Youth Smoking Research Articles

Pairing Peer Education and Social Media for Adolescent Smokers with Disabilities

Tobacco usage for adolescents with and without disabilities is associated with negative outcomes in health and finance. To combat usage, inclusive peer-education combined with social media outreach may benefit efforts to minimize, prevent, and discontinue tobacco use in adolescents with and without disabilities. This article aims at concisely reviewing current literature associated with tobacco usage, associated with the term health outcomes, and social media usage; specifically connecting the relationships with adolescents with and without disabilities.

Analysis of the Influence of Social Networks on Human Health

Health issues are of critical importance in the global context, as they directly affect the quality of human life, economic prosperity and social stability. Health is not only the concern of individuals and societies, but also the shared responsibility of the international community. Maintaining and improving global health is one of the priorities of the global community. This paper uses literature analysis to analyze obesity and overweight, smoking and smoking cessation, and mental health status respectively, and studies the impact of social network on human health. At the same time, based on the social network theory, the intervention principle and related strategies are proposed. The results show that: There are three different social processes that connect the underground network with weight and its effect on behavior. They are social contagion, a sense of belonging, and homophily. Studying the phenomenon of youth smoking can help us understand adult smoking. Social homophily, peer and parental effects are crucial when considering smoking behavior. Focusing on social support, social influence, self-esteem, and belongingness forms the understanding regarding mental health. In addition, to achieve better health conditions, interventions should be carried out through the most influential person in a certain social network.

Pairing Peer Education and Social Media for Adolescent Smokers with Disabilities

Tobacco usage among adolescents with and without disabilities is associated with negative outcomes in health and finance. To combat usage, inclusive peer education combined with social media outreach may benefit efforts to minimize, prevent, and discontinue tobacco use in adolescents with and without disabilities.

Tobacco advertising, promotion, sponsorship and youth smoking behavior: The Indonesian 2019 Global Youth Tobacco Survey (GYTS)

Tobacco advertising, promotion, sponsorship and youth smoking behavior: The Indonesian 2019 Global Youth Tobacco Survey (GYTS)

Population-level impact of ‘The Real Cost’ campaign on youth smoking risk perceptions and curiosity, United Sates 2018– 2020

Population-level impact of ‘The Real Cost’ campaign on youth smoking risk perceptions and curiosity, United Sates 2018– 2020

A Brief Digital Screening and Intervention Tool for Parental and Adolescent Tobacco and Electronic Cigarette Use in Pediatric Medical Care in Canada: Protocol for a Pilot Randomized Controlled Trial.

Though rates of tobacco smoking have decreased consistently over the past 3 decades, cigarette use remains the top preventable cause of premature death in North America. The Clinical Effort Against Secondhand Smoke Exposure (CEASE) is a medical clinic-based intervention that systematically screens parents for tobacco use and offers them direct access to evidence-based smoking cessation services. While the effectiveness of CEASE for parents who smoke has already been demonstrated in the United States, the CEASE model has not yet been tested in Canada, among parents who use e-cigarettes, or among adolescents who use cigarettes and e-cigarettes. We aim to demonstrate the feasibility and evaluate the preliminary effectiveness of the CEASE program for parental smoking cessation and its adapted version for adolescent smoking cessation and adolescent and parental vaping cessation. We will approach parents or guardians of children aged between 0 and 17 years, as well as adolescent patients aged between 14 and 17 years, from a tertiary care pediatric hospital in Montreal, Quebec, Canada, for participation in this single-blinded, pilot randomized controlled trial. Eligible participants are those who report using tobacco cigarettes or e-cigarettes at least once in the last 7 days and present to an outpatient pediatric clinic for a scheduled appointment. Our recruitment target is 100 participants: 50 parents or guardians of children aged 17 years or younger, and 50 adolescents aged between 14 and 17 years. The feasibility of implementation of the CEASE model will be measured by recruitment and retention rates for all 4 participant groups (stratified as follows: parents who use cigarettes, parents who use e-cigarettes exclusively, adolescents who use cigarettes, and adolescents who use e-cigarettes exclusively). Parent and adolescent participants within each group are randomized to the intervention and control groups using a 1:1 ratio through a computer-generated randomization list. Preliminary effectiveness outcomes include self-reported smoking and e-cigarette cessation, use of cessation resources, changes in smoking and e-cigarette use, motivation to quit, and quit attempts among participants. Participants complete electronic questionnaires on a tablet in the clinic at baseline as well as electronic follow-up questionnaires at 1, 3, and 6 months. Individuals reporting successful quit attempts are invited to provide a urine sample for cotinine testing to biochemically confirm quit. Analyses include descriptive statistics as well as exploratory trajectory analyses of smoking, e-cigarette use, and motivation to quit. Research activities began in June 2022. Participant enrollment and data collection began in February 2023 and are expected to be completed in 15 months. There is a strong need for effective and cost-effective smoking and vaping cessation interventions for parents and adolescents. If successful, this study will help inform the preparation of a fully powered randomized controlled trial of CEASE in Canada in these populations. Clinicaltrials.gov NCT05366790; https://www.clinicaltrials.gov/study/NCT05366790. DERR1-10.2196/47978.

From Impression to Addiction: The Pathways of Adolescent Tobacco Use.

To understand the psychodynamics of tobacco use among 11- to 14-year-olds in Ahmedabad, India. A self-administered questionnaire was used to gather information on tobacco use from 5,266 students, aged 11 to 14, enrolled in government-aided English medium schools in Ahmedabad. IBM® SPSS® 26.0 software along with Chi-square tests were used to analyze the data. A total of 7.2% (376) had ever used tobacco. Of the users, 96.6% (363) knew it was harmful, 76.3% (287) were boys, and 85.2% (320) were initiated by family and friends. Despite being aware of the dangers of tobacco and being unable to purchase from vendors, children continued to obtain tobacco products, being influenced by their close social networks. An effective cessation measure should be directed toward this psychodynamic etiology.

EP01.01-12 Binge-Watching Frequency and Tobacco Use in Adolescents: Data from “Blaam Smoke-Free Movie” Program

EP01.01-12 Binge-Watching Frequency and Tobacco Use in Adolescents: Data from “Blaam Smoke-Free Movie” Program

Associations of adolescent substance use and depressive symptoms with adult major depressive disorder in the United States: NSDUH 2016–2019

BackgroundFew studies have focused on the associations of adolescent substance use and depressive symptoms with adult major depressive disorder (MDD). MethodsData from 168,859 adults, among which, 15,959 had experienced MDD in the past year, as indicated by a major depressive episode (MDE) marked by MDD symptoms, were from the 2016–2019 National Surveys on Drug Use and Health. Weighted multivariable logistic regression (MLR) analyses were used to determine the associations. ResultsThe overall MDD prevalence was 7.2 %, whereas the prevalence for adults without early onset depressive symptoms prior to age 18 was 4.6 %. Variable cluster analysis revealed that adolescent use of alcohol, cigarettes, marijuana, cocaine, hallucinogen use, and inhalants prior to age 18 were in one cluster. MLR analyses showed that the presence of depressive symptoms prior to age 18 was the major risk factor for MDD, while adolescent use of alcohol, marijuana, and inhalants prior to age 18 were associated with increased odds of MDD (p < 0.05) both in the whole data and the subset of adults without depressive symptoms prior to age 18. Adolescent use of cocaine prior to age 18 were associated with MDD only in the whole data, whereas adolescent smokeless tobacco use was associated with MDD only in those without depressive symptoms prior to age 18. ConclusionsThese findings highlight the comorbid early substance use and depressive symptoms during adolescence with adult MDD. Intervention strategies should simultaneously address early-onset substance use and depressive symptoms prior to age 18.

Anxiety as a predictor of the age of initiation of tobacco and cannabis use in adolescents and young adults

BackgroundPrevious research has shown important links between anxiety and the use of tobacco and cannabis. However, it remains unclear whether anxiety leads youth to start using tobacco and cannabis at an earlier age. MethodsData were drawn from Texas Adolescent Tobacco and Marketing Surveillance System for the years 2019–2021(Waves 9–14). Participants were in 10th-grade, 12th-grade, and two years post-high school at baseline. The outcomes were the age of first use of cigarettes, e-cigarettes, and cannabis. Interval-censoring Cox proportional hazards models were fit to examine the differences in the estimated age of initiation of tobacco and cannabis use by anxiety. ResultsAmong the 10th-grade cohort, participants with anxiety had an increased risk of an earlier age of cigarette [AHR = 2.29(1.63–3.23)], e-cigarette [AHR = 1.53(1.17–2.00)], and cannabis [AHR = 1.59(1.23–2.05)] initiation. Among the 12th-grade cohort, participants with anxiety had an increased risk of an earlier age of cigarette [AHR = 1.52(1.21–1.90), e-cigarette [1.25(1.01–1.60)] and cannabis [AHR = 1.35(1.09–1.67] initiation. Among the post-high school cohort, the only significant association found was for cannabis initiation [AHR = 1.33(1.11–1.58). Between ages 18-to-19 years in the 10th-grade cohort, and between ages 20–21 years in the 12th-grade cohort, cumulative incidence of each of the three outcomes initiation doubled among anxious youth. ConclusionsThis study's findings show that anxiety symptoms can increase the risk of substance use initiation at an earlier age, especially among the youngest adolescent cohort (∼15-to-16-year-olds). These findings highlight the importance of early screening and treatment of anxiety symptoms as a preventive measure to delay or prevent the onset of substance use initiation.

Qualitative Study on Youth Smoking and Drinking Patterns in 2019

Qualitative Study on Youth Smoking and Drinking Patterns in 2019

Dramatic Reductions in Cigarette Smoking Prevalence among High School Youth from 1991 to 2022 Unlikely to Have Been Undermined by E-Cigarettes.

There is concern that youth e-cigarette use could lead youth to initiate cigarette smoking. This study identifies epochs of cigarette smoking among U.S. high school students in three commonly utilized national school-based surveys over three decades without a priori assumptions. We examined trends in ever and current cigarette smoking among high school youth from 1991 to 2022 in three datasets: Monitoring the Future (MTF), the National Youth Risk Behavior Survey (NYRBS) and the National Youth Tobacco Survey (NYTS) via Joinpoint regression. High stable rates of ever smoking were noted from 1991 to 1999 (NYRBS and MTF) and then significantly declined from 1999 to 2013; declines accelerated through to 2022. In the NYTS, ever cigarette smoking significantly declined from 1999 to 2018 and then declines accelerated to 2022. Current cigarette smoking reached its peak in 1997, and then significantly declined from 1997 to 2013 in the NYRBS and MTF and similarly in the NYTS from 1999 to 2018. Declines in current smoking then accelerated in all surveys through to 2022. These findings suggest dramatic successes in reducing youth smoking since the late 1990s, with more rapid declines in prevalence in the past decade.

Use of tobacco cigarettes, e-cigarettes, and shishas among children and adolescents: Results of the 'Präventionsradar' from 2016 to 2023

To measure trends in the use of various smoking products among children and adolescents from 2016 to 2023. The data is based on seven waves of the "Präventionsradar", a school-based epidemiological study in grades 5 to 10. The primary endpoints of the study were the lifetime and monthly prevalence of the use of tobacco cigarettes, e-cigarettes, shisha and the use of at least two of these smoking products (combined use). Prevalence estimates are based on logistic regression models. The analysis was based on 94,127 questionnaires. The sex ratio was balanced (49% female), mean age was 13 years (SD=1.8). In 2022/2023, the lifetime prevalence of smoking tobacco cigarettes was 18.8% (95% CI 18.1-19.5), of e-cigarettes 23.5% (95% CI 22.8-24.3), of shisha 14.0% (95% CI 13.4-14.7) and combined use 19.0% (95% CI 18.3-19.7). The monthly prevalence of smoking tobacco cigarettes was 5.9% (95% CI 5.5-6.4), of e-cigarettes 7.0% (95% CI 6.5-7.4), of shisha 3.2% (95% CI 2.8-3.5) and combined use 4.8% (95% CI 4.4-5.2). The following trends in lifetime prevalence have emerged since 2016: tobacco cigarettes (-3.0 percentage points), e-cigarettes (+1.8 percentage points), shisha (-9.2 percentage points), combined use (-2.7 percentage points). In the years of the COVID-19 pandemic, youth smoking decreased and rose again post-COVID with the exception of shisha. The use of smoking products in adolescence occurs frequently. Over the observational period, a trend reversal towards e-cigarettes as the most popular product among children and young people is most likely. In addition, the combined use of several smoking products has become a common pattern of consumption. Consistent preventive measures are required in order to achieve the goal of a smoke-free society in 2040.

Contextual effects of community capacity as a predictor for adolescent alcohol, tobacco, and illicit drug use: A multi-level analysis

Adolescent substance use is a major public health issue that can result in enduring physical, psychological, and social consequences. This study seeks to examine the relationship between community capacity for prevention and the 4-week prevalence rate of substance use, including tobacco, alcohol, other drugs, and binge-drinking, among students in Germany ranging from grades 5 to 11. This study employed a cross-sectional design and used baseline data from 28 communities participating in the CTC-EFF study. The sample consisted of 7210 students who were surveyed about their substance use behavior. Additionally, 158 local key informants were surveyed on ten capacity domains, which included commitment, knowledge and skills, resources, leadership, inclusiveness, prevention collaboration, sectoral-collaboration, cohesion, problem-solving skills, and needs orientation. Furthermore, a total capacity score was calculated as the mean of the ten capacity domains. To examine the associations between community capacity and substance use behavior, logistic multi-level models were utilized. The analysis shows a negative association between community capacity (total score) and any substance use (OR = 0.28, 95% CI 0.12-0.56). Specifically, higher levels of total community capacity are associated with lower odds of alcohol use (OR = 0.30, 95% CI 0.13-0.80), tobacco use (OR = 0.09, 95% CI 0.01-0.60), and binge-drinking (OR = 0.67, 95% CI (0.46-0.99). Further analyses of distinct community capacity domains indicate that higher levels of sectoral-collaboration (OR = 0.62, 95% CI 0.37-0.97), knowledge and skills (OR = 0.74, 95% CI 0.40-0.79), resources (OR = 0.52, 95% CI 0.36-0.76), and problem-solving skills (OR = 0.71, 95% CI 0.36-0.89) are associated with lower odds of any substance use. The study findings suggest that community capacity is associated with substance use behavior, emphasizing the importance of capacity building in interventions targeting the reduction of substance use among adolescents.

Adolescent Exposure to Online Advertisements and Promotions for Tobacco Products on the Internet—A Cross-Sectional Analysis of the Global Youth Tobacco Surveys

PurposeAlthough many countries have banned tobacco advertising on traditional media platforms, the tobacco industry actively promotes their products via online channels. Adolescents are at high risk of exposure due to spending substantial time online. We examined the prevalence of adolescent exposure to online tobacco advertisements and promotions. MethodsWe analyzed data from the Global Youth Tobacco Surveys (GYTS; 2013–2018; average response rate = 76.8%). We included 15 countries in four regions that measured self-reported exposure to tobacco advertising on the internet in the past month (N = 111,356, adolescents aged 11–18): Region of the Americas (Argentina, Costa Rica, Cuba, Ecuador, Panama, Paraguay, Peru), African (Mauritius, Zimbabwe), European (Czech Republic, Turkey), and the Western Pacific (Micronesia, Macao, Papua New Guinea, Samoa). We calculated the prevalence of online exposure to tobacco advertising by past-month cigarette use. ResultsPrevalence of adolescent exposure to online advertisements for tobacco products ranged from 18.2%–34.3% and 12.3%–34.4% for tobacco advertisements that “looked fun or cool”. Exposure to online tobacco product advertisements was prevalent across countries, including those with advertising bans in place, and included adolescents who have never smoked (14.4%–28.4% exposed to any, 9.1%–31.0% exposed to fun or cool advertisements). Reporting seeing tobacco advertising online that looked fun or cool was positively associated with the prevalence of past-month smoking (r = 0.64, p = .010). DiscussionA substantial proportion of adolescents in countries that have banned tobacco advertising are still exposed to advertisements for tobacco products online. Internet tobacco advertising needs better enforcement to prevent adolescent tobacco use and uptake worldwide.

Household vaping bans and youth e-cigarette use.

The aims of this study were to measure whether household bans on vaping were associated with lower odds of youth past-month vaping when compared with (1) otherwise similar youth whose households did not have a vaping ban (using coarsened exact matching); and (2) themselves in waves when their household did not have a ban (using hybrid panel models). We used the same analytical strategies to examine cross-sectional associations between household smoking bans and adolescents' past-month cigarette smoking. This was a longitudinal study using data from a nationally representative sample of youth (age 12-17 years) in the Population Assessment of Tobacco and Health Study. United States of America. A total of 16 214 adolescents followed over 48 103 total observations (approximately three waves). Measurements comprised youth past-month e-cigarette and cigarette use and parent-reported household bans on vaping and smoking. Potential confounders were prior adolescent smoking, vaping, and other nicotine product use; parent current smoking, vaping, and other nicotine use; adolescent peer e-cigarette/cigarette use; parental monitoring; and demographic characteristics. Before matching, smoking bans were associated with 46% lower odds of youth smoking [odds ratio (OR) = 0.54; 95% confidence interval (CI) = 0.41-0.70] and vaping bans with 37% lower odds of youth e-cigarette use (OR = 0.63; 95% CI = 0.50-0.80). However, households with and without bans differed significantly on all confounders before matching. After matching, household vaping bans were associated with 56% lower odds of youth vaping (OR = 0.44; 95% CI = 0.33-0.58). Results from hybrid panel models also revealed 37% lower odds of vaping in waves when youth lived in a vape-free household compared to waves when they did not (OR = 0.63; 95% CI = 0.50-0.78). Associations between smoking bans and youth smoking were not statistically significant after matching or when using hybrid panel models. Household vaping bans appear to be associated with lower odds of past-month vaping among US adolescents, compared with similar youth whose households did not have a ban and to themselves in waves when their households did not have a ban.

Addressing the Issues and Approaches to Reduce Youth Smoking in Indonesia

This article examines prominent concerns regarding adolescent smoking in Indonesia and investigates diverse strategies targeted at mitigating this public health issue. Indonesia is confronted with an escalating epidemic of tobacco consumption among young people, which is worsened by inadequate legislation and assertive marketing strategies employed by tobacco corporations. This article addresses the difficulties associated with the cultural acceptability of smoking, the restricted availability of quitting resources, and the lack of comprehensive anti-smoking programs. The paper emphasizes the significance of enhancing more stringent tobacco control legislation and implementing cross-sector collaboration activities specifically designed for the Indonesian context to address the problem of individuals who start smoking for the first time. This article emphasizes the importance of protecting the health and future of Indonesia's youth population by tackling these challenges and applying different prevention techniques.

The validity of self-rated alcohol susceptibility in predicting alcohol use in early adolescents in Latin America.

The measurement of substance use susceptibility was first conceived as part of the preparatory stage that precedes youth smoking initiation and is defined as the lack of a firm commitment not to smoke in the future. Despite being a consistent and validated predictor of smoking initiation, there has been little research on whether susceptibility can predict alcohol use. This study assessed the validity of an adapted alcohol susceptibility measure to predict alcohol consumption among early adolescent students in Argentina and Mexico who had not previously consumed alcohol. A school-based longitudinal study was conducted among first-year students in 33 secondary schools in Argentina and 57 in Mexico. The baseline sample included 1504 never-drinker adolescents in Argentina and 5264 in Mexico, of whom 1055 and 3540, respectively, completed a follow-up survey one and a half years later. Logistic regression with school as a random effect was used to estimate the adjusted odds ratios for the transitions from never-drinker to ever-drinker, current drinker, and binge drinker. At baseline, 34% and 23.6% of adolescent never-users in Argentina and Mexico, respectively, were susceptible to alcohol. After controlling for other known predictors of alcohol use initiation, alcohol susceptibility was positively associated with ever-drinking (OR = 3.23, 95% CI 2.38-4.36 in Argentina, OR = 1.73, 95% CI 1.43-2.10 in Mexico), current drinking (OR = 2.41, 95% CI 1.71-3.4 in Argentina, OR = 1.77, 95% CI 1.37-2.28 in Mexico), and binge drinking (OR = 2.27, 95% CI 1.78-2.91 in Argentina, OR = 1.89, 95% CI 1.32-1.99 in Mexico). The susceptibility measure adapted for use with alcohol appears valid for identifying individuals or groups at risk of drinking initiation and problematic drinking among early adolescents in Argentina and Mexico.

E-cigarette use and other risk factors associated with tobacco smoking susceptibility among Australian adolescents

ObjectiveTo explore risk factors for smoking susceptibility among Australian adolescents to inform prevention policies and programs. MethodsCross-sectional survey of students aged 12–17 years who reported having never smoked (n=4,171). Bivariate associations between smoking susceptibility and a range of factors previously linked to youth smoking and smoking susceptibility were initially examined, with significant factors (p<0.05) included in a final multivariable logistic regression model. ResultsEleven percent of adolescents who had never smoked were susceptible to smoking. Smoking susceptibility was independently associated with ever use of e-cigarettes (adjusted odds ratio [AOR]=3.26, 95% confidence interval [CI]: 1.83-5.81), perceiving those who smoke to be more popular (AOR=2.87, 95% CI: 1.62-5.10), having a close friend/s who smokes (AOR=2.66, 95% CI: 1.61-4.40), not perceiving smoking one or two cigarettes occasionally as personally dangerous (AOR=2.56, 95% CI: 1.61-4.09), and having symptoms of depression (AOR=1.59, 95% CI: 1.06-2.38). ConclusionsThe strongest smoking-initiation risk factor identified was ever use of e-cigarettes, with social norms, harm misperceptions around low-rate tobacco use and mental health also linked to smoking susceptibility. Implications for Public HealthStronger e-cigarette regulations that reduce promotion to and access by youth, as well as interventions addressing the other identified risk factors, may help prevent future smoking uptake among Australian adolescents.

Nationwide experiences with youth-targeted smoking and nicotine product cessation.

Most adolescent and young adult (youth) smokers and users of novel nicotine products wish to quit. Little is known, at a population level, about youth cessation activities, and the counselor's experiences in working with youth smoking and nicotine product cessation. A questionnaire was mailed to all 98 municipalities in Denmark on 31 October 2022. Youths were defined as those aged 16-25 years. The participation rate was 96% (n=94). Simple descriptive statistics were performed. This survey explored youth-targeted smoking and nicotine product cessation activities and ex-periences from municipality counselors across the whole nation. Overall, 60% of the Danish municipal counselors had low/very low/no personal experience with youth cessation interventions, 89% found it dif-ficult to work with youth counseling, 90% found it difficult to recruit youth to nicotine cessation services, and only 25% of the active municipalities were described as highly experienced. A higher percentage of the highly experienced municipalities reported that they share the responsibility of recruitment to cessation services with schools, counsel youths in separate groups from adults, and have good experiences with online counseling. This Danish nationwide survey showed that even in a country with very well-organized and free-of-charge cessation counseling programs, very few municipalities give assistance to youth, and most find it difficult to work with youth. Cessation services have been designed for adult smokers and seem to have failed to meet the needs of young smokers and users of novel nicotine products, at least in Denmark. There is an urgent need for research on how to effectively recruit youth to cessation services, and what works to help youth quit.