Initiation Of Tobacco Use Research Articles

Polygenic Risk for Substance Use Disorders as Predictors of Substance Use Initiation Among African American Youth.

Despite adverse health consequences associated with early substance use initiation, less is known about the influence of genetic risk on initiation and environmental characteristics that may moderate these associations, particularly among African Americans. We examined whether genetic risk for alcohol and cannabis use disorder, and nicotine dependence, is associated with age of initiation of these substances, and whether community disadvantage and parental monitoring moderate these associations in a sample of African American youth. Participants (n=1,017; 56% female) were initially recruited for an elementary school-based universal prevention intervention trial. At age ~20, participants reported on age of initiation of alcohol, tobacco, and cannabis use and provided a saliva or blood sample. At age ~12, caregiver reports on parental monitoring were obtained, along with census-tract data to measure community disadvantage. Hypotheses were tested using Cox Proportional Hazard Models. Higher alcohol use disorder PRS was associated with later alcohol initiation (HR=0.78, 95% CI =0.65-0.94). Cannabis use disorder and nicotine dependence PRSs were not associated with initiation of these substances. We observed an interaction between the cannabis use disorder PRS and parental monitoring; among individuals with high cannabis use disorder PRS, high monitoring was associated with earlier cannabis initiation, whereas among individuals with low PRS, low monitoring was associated with earlier initiation. Findings largely indicate that PRS for substance use disorders are not associated with age of initiation among African American youth. Parental monitoring may influence the association between cannabis use disorder PRS and age of cannabis initiation, but replication of our findings is warranted.

Risk Perception and Knowledge Following a Social Game-Based Tobacco Prevention Program for Adolescents: Pilot Randomized Comparative Trial.

Adolescence is a critical developmental stage that is particularly vulnerable to the initiation of tobacco use. Despite the well-documented health risks associated with tobacco use, it remains prevalent among adolescents. Games for health are a promising strategy for tobacco prevention, using experiential and social learning theories to enhance engagement and improve behavior change. This pilot study aims to (1) compare the social game-based program Storm-Heroes to a nonsocial program regarding adolescents' personal and social experiences and (2) examine how these experiences predict higher tobacco knowledge and perceived risks of vaping and conventional tobacco use. In a cluster-randomized comparative design, 4 after-school sites (N=79 adolescents) were recruited in person and randomized in a single-blinded format to 1 of 2 interventions: the social game Storm-Heroes (44/79, 56%) or the nonsocial program A Smoking Prevention Interactive Experience (ASPIRE; 35/79, 44%). A study team member supervised both interventions. Data were collected at baseline, immediate follow-up, and a 1.5-month follow-up (45/74, 61% retained). Repeated measures mixed effects models were conducted. A total of 45 participants continued until the 1.5-month follow-up. Participants in the Strom-Heroes group were more likely to increase their perceived risk of vaping (B=0.40; P<.001), perceived risk of conventional tobacco use (B=0.35; P=.046), and tobacco knowledge (B=1.63; P<.001) than those in the control condition. The usability level of the program was related to a higher perceived risk of vaping (B=0.16; P=.003) and conventional tobacco use (B=0.16; P=.02) by follow-up. Attention to the program was also related to higher perceived risk of vaping (B=0.12; P=.002) and conventional tobacco use (B=0.14; P<.001). Distraction was not related to either perceived risk of vaping (P=.15) or perceived risk of conventional tobacco use (P=.71). In contrast, both more attention (B=0.60; P<.001) and less distraction (B=-0.37; P<.001) were related to higher tobacco knowledge. The increased perceived risk of vaping and conventional tobacco among Storm-Heroes participants aligns with the program's goals of improving participants' awareness of the risks associated with tobacco use and their tobacco knowledge. However, distraction weakened the effect of the program on tobacco knowledge, indicating that emphasis needs to be placed on minimizing distraction for better outcomes. With the results of this study, researchers can work to advance the current version of Storm-Heroes and amplify engagement in the program to improve its potential for preventing adolescents' initiation of tobacco use. ClinicalTrials.gov NCT02703597; https://clinicaltrials.gov/study/NCT02703597.

Prevalence of substance use among adolescents residing in urban slums of Vellore: A cross-sectional study

ABSTRACT Background: Adolescent substance abuse is a growing public health concern. Adolescence is the starting point for adult substance misuse. The likelihood of acquiring dependence in adulthood is significantly decreased when substance use is not initiated during adolescence. The purpose of this study was to estimate the prevalence of substance use among teenagers, as well as to determine the age of initiation and identify the factors that are linked to substance use. Methods: A community-based cross-sectional study was conducted in an urban community in Vellore by a tertiary care teaching hospital. A structured questionnaire was administered by the principal investigator to all adolescent boys aged between 10 and 19 years residing in that area for the past year who gave informed consent/assent to assess the prevalence of substance use among teenagers. Results: The total number of adolescent boys enrolled in the study was 266. The mean (standard deviation [SD]) age of the participants was 16.14 (2.2) years, with a median age of 16 years. Out of the 266 adolescent boys, 33.8% are currently using substances and 15% were past users. The common substance used was smoking tobacco (30%), followed by alcohol consumption (29%). The minimum age of initiation of smoking tobacco and ganja use was 9 and 7 years, respectively. Significant predictors of substance usage included the participant’s educational background and the substance use of their parents. Conclusion: According to this community-based study’s findings, smoking tobacco was the most frequently used substance by teenagers, with a higher prevalence of current substance use. Substance misuse in the family was substantially associated with increased drug usage among teenagers. Notwithstanding having an adequate comprehension of the negative results of substance utilisation, teenagers develop this habit, which they might carry into adulthood. It is therefore necessary to establish comprehensive prevention and control programs in schools and the community that target teenagers and their parents.

Prevalence and patterns of tobacco use among young adults in India - does perceived stress play a role?

Background: Tobacco use among young people is a public health concern. Perceived stress among young adults as a determinant for tobacco use has not been extensively explored previously in India. Methods: A cross-sectional study was conducted among young adults aged 18-30 years across India. Data was collected using a self-administered, web-based, online questionnaire, on sociodemographic characteristics, tobacco use and its pattern, and the levels of perceived stress using the Perceived Stress Scale (PSS-10). Results: The prevalence of tobacco use in our study sample was 25.7% and the mean age at initiation of tobacco use was 20.71 years. Though tobacco use was significantly associated with male gender [aOR=2.26 (1.16-4.38), p=0.01], current alcohol consumption [aOR=13.73 (6.72-28.04), p=0.00] and having known smokers among family and friends [aOR=3.13 (1.39-7.04), p=0.01], there was no association between levels of perceived stress and tobacco use. Cigarettes/beedis were the most commonly used tobacco product, 27.58% of respondents reported using tobacco products daily or for more than half the days of the week and 48.27% of respondents started using tobacco out of curiosity. Seventy percent of users used tobacco during specific events like social gatherings and vacations while 57.47% used tobacco while meeting specific colleagues/ friends. Conclusions: We found no association between perceived stress and tobacco use. However, current use of alcohol and having knowledge about smokers among family and friends significantly determined tobacco use among our study population. This necessitates more holistic approaches towards behaviour change efforts for tobacco control.

Examining associations between brain morphology in late childhood and early alcohol or tobacco use initiation in adolescence: findings from a large prospective cohort

A prominent challenge in understanding neural consequences of substance use involves disentangling predispositional risk factors from resulting consequences of substance use. Existing literature has identified pre-existing brain variations as vulnerability markers for substance use throughout adolescence. As early initiation of use is an important predictor for later substance use problems, we examined whether pre-existing brain variations are associated with early initiation of use.In the Generation R Study, a prospective population-based cohort, brain morphology (gray matter volume, cortical thickness and surface area) was assessed at ages 10 and 14 using neuroimaging. In the second wave, participants reported on alcohol and tobacco use initiation. From a base study population (N = 3019), we examined the longitudinal (N = 2218) and cross-sectional (N = 1817) association between brain morphology of frontolimbic regions of interest known to be associated with substance use risk, and very early (age < 13) alcohol/tobacco use initiation. Additionally, longitudinal and cross-sectional associations were examined with a brain surface-based approach. Models were adjusted for age at neuroimaging, sex and relevant sociodemographic factors.No associations were found between brain morphology (ages 10 and 14) and early alcohol/tobacco use initiation (<13 years). Sex-specific analyses suggested a cross-sectional association between smaller brain volume and early initiated tobacco use in girls. Our findings are important for interpreting studies examining neural consequences of substance use in the general population. Future longitudinal studies are needed to specify whether these findings can be extended to initiation and continuation of alcohol/tobacco use in later stages of adolescence.

An analysis of flavor descriptors on tobacco products in the Philippines: Regulatory implications and lessons for low- and middle-income countries

BackgroundHistorically, tobacco companies have used flavored tobacco products to enhance the appeal of tobacco consumption, encourage initiation and experimentation of tobacco use, and contribute to sustained tobacco use. While flavored tobacco products are regulated in several countries, there is no existing regulation on flavored tobacco products in the Philippines, specifically for cigarettes and cigars. This study aims to update evidence on the flavored tobacco product landscape in the Philippines by assessing both the flavor descriptors and flavor imagery featured on cigarette and cigar packaging.ResultsWe collected 106 cigarette and cigar products from four major cities in the National Capital Region, Balanced Luzon, Visayas, and Mindanao. Of these 106 cigarette and cigar products, 62 (58.49%) had flavor descriptors. Three crushable capsule products did not feature any flavor descriptor but were included for flavor imagery examination. We identified five categories of flavor descriptors: menthol, concept descriptors, tobacco, beverages, and other flavors. Out of 62 packs, ten featured more than one flavor descriptor on the packaging. Menthol flavor descriptors comprised the majority of flavor descriptors. Imagery and other graphic elements closely resonate with and enhance the flavor descriptors found on these packs.ConclusionsThis study aimed to update the evidence on the flavored tobacco product landscape in the Philippines and address their absence of regulation. Regulating flavored tobacco products requires a comprehensive policy approach complemented by complete enforcement. Flavor substances, flavor descriptors, and flavor imagery must be regulated altogether; however, it is ideal to enforce a ban on flavored tobacco products in compliance with the WHO FCTC, to which the Philippines is a signatory. Policymakers should consider plain packaging as an intervention to eliminate the appeals associated with flavored tobacco products.

Exploring the Determinants of Tobacco Usage Among Adolescents: A Cross-Sectional Study in Western Maharashtra.

Introduction The widespread use of tobacco is a major global health threat, causing significant morbidity and mortality. The World Health Organization (WHO) estimates that annually, millions of people die prematurely due to tobacco use, with this number projected to increase significantly in the future. Developing countries, including India, bear a substantial burden of tobacco-related deaths, often beginning during adolescence. This study estimated the prevalence of tobacco use among adolescents in the 13-19 years age group, identified the types of tobacco products used, explored the reasons for initiation, and examined the influence of family, peers, and socio-demographic factors on tobacco use. Methods A community-based cross-sectional study was conducted from August 2022 to June 2024 in a medical college's urban and rural field practice areas in Pune district, Maharashtra. A total of 310 adolescents were surveyed using convenience sampling. Data were collected using a pre-designed, pre-tested questionnaire, and statistical analysis was performed using Jamovi software version 2.3.28. Chi-square and Fisher's exact tests were applied to assess associations between variables. Results Out of 310 participants, 94 (30.32%, 95% CI: 25.25%-35.77%) reported using tobacco. Among these 94 participants, 82 (87.23%) used smokeless tobacco, 19 (20.21%) used the smoked form of tobacco, and seven (7.45%) used both forms. The mean age of initiation was 15.94 years for smoking and 15.59 years for smokeless tobacco. The data indicate a higher percentage of tobacco use among females (50%) compared to males (24.8%). However, in terms of absolute numbers, more males (60) than females (34) reported using tobacco due to the larger number of males in the study sample. The most common reasons for initiation included curiosity (43.74%) and peer pressure (53.99%). Specifically, 49 individuals (42.6%) aged 13-15 were using tobacco, compared to 23 individuals (30.3%) aged 16-17, and only 22 individuals (18.5%) aged 18-19. Participants from urban areas reported higher tobacco use (48%) compared to those from rural areas (46.7%). Among those from joint families, about 24 (31.6%) reported tobacco use, while in nuclear families, it was slightly lower at about 70 (29.9%). Conclusion Factors such as peer pressure and curiosity played significant roles in the initiation of tobacco use, with more than half of the participants citing peer influence as the primary reason for starting. This study revealed differences in tobacco usage patterns across age groups, with younger participants showing higher usage rates. The findings highlight the need for targeted interventions, such as health education and anti-tobacco media campaigns, to reduce tobacco use among adolescents.

Cognitive and Psychological Mediators of the Social Gradient in Tobacco Use Initiation Among Adolescents: Evidence from the ABCD Study.

Tobacco use among adolescents is a significant public health concern, with early initiation leading to long-term health risks. Understanding the factors that contribute to the initiation of tobacco use is crucial for developing effective prevention strategies. This study investigates the roles of substance use harm knowledge and tobacco susceptibility in mediating the relationship between social gradients (race, ethnicity, and socioeconomic status) and tobacco use initiation among adolescents. Data from the Adolescent Brain Cognitive Development (ABCD) study, comprising a racially, ethnically, and economically diverse sample of tobacco-naive adolescents aged 9 to 16, were analyzed. Structural equation modeling (SEM) was used to test whether substance use harm knowledge and tobacco susceptibility mediate the effects of socioeconomic status (SES) on the initiation of tobacco use. Findings indicated that both substance use harm knowledge and tobacco susceptibility partially mediate the relationship between SES and tobacco use initiation. Adolescents from lower SES backgrounds exhibited lower levels of harm knowledge and higher levels of tobacco susceptibility, which increased their likelihood of initiating tobacco use. This study highlights the complex interplay between social determinants and individual cognitive and psychological factors in influencing tobacco use initiation among adolescents. Public health interventions that enhance harm knowledge and reduce susceptibility to tobacco use are crucial for preventing initiation, particularly among racially, ethnically, and economically diverse adolescents. These efforts can help reduce health disparities and promote health equity.

Social Epidemiology of Early Initiation of Electronic and Conventional Cigarette Use in Early to Middle Adolescents.

Early initiation of tobacco use among adolescents is a significant public health concern. While there is extensive research on overall tobacco use, much of it focuses on initiation in late adolescence, uses cross-sectional designs, and lacks specific exploration of electronic versus conventional cigarette use. This study aims to investigate social determinants influencing the early initiation of electronic and conventional cigarette use among U.S. adolescents. We utilized data from the Adolescent Brain Cognitive Development (ABCD) study, which follows a cohort of tobacco-naïve children from age nine through age 16. The social determinants examined included household income, parental education, financial difficulties, racial/ethnic minority status, family structure, neighborhood income, and gender minority status. Structural equation models were employed to assess associations between these determinants and early initiation of electronic and conventional cigarette use. Male gender was associated with a higher likelihood of conventional cigarette use, while the risk of early initiation of electronic cigarette use was similar across genders. White adolescents were at a higher risk of conventional cigarette use; however, the risk for electronic cigarette use was comparable across White and non-White groups. Financial difficulties were linked to an increased likelihood of early initiation of conventional cigarette use but not electronic cigarette use. Higher household income was associated with a reduced risk of initiating conventional cigarettes but did not significantly impact electronic cigarette use. Adolescents from married families were less likely to initiate electronic cigarette use. No significant effects were found for parental education or neighborhood income on the initiation of either type of cigarette use. Age did not significantly affect the initiation of either cigarette type, and gender minority status was marginally associated with early initiation of conventional cigarette use. The social patterning of electronic cigarette use differs from that of conventional cigarette use, suggesting that distinct tobacco products do not pose a uniform risk across all adolescents. This study underscores the importance of tailored prevention efforts that address the unique challenges associated with early initiation of electronic and conventional cigarette use among adolescents. The differential risk factors identified suggest targeted prevention strategies for conventional cigarette use, focusing on financial difficulties, household income, and gender-specific interventions. In contrast, prevention efforts for electronic cigarette use may require broader, more inclusive approaches that address all adolescents, regardless of their background. Comprehensive universal screening for electronic cigarette use and targeted screening for conventional cigarette use among adolescents are recommended.

The patterns and correlates of tobacco use in patients with schizophrenia: A cross-sectional study from North India

Abstract: BACKGROUND: Schizophrenia is a severe mental illness that is attributed to significant morbidity. Tobacco use is widespread among patients with schizophrenia. The purpose of this research was to evaluate the patterns and correlates of tobacco use in patients with schizophrenia. METHODS: This was a cross-sectional study conducted on patients with schizophrenia visiting a tertiary care center in North India. Adult patients of schizophrenia who were adherent to antipsychotic treatment were evaluated for the pattern and severity of tobacco use with reference to sociodemographic and clinical characteristics. RESULTS: A total of 93 patients were enrolled in the study. The current prevalence of tobacco use was found to be 61.54% among the patients with schizophrenia, and the majority (65.6%) of them was tobacco chewers with initiation of tobacco use during the second to third decades of life. More than half the tobacco users had at least a moderate level of dependence and had a positive family history of tobacco use. Patients with moderate-to-severe tobacco dependence had more severe psychopathology of schizophrenia than those with mild-to-moderate levels of tobacco dependence. CONCLUSION: The prevalence of tobacco use is high among patients with schizophrenia, and the psychopathology of schizophrenia may have a bearing on tobacco use behavior.

The Negative Impact of Vaping and Electric Cigarettes for Healing of Chronic Wounds: A Literature Review

Non-smokers, particularly adolescents, face significant public health risks from e-cigarette use due to immediate health hazards, the potential for initiating tobacco use, and insufficient data on critical health outcomes, including wound healing. This study investigates vaping's impact on chronic wound healing, emphasizing e-cigarette chemical components. E-cigarettes contain common constituents: 1) Base liquids: Propylene glycol (PG) and vegetable glycerin (VG), 2) Nicotine, 3) Flavoring chemicals and additives, 4) Trace contaminants and toxins. Chronic wounds exhibit persistent inflammation, impaired proliferation, delayed remodeling, and environmental factors (e.g., ischemia, infection, trauma). E-cigarette components impair wound healing: VG induces osmotic effects and cellular toxicity, nicotine causes vasoconstriction, reduced oxygenation, and impaired angiogenesis. Flavoring chemicals contribute to cytotoxicity and modulate inflammatory responses, while contaminants like heavy metals induce oxidative stress and inflammation. Despite e-cigarettes' lower harm compared to traditional cigarettes, their effects on chronic wound healing remain poorly understood. Further research is essential to elucidate smoking's precise impact on chronic wound healing.

Racial Differences in Biopsychosocial Pathways to Tobacco and Marijuana Use Among Youth.

The influence of socioeconomic disparities and multidimensional stressors on youth tobacco and marijuana use is recognized; however, the extent of these effects varies among different racial groups. Understanding the racial differences in the factors influencing substance use is crucial for developing tailored interventions aimed at reducing disparities in tobacco and marijuana use among adolescents. This study aims to explore the differential effects of socioeconomic disparities and multidimensional stressors on tobacco and marijuana use between Black and White adolescents. Utilizing longitudinal data from the Adolescent Brain Cognitive Development (ABCD) study, this research includes a cohort of pre-youth, monitored from the age of 9-10years for a period of up to 36months. We examined the impact of various socioeconomic status (SES) indicators and multidimensional stressors, including trauma, financial stress, racial discrimination, and family stress, alongside baseline average cortical thickness and the subsequent initiation of tobacco and marijuana use over the 36-month follow-up. Overall, 10,777 participants entered our analysis. This included 8263 White and 2514 Black youth. Our findings indicate significant differences in the pathways from SES indicators through stress types to cortical thickness between Black and White youths. Notably, cortical thickness's impact on the future initiation of tobacco and marijuana use was present in both groups. The study suggests that compared to White adolescents, Black adolescents' substance use and associated cortical thickness are less influenced by stress and SES indicators. This discrepancy may be attributed to the compounded effects of racism, where psychosocial mechanisms might be more diminished for Black youth than White youth. These findings support the theory of Minorities' Diminished Returns rather than the cumulative disadvantage or double jeopardy hypothesis, highlighting the need for interventions that address the unique challenges faced by Black adolescents.

Correlates of nicotine dependence among patients visiting a tobacco cessation centre in India: A retrospective analysis.

Background We did a retrospective secondary analysis of 1-year data of a tobacco cessation clinic (TCC) to assess correlates of nicotine dependence among tobacco users visiting the TCC at a tertiary care dental hospital. Methods Secondary data were obtained from the records of patients who had visited the TCC from January to December 2019. Of the 1436 records, 1144 were found to contain all the information needed for the study. Patient records were obtained from a pre-validated standard TCC patient assessment sheet (PAS), which included various sections: Sociodemo-graphic items, tobacco use profile items, nicotine dependence status, strategy used for cessation and follow-up details. Results Of the 1144 proformas, 97.1% (n=1111) were of men and 2.9% (n=33) were of women. Around 48.5% had medium nicotine dependence followed by high nicotine dependence (29.7%) and low nicotine dependence (21.8%). The mean (SD) age of initiation of tobacco use was 26.1 (9.44) years and a significantly lower age of initiation was observed in patients with high nicotine dependence. Greater number of years of tobacco use was significantly associated with high nicotine dependence. About 47% of patients had attempted to quit tobacco in the past and the quitting attempts were found to be significantly higher in patients with high dependence. Conclusion We explored crucial determinants of nicotine dependence among tobacco users reporting to the TCC. These factors may be incorporated in routine assessment of the tobacco use status and may be used in tailored cessation counselling strategies.

Tobacco Use and Perceived Stress Among Male College Students in Bangalore, India

BACKGROUND: More than 250 million individuals use tobacco in some form on a daily basis in India and adolescents make up a significant proportion of that number. The period of adolescence is critical in the initiation of smoking or tobacco use as well as its progression from experimentation to dependency. In this study, the role of psychological stress was explored with respect to cigarette consumption and level of addiction or dependence. METHODS: A total of 183 male college students (mean age= 19.8 years) from Bangalore, India completed the questionnaire booklet which included a Cigarette use screening form, the Perceived Stress Scale and the Autonomy over Smoking Scale. Of the 183 participants, there were 85 (46.2%) current smokers and 98 (53.7%) nonsmokers, and their scores on the perceived stress scale were compared using analysis of variance and independent samples _t_ tests. The relationship between levels of stress and dependence on tobacco (loss of autonomy) was also explored using Pearson’s product moment correlation (_r_). RESULTS: There was no significant difference between current smokers and nonsmokers on perceived stress (_t_[181] = -1.26, _p_ &gt;0.05), The same result was extended when the group of nonsmokers was divided into three (Never smokers, experimental smokers and former regular smokers) and the differences in scores were tested again between all four groups (_F_[3, 179]=.642, _p_ &gt;0.05). There was, however, a significant positive correlation between level of dependence on tobacco and perceived stress (_r_=.743, _p_ &lt;0.01). CONCLUSION: The study found that there was no difference in perceived stress levels between smokers and nonsmokers, although there was a positive relationship between the level of perceived stress and level of tobacco dependence (loss of autonomy) among the current smokers.

Racialized influence of parental education on adolescents’ tobacco and marijuana initiation: Mediating effects of average cortical thickness

Various regions of the cerebral cortex, such as the prefrontal cortex, parahippocampal gyrus, insular cortex, temporal cortex, and anterior cingulate cortex, play critical roles in emotion regulation and executive/cognitive control. Given these regions' involvement, it is hypothesized that average cortical thickness might play a role in mediating the socioeconomic gradient observed in substance use behaviors. However, the mechanisms through which average cortical thickness influences the differential impact of socioeconomic factors, such as parental education, on the initiation of tobacco and marijuana use among youths from diverse backgrounds remain unclear. Recent studies indicate that the effects of socioeconomic factors on substance use and brain development are racialized, often showing weaker associations in racialized populations due to social stratification and racism. Our aim was to examine whether average cortical thickness mediates the racialized effects of parental education as a major socioeconomic determinant on the initiation of tobacco and marijuana use among youth. This longitudinal study, spanning 36 months, utilizes data from the Adolescent Brain Cognitive Development (ABCD) study, which included 10,777 pre-adolescents aged 9–10 years. From this, 8263 (76.67%) were White youth and 2514 (23.33%) were Black. Structural equation modeling was employed to assess the mediating role of average cortical thickness in the relationship between parental education (social determinant), race, and the initiation of tobacco and marijuana use, while considering covariates such as sex and age. Socioeconomic factors were predictive of future substance use. However, the association between these socioeconomic factors and substance use was found to be weaker among Black youths compared to White youths. Average cortical thickness partially mediated the influence of the racialized socioeconomic gradient on substance use, indicating both direct and indirect effects. Average cortical thickness acts as a partial mediator in the racialized impact of socioeconomic determinants on the initiation of adolescent substance use, underscoring the intricate relationship between neurodevelopmental and social factors in influencing substance use behaviors. This observation supports a biopsychosocial model that incorporates the effects of racism, aligning with the theory of minorities’ diminished returns.

Even worse for Black girls: the longitudinal association of racial bullying with the initiation of alcohol and tobacco use.

We used Poisson's linear regression to examine the association between racial bullying (RB) and the initiation of alcohol and tobacco uses after 9 months. Two cluster-randomized controlled trials were conducted in 2019 with children in grades five (girls: 50.0%; 10 years old: 82.0%; White: 36.8%; Black: 58.7%; others: 4.5%) and seven (girls: 49.5%; 12 years old: 78.1%; White: 33.2%; Black: 60.4%; others: 6.4%) from 30 public schools in the municipality of São Paulo, Brazil. We restricted our analyses to 2 subsets of students in each grade: those who reported no lifetime alcohol use at baseline and those who reported no lifetime baseline tobacco use. At baseline, 16.2% of fifth and 10.7% of seventh graders reported suffering from RB in the 30 days before data collection. After 9 months, 14.9% of fifth graders started using alcohol and 2.5%, tobacco. Among seventh graders, the figures were 31.2% and 7.7%, respectively. RB predicted the initiation of use of alcohol (risk ratio [RR]= 1.36; 95% CI, 1.07-1.70) and tobacco (RR= 1.81; 95% CI, 1.14-2.76) among seventh graders, with race-gender differences, particularly in Black girls (alcohol: RR= 1.45; 95% CI, 1.07-1.93; tobacco: RR= 2.34; 95% CI, 1.31-3.99). School-based programs and policies must explicitly address issues related to racism and gender in alcohol and tobacco prevention strategies.

Behavioral and psychosocial correlates of hope among youth

IntroductionHope plays a crucial role in the well-being of youth, impacting various aspects of their lives. However, less is known about the role of hope in pre-adolescents. This study aims to explore the psychosocial and behavioral correlates of hope in 9–10-year-old pre-youth transitioning into adolescence. MethodsUsing data from the Adolescent Brain Cognitive Development (ABCD) study, 4631 youth entered our study. The investigation follows these individuals for up to 36 months, specifically observing the initiation of marijuana and tobacco use. The methods employed include bivariate correlations. ResultsBaseline high hope offered protection against marijuana and tobacco use over the following 36 months. Elevated levels of hope could be seen in pre-youth with higher family income and those experienced lower levels of stressful life events and financial difficulties. High hope was also linked to lower behavioral problems, improved emotional function, lower impulsivity, lower sensation seeking, and higher cognitive function. Notably, hope was not correlated with parental education, neighborhood income, family conflict, blood pressure, body mass index, grade point average, prosocial behaviors, or puberty. ConclusionIn conclusion, the findings suggest a close interplay between hope and various dimensions of resilience including lower tobacco and marijuana use. Higher levels of hope, influenced by factors such as family income and life events, may be a mechanism that connects hope to enhanced emotional and cognitive functioning and acts as a protective factor against early initiation of substance use. These findings underscore the potential utility of fostering hope as a strategy to promote positive development and reduce tobacco and marijuana use.

Association between nucleus accumbens volume and future tobacco and Marijuana use in early adolescence

IntroductionNucleus accumbens (NAc), a crucial component of the brain's reward network, plays a role in reward-related behaviors like substance use. However, limited knowledge exists about sex differences in the predictive power of NAc volume for the initiation of tobacco and marijuana use among children transitioning into early and middle adolescence. Our aim was to compare the predictive utility of NAc volume for adolescents' initiation of tobacco and marijuana use over a three-year period. MethodsData from the Adolescent Brain Cognitive Development study (ABCD), a longitudinal study of pre-adolescents aged 9–10 years, were utilized. The study included 9–10 pre-adolescents (n = 11,795) who were followed for 36 months. Cox regression was employed to examine whether NAc volume predicts subsequent initiation of tobacco and marijuana during the follow-up period. Covariates included age, race/ethnicity, puberty, parental composition, parental education, and area-level median income. Sex was the moderator. ResultsWhile NAc volume predicted future substance use, this association varied based on substance type (tobacco vs. marijuana), sex (male vs. female), and laterality (brain hemisphere). A larger right NAc volume (mm^3) inversely associated with subsequent tobacco use initiation for female youth (HR = 0.998; 95% CI: 0.996–1.000), while it showed no association for male youth (p = 0.385). Larger left NAc volume (mm^3) did not associate with subsequent tobacco use initiation for female youth (p = 0.108) but showed a positive association for male youth (HR = 1.002; 95% CI: 1.001–1.003). NAc volume did not show an association with subsequent marijuana use initiation for either sex. ConclusionsThe predictive impact of right and left NAc volumes on future tobacco or marijuana use may differ for male and female adolescents, suggesting that the salience of NAcc in regulating the reward system is influenced by sex, substance type, and brain hemisphere.

Barriers to seeking tobacco cessation services: a qualitative assessment of university students' needs in Qatar.

The prevalence of tobacco use in the Middle East is alarmingly high, especially among university students; most users initiate tobacco use during adolescence and young adulthood. Evidence-based cessation services can be beneficial when quitting tobacco use; however, these services are underutilized. This study aimed to explore the barriers preventing university students in Qatar from seeking tobacco cessation services. Semi-structured interviews were conducted with 20 Qatar University students who are current or former tobacco users (n = 18/2); most current cigarette smokers were also waterpipe users. The interviews were transcribed verbatim, coded, and analyzed using thematic analysis. The major barriers to seeking tobacco cessation services included misconceptions regarding nicotine addiction, negative perceptions of the cessation services' effectiveness, self-efficacy regarding the ability to quit without seeking cessation services, concerns and preferences regarding practitioners' characteristics at clinics, masculine culture that discourages men from seeking cessation help, social stigma around women who use tobacco in Arab culture, and a lack of time to visit cessation clinics. Our findings address gaps in the literature regarding the individual and sociocultural barriers to seeking tobacco cessation among youth in Qatar. A better understanding of these barriers can facilitate successful promotion of tobacco cessation services and enhance cessation-seeking behaviors.

Prospective Association Between Tobacco Use and at-Risk Alcohol Consumption Among Swedish Adolescents: Outlining the Influence of Tobacco Product, Frequency of Use and Gender in the LoRDIA Cohort.

Introduction: Tobacco use is not only a major risk factor for morbidity and mortality but also associated with alcohol misuse. While personality traits may be driving this association, the psychoactive component of tobacco, nicotine, may also be a major risk factor. The aim with this study was to further assess the prospective association between tobacco use and alcohol consumption, with special emphasis on the role of the tobacco product used (cigarettes and Swedish snus), frequency of use, and gender. Methods: Data was extracted from the prospective cohort Longitudinal Research on Development In Adolescence (LoRDIA), following Swedish adolescents over four waves (∼13 to 17years of age). Tobacco use was reported with respect to product used and frequency of use, while alcohol use was assessed using AUDIT-C, as well as frequency of use within the last year. Results: Use of tobacco, independent of product used and gender, was associated with increased alcohol consumption. High frequency of use and dual use strengthened to association. Individuals initiating tobacco use during the study period progressively increased their frequency of alcohol consumption compared to non-users during consecutive waves. Furthermore, tobacco use was associated with at-risk consumption of alcohol at follow up, even when adjusting for previous alcohol inebriation, socioeconomical factors, gender and novelty seeking. Conclusions: The data presented here suggests that nicotine use during adolescence, and especially dual use, is a major risk factor for future hazardous alcohol intake. This finding is especially important considering the escalated use of nicotine pouches, which in many ways resembles Swedish snus. From a public health perspective, preventive measures and policies designed to counteract all forms of nicotine use among youths is warranted.