychiatric diagnosis, cannabis use associated with positive PROD-screen and PROD-items indicating anxiety, bodily restlessness, depression, difficulty completing tasks, difficulty thinking clearly, difficulty controlling the speed of thoughts, feelings of strange things happening, feelings, thoughts or behaviors that could be considered weird and feelings of being followed or influenced. In the same group, daily smoking was associated with bodily restlessness and depression.DiscussionLifetime cannabis use in adolescence is associated with psychotic experiences in individuals with or without subsequent psychosis. In those with subsequent psychosis, cannabis use had smaller impact on symptom profile. The inverse association between visual hallucinations and daily smoking in adolescence among individuals with subsequent psychotic disorder is a novel finding and needs further exploring.

Associations of cannabis- and tobacco-related problem severity with reward and punishment sensitivity and impulsivity in adolescent daily cigarette smokers.

Cannabis and tobacco use and related disorders have been separately associated with sensitivity to reward (SR), sensitivity to punishment (SP), and impulsivity. Given the frequent co-occurrence of cannabis and tobacco consumption in adolescents, it is important to understand how SR, SP and impulsivity may relate to both cannabis-use and tobacco-use co-occurrences and problem severities. Presently, sixty-five adolescents (14-21 years, 65% male), including 36 adolescents with daily tobacco smoking and regular cannabis use and 29 non-smoking healthy controls (HCs), completed self-report questionnaires assessing substance use, addiction severity, SR, SP, and impulsivity. Adolescent smokers had decreased SP and increased impulsivity compared to HCs. SR and impulsivity were independent predictors of concurrent cannabis-related problem severity among smokers. These findings suggest that specific approach/avoidance motives and impulsivity warrant further investigation as potential treatment targets in adolescents who consume both tobacco and cannabis.

Examining The Relationship Between Smoking Cigarettes and Experiences of Sleep Disturbances

Research has shown there is a relationship between adolescent and young adult cigarette smokers and experiences of sleep disturbances. The purpose of this study was to determine the correlation between cigarette smoking and sleep disturbances, such as bad dreams, sleeping restlessly or falling asleep during the day among adolescent and young adult smokers who are participants in the Population Assessment of Tobacco and Health (PATH) study. Participants were (N = 25,049) adolescents and early adulthood participants (Mean age = 15.83, SD = 4.53) who answered the questions for the variables in this study. Approximately 55% of the participants reported significant problems with sleep trouble, such as bad dreams, sleeping restlessly or falling asleep during the day in the past month (29.7%), two to twelve months (13.8%), and over a year ago (11.3%) (measured using the Audio Computer-Assisted Self-Interviews [ACASI]). Approximately 54% of the same participants reported smoking daily (39.6%) or some days (14.1%) (measured using ACASI). The specific methods used in this study was a correlational test of the variables predicted to be positively related. It was hypothesized that there is a positive link between one's cigarette smoking and having significant difficulty with sleeping, such as bad dreams, sleeping restlessly or falling asleep during the day. Consistent with the hypothesis, current cigarette smoking was statistically significantly related to having significant difficulty with sleeping, such as bad dreams, sleeping restlessly or falling asleep during the day, resulting with r = .073 (p < .01) at the 0.01 level (1-tailed). The R2 and adjusted R2 = .005, and the ANOVA table revealed there is a statistically significant linear relationship between current smoking of cigarettes and having sleep disturbances such as bad dreams, sleeping restlessly or falling asleep during the day. These results suggest that as one’s cigarette smoking increases their experience with sleep disturbance, such as bad dreams, sleeping restlessly or falling asleep during the day increases. These results support the rejection of the null hypothesis of there being no statistically significant relationship between current cigarette smoking and having sleep disturbances. There is a weak positive correlation between current cigarette smoking and having sleep disturbances. It is concluded that cigarette smoking among young adults is associated with experiences of sleep disturbances. Future research is needed to determine the complex relationship between smoking and sleep disturbances; there are several other factors that should be considered, such as genetic factors, race/ethnicity, lifestyle choices and SES.
 
 
 
 
 
 
 
 
 
 
 
 

Youth Perceptions of Parental Involvement and Monitoring, Discrepancies With Parental Perceptions, and Their Associations With First Cigarette Use in Black and White Girls

Low parental involvement and monitoring are risk factors for adolescent cigarette use. Assessments of parental involvement and monitoring by youth and parents may capture an additional source of risk: differences in perceptions of these parenting behaviors. This study tested for unique contributions of youth-reported parental involvement and monitoring and youth-parent discrepancies in reporting to first cigarette use in girls. Data were drawn from interviews at ages 8-17 with 1,869 girls (57.3% Black, 42.7% White) and their primary caregivers (94% mothers) in the Pittsburgh Girls Study. Cox proportional hazards regression analyses were conducted to predict first cigarette use as a function of girls' reports of parental involvement and monitoring, magnitude and direction of youth-parent reporting discrepancies, and the interaction between them, adjusting for neighborhood, socioeconomic, and individual level factors. High magnitude of discrepancy in parental involvement reports (hazard ratio [HR] = 1.14, 95% confidence interval [CI] [1.03, 1.26]) and lower perceived parental involvement by girls (HR = 1.14, CI [1.03, 1.27]) were associated with an elevated risk for first cigarette use. Girls' reports of low parental monitoring also predicted first cigarette use (HR = 1.14, CI [1.06, 1.21]). Girls whose parents have limited awareness of their whereabouts and friends (i.e., low monitoring) are at an elevated risk for trying cigarettes, but parent-daughter differences in perceived awareness do not affect risk. By contrast, girls who perceive a lower degree of parental involvement than their parents do are at increased risk. Monitoring is one component of parenting that may reduce smoking risk; shared perspectives on the parent's level of involvement are similarly important.

Trends in Smoking Behaviors Among US Adolescent Cigarette Smokers.

Identifying trends in smoking behaviors among youth cigarette smokers could inform youth policy and interventions. Using 2011-2018 National Youth Tobacco Survey data, logistic/linear regressions were used to analyze trends in smoking frequency, intensity, age of first cigarette use, and electronic cigarette (e-cigarette) use frequency among current smokers. Stratified analyses were conducted among male, female, middle school, and high school students and race and ethnicity subgroups separately. From 2011 to 2018, there was a decrease in smoking ≥10 days (50.0% to 38.3%), ≥20 days (37.2% to 26.3%), and 30 days (26.6% to 18.2%) among current smokers. Smoking prevalence decreased among male, female, high school, non-Hispanic white, and non-Hispanic other students. Overall, light smoking (≤5 cigarettes per day [CPDs]) increased (76.6% to 82.7%), and moderate smoking (6-10 CPDs) decreased (10.7% to 8.3%). Trends in light, moderate, and heavy smoking varied by demographic groups. Age at first cigarette use increased among female (12.28 to 13.29), high school (12.91 to 13.18), and non-Hispanic other students (11.64 to 12.83) and decreased among male students (12.90 to 12.57). From 2014 to 2018, there was an increase in e-cigarette use frequency for ≥10 days (20.8% to 40.9%), ≥20 days (13.5% to 31.7%), and all 30 days (9.3% to 22%). From 2011 to 2018, current youth cigarette smokers smoked fewer days and fewer CPDs, and age of first cigarette use increased. However, over time, male youth smoked more heavily and started smoking earlier. E-cigarette use increased from 2014 to 2018. Differences by demographic characteristics can inform future research and interventions.

Comparison of the Relative Abuse Liability of Electronic Cigarette Aerosol Extracts and Nicotine Alone in Adolescent Rats: A Behavioral Economic Analysis.

Background: Characterizing the determinants of the abuse liability of electronic cigarettes (ECs) in adolescents is needed to inform product regulation by the United States Food and Drug Administration (FDA). We recently reported that Vuse Menthol EC aerosol extract containing nicotine and a range of non-nicotine constituents (e.g., menthol, propylene glycol) had reduced aversive effects compared to nicotine alone in adolescent rats, whereas Aroma E-Juice EC aerosol extract did not. The current study used a behavioral economic approach to compare the relative abuse liability of these EC extracts and nicotine alone in an i.v. self-administration (SA) model in adolescents. Methods: Adolescents were tested for the SA of EC extracts prepared using an ethanol (ETOH) solvent or nicotine and saline, with and without 4% ETOH (i.e., the same concentration in the EC extracts) in 23 h/day sessions. Results. Although acquisition of SA was faster for nicotine + ETOH compared to all other formulations, the elasticity of demand for all nicotine-containing formulations was similar. Conclusions: EC aerosol extracts did not have greater abuse liability than nicotine alone in adolescents. These data suggest that nicotine may be the primary determinant of the abuse liability of these ECs in youth, at least in terms of the primary reinforcing effects of ECs mediated within the central nervous system.

The Type and Timing of Child Maltreatment as Predictors of Adolescent Cigarette Smoking Trajectories

Background: There is limited research examining the association between child maltreatment and cigarette smoking as a specific type of adolescent substance use, and research examining high-risk samples and variations based on maltreatment type and timing remain sparse. Objectives: The primary aim of the study was to examine the relationship between child maltreatment and cigarette smoking trajectories. Methods: Latent class growth analysis and multinomial logistic regression were performed on 903 youth drawn from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). Results: Three distinct classes of cigarette smoking trajectories were identified: (1) Stable no/low cigarette use (61%); (2) Gradually increasing cigarette use (30%); and (3) Sharply increasing cigarette use (9%). Physical abuse during early childhood and adolescence predicted membership in the sharply increasing cigarette use class. Neglect during early childhood predicted membership in the gradually increasing cigarette use class. Conclusions: Findings suggest that interventions for adolescent cigarette smoking should integrate trauma-informed approaches. Further, the results highlight early childhood and adolescence as particularly vulnerable periods with respect to the influence of physical abuse and neglect on cigarette smoking, pointing to the need for additional maltreatment prevention efforts during these developmental stages.

Cigarette Smoking and Nicotine Dependence Trajectories Among Incident Adolescent Smokers.

Few interventions target adolescent cigarette smokers to prevent escalation in cigarette use or promote cessation, in part because little is known about co-developing smoking and nicotine dependence (ND). Our objectives were to: (1) estimate developmental trajectories of ND/cravings, withdrawal symptoms, the modified Fagerström Tolerance Questionnaire (mFTQ) and ICD-10 tobacco dependence in incident adolescent smokers; (2) describe concordance in number and shapes of trajectories across the four ND indicators; and (3) classify participants in each ND trajectory according to cigarette smoking trajectories. Data were drawn from an ongoing longitudinal investigation of 1294 grade 7 students recruited in 1999-2000 in 10 Montreal-area high schools. Group-based joint trajectory models were used to identify distinct subgroups defined by the four ND indicators, in 307 incident smokers. The optimal trajectory model included five groups for ND/craving and four groups for each of withdrawal symptoms, the mFTQ and ICD-10 tobacco dependence. The four ND indicators showed similar developmental patterns and classification into smoking trajectory groups, although some discordance was observed. Smokers in the low-level decreaser group and stable low consumers who exhibited high ND were younger than those in the cigarette-low ND trajectory groups. Moderate or rapid escalators who exhibited no/low ND were less likely to have university-educated mothers and more likely to have parents who smoke. Trajectories were similar across ND indicators, and generally reflected cigarette smoking trajectory shapes. Novice smokers may need education to become self-aware of developing ND symptoms, as well as to learn about alternative courses of action once ND symptoms manifest. Trajectories of cigarette smoking and ND symptoms have rarely been investigated concurrently. This study provides evidence of high concordance across four distinct ND indicators in the proportion of participants with no/low-level dependence, and with high or increasing ND. Moreover, the development of cigarette smoking is concordant with ND symptom development. Interventions to prevent escalation and promote cessation should target adolescents before first puff to increase self-awareness of developing ND symptoms, as well as to learn about alternative courses of action once ND symptoms are experienced.

Psychological well-being and dual-use of cigarettes and e-cigarettes among high school students in Canada

BackgroundCigarette and e-cigarette use are prevalent among Canadian adolescents. Evidence shows psychiatric comorbidity with adolescent cigarette smoking, but little is known about psychological well-being among dual users of e-cigarettes and cigarettes. This study examined the association between dual-use status and psychological well-being among high school students. MethodsWe used the 2016–2017 Canadian Student Tobacco, Alcohol, and Drugs Survey. Scales of psychological well-being (relatedness, autonomy, competency, prosocial behavior, and social responsiveness) were derived from self-reported data. Dual-use status was categorized into non-users, cigarette-only smokers, e-cigarette-only users, and four types of dual-users. Multivariable linear regression models examined the association between dual-use and psychological well-being. ResultsAmong the participants, 6.3% were current dual-users, 4.1% were cigarette-only smokers, 12.6% were e-cigarette-only users, and 77.0% were non-users. Compared to non-users, relatedness and social responsiveness were lower for all users. When compared to e-cigarette users, most other users had lower relatedness (high-frequency dual-users [β=-6.05], high-frequency cigarette dual-users [β=-2.27], high-frequency e-cigarette dual-users: [β=-1.32], low-frequency dual-users [β=-1.91], and cigarette-only smokers [β=-1.66]) and social responsiveness. High-frequency dual-users had lower scores for relatedness and social responsiveness, while high-frequency cigarette dual-users had higher autonomy, compared to low-frequency dual-users. ConclusionDual-users had poorer psychological well-being, which differed among dual-user sub-groups. This study highlights an opportunity for specialized programs to promote psychological well-being and reduce tobacco product use among adolescents. LimitationsThe study is based on respondent self-report, and the use of cross-sectional data precludes us from determining the temporal order between dual-use and psychological well-being.

The great decline in adolescent cigarette smoking since 2000: consequences for drug use among US adolescents

ObjectiveAdolescent cigarette smoking declined steadily and substantially from 2000 to 2018. This paper considers the potential consequences of this ‘great decline’ for the prevalence of other drug use among adolescents.MethodsData...

Relationship between Extraversion and Tobacco Smoking Among High School Students.

Background:There is limited information about the relationship between extraversion, as a personality trait, and the modes of tobacco smoking. The aim of this study was to investigate the relationships between extraversion and cigarette and water-pipe smoking among a representative sample of Iranian high school students.Methods:A sample of 2,312 tenth-grade students in Tabriz (Northwest of Iran) was selected through multistage proportional cluster sampling. Participants completed a self-administered questionnaire including information on cigarette smoking, water-pipe smoking, extraversion, socioeconomical information, as well as demographic characteristics. An ordinal logistic regression model was used for data analysis.Results:In total, 4.2% and 3.5% of the students were regular cigarette and water-pipe smokers, respectively. The adjusted odds ratios were 1.10 (95% CI: 1.04–1.15, P < 0.001) and 1.10 (95% CI: 1.06–1.15, P < 0.001) for the relationships between extraversion and the stages of cigarette smoking and water-pipe smoking status, respectively.Conclusions:It seems that extraversion is in a positive relationship with a cigarette and water-pipe smoking among adolescents. Longitudinal studies are needed to examine the effect of this personality trait on the modes of tobacco smoking and the transition in the stages of cigarette and water-pipe smoking in adolescents.

Effect of Cigarette and Shisha smoking on cognitive functions impairment: A cross sectional study.

Objectives:Cigarette and Shisha smoking is becoming a common practice in young generation worldwide. Since, this is a growing threat to public health, our study aims to investigate the cognitive function responses of cigarette and Shisha inhalation in adolescents.Methods:This retrospective cross sectional study comprised three groups, cigarette smoker, Shisha smoker, and nonsmoker control group (each n=25). All the participants were apparently healthy male volunteers aged 21-24 years. Cognitive functions were assessed by employing “Cambridge Neuropsychological Test Automated Battery”. The cognitive functions outcome variables were response time tasks (attention switching task (AST) and the percentage of correct answers pattern recognition memory (PRM) task.Results:Cigarette and Shisha smokers exhibited a considerable decline in cognitive performance parameters, AST mean correct latency (p=0.001), AST mean correct latency (congruent) (p=0.001), AST mean correct latency (incongruent) (p=0.001) and AST mean correct latency (switching) (p=0.001) compared to matched control group.Conclusions:Cigarette and Shisha smokers exhibited significant impairment in their cognitive functions. The present study findings convince that cigarette and Shisha smokers should quit smoking.

E-Cigarette, Cigarette, and Dual Use in Korean Adolescents: A Test of Problem Behavior Theory

ABSTRACTE-cigarettes are becoming increasingly popular among adolescent cigarette users. However, little is known about the various factors related to adolescents’ use of e-cigarettes, cigarettes, or both in South Korea. Using nationally representative data from the 2017 Korea Youth Risk Behavior Web-based Survey, this study examined the possible problem behavior theory factors that contribute to (1) current e-cigarette use among those who have ever used cigarettes (Model 1), (2) current cigarette use among those who have ever used e-cigarettes (Model 2), and (3) current dual use among current cigarette or e-cigarette users (Model 3). In all three models, our analysis showed that tobacco accessibility and sexual intercourse were significant factors. For Model 2, reasons for using e-cigarettes and alcohol use were correlated with current cigarette use. Except for gender, the significant factors, which included secondhand smoke exposure at home and school type, were the same in Models 1 and 3. Based on these findings, we encourage the South Korean government to pay close attention to potential increase in dual use among adolescents and to take the necessary steps in addressing adolescent e-cigarette use in tobacco prevention and control programs.

Anticipated Effects of Nicotine Reduction on Youth Smoking Initiation and Maintenance.

This commentary summarizes emerging findings on the potential impact of a nicotine reduction policy on youth and young adults. We conclude that: (1) adolescent smokers and nonsmokers alike are likely to be less sensitive to reinforcement from very low nicotine content (VLNC) cigarettes compared with adults; (2) reducing nicotine in cigarettes to 0.4 mg/g would reduce the abuse potential of cigarettes in adolescents and young adults; (3) findings to date do not support concerns that nicotine reduction leads to compensatory smoking in young smokers; and (4) if the scope of a reduced nicotine product standard were applied to all combusted tobacco products, that would likely maximize public health benefit of this policy.

Prevalence of tobacco smoking and electronic cigarette use among adolescents in Italy: Global Youth Tobacco Surveys (GYTS), 2010, 2014, 2018

This research aims to study tobacco smoking and vaping among adolescents in Italy through three repeat national cross sectional surveys conducted before (in 2010, 2014) and after (2018) the 2016 introduction of the European Union - Tobacco Product Directive (EU-TPD) and its transposition into Italy, and before Juul entered the Italian market in 2019.Prevalence of smoking and vaping, access to cigarettes and electronic cigarettes in adolescents aged 13–15 years were estimated from the 2010, 2014, and 2018 Global Youth Tobacco Surveys (N = 1587; N = 1428; N = 1518, respectively) conducted in Italy.Prevalence of current smokers and/or current vapers combined, accounting for dual users, non-significantly increased from 20.7% in 2010 to 27.9% in 2018. Although current smokers stalled around 20%, current vapers substantially increased from 0% in 2010, 7.4% in 2014, to 17.5% in 2018, and current exclusive vapers recorded an almost 3-fold significantly increase from 2.9% in 2014 to 8.2% in 2018. Moreover, 42% of ever vapers used nicotine-free electronic cigarettes, and only 5% of current users were frequent vapers (≥20 days in the past month). About 65% of current smokers and 76% of current vapers easily accessed to cigarettes or electronic cigarettes in 2018.After 2 years from its implementation in 2016, the EU-TPD does not seem to have slowed down the increase in vaping among Italian adolescents before Juul entered the Italian market. Additional research is needed in order to show a clear association between EU-TPD and changes in vaping and smoking in Italy and in the EU.