Vaping Use Research Articles

Young people's support for various forms of e-cigarette regulation in Australia and the UK.

The aim of this study was to examine young people's support for e-cigarette policies in two countries with very different e-cigarette regulatory environments - Australia and the UK. An online survey was administered to 1,185 15-24 year olds (590 from Australia, 595 from the UK). Survey items assessed demographics, use of vaping and tobacco products, exposure to others' vaping behaviours, exposure to e-cigarette advertising, perceptions of harms associated with e-cigarettes, and support for 14 e-cigarette policies. Frequencies for support were calculated for each policy by country and overall, and a mixed effects negative binomial regression was performed to identify factors associated with support. Majority support was expressed for 10 of the 14 policies in the Australian sample and six in the UK sample. Significantly higher levels support were found among Australian respondents compared to UK respondents for all policies except one where the difference failed to reach statistical significance. Support was strongest for policies relating to preventing access by minors, including warnings on packages, and prohibiting misleading advertising. Support was weakest for policies restricting access to e-cigarettes and flavours. Factors associated with higher levels of support were harm perceptions, never having used e-cigarettes, and older age. The results suggest general support for a broad range of e-cigarette control policies among young people in Australia and the UK, despite very different e-cigarette regulatory environments in these countries. Enhancing awareness of the potential harms associated with e-cigarette use appears to be key to optimising support for the assessed policies among members of this age group.

Electronic cigarette or vaping use among adolescents in the United States: A call for research and legislative action.

Vaping among adolescents is increasingly common and may result in poor health outcomes; however, little research has been conducted evaluating the risks of vaping among adolescents and the knowledge and perceptions that drive use. We must gain a better understanding of vaping outcomes and adolescents' perceptions while identifying potential ways to lessen or eradicate the health burdens associated with vaping. This knowledge could then inform robust educational and public health programs to prevent and mitigate vaping among youths. Health education incorporating a target populations' world view, spheres of influence, readiness, motivation, intention, and determination promotes informed decision making. There are few resources currently being allocated to the problem even though legislators and enforcement agencies are aware. We cannot simply rely on existing laws to serve as a sufficient deterrent to prevent underaged usage. Further efforts are needed in the areas of behavioral science, health education, and public policy to tackle this urgent public health concern.

A comparison of the caries risk between patients who use vapes or electronic cigarettes and those who do not: A cross-sectional study

BackgroundEvidence on the potential oral health effects of vaping is scarce and there are limited data on possible links to both caries and periodontal disease. The authors assessed the association between electronic cigarette (e-cigarette) or vape use and caries risk level. The Caries Management by Risk Assessment tool was used. MethodsA cross-sectional study of patient records was conducted; 13,098 patients who attended the dental school clinics from January 1, 2019, through January 1, 2022, were included in the study. Mann-Whitney U test and multivariable ordinal logistic regression were used to assess the relationship between use of e-cigarettes or vapes and caries risk level. ResultsData from 13,216 patients were included in the data set initially; 13,080 responded “no” when asked whether they used e-cigarettes or vapes (99.3%), and 136 responded “yes” (0.69%). There was a statistically significant difference (P < .001) in caries risk levels between the e-cigarette or vape group and the control group; 14.5%, 25.9%, and 59.6% of the control group were in the low, moderate, and high caries risk categories, respectively, and 6.6%, 14.3%, and 79.1% of the e-cigarette or vape group were in the low, moderate, and high caries risk categories, respectively. ConclusionsIn this study population, there was an association between use of e-cigarettes or vapes and caries risk level of patients; vaping patients had a higher risk of developing caries. Practical ImplicationsWithin the study limitations, it was recommended that use of e-cigarettes or vapes should not only be included in the routine dental-medical history questionnaire, but also among the risk factors that increase a patient’s caries risk level.

Intersectional Disparities in Youth Tobacco Use by Sexual and/or Gender Minority Status and Race and/or Ethnicity.

The current study applied an intersectional lens to examine societal factors, individual psychological outcomes, and youth combustible tobacco and vape use at the intersection of sexual and/or gender minority (SGM) status and race and/or ethnicity. Data were drawn from 133 969 youth respondents surveyed in the 2019-2020 California Student Tobacco Survey, a representative school-based survey of 8th and 10th-grade public school students throughout California. The impact of multiple marginalized group membership using four mutually exclusive intersectional positions (non-SGM white, SGM white, racial minority only, and both SGM and racial minority), in addition to specific differences across ten SGM by race and/or ethnicity groups (e.g. non-SGM black or African American, SGM black or African American, etc.) were assessed. Compared to heterosexual and cisgender white youth, SGM and racial minority adolescents were shown to experience poorer school tobacco education quality and cessation support, lower school and family connectedness, and higher anxiety and depression symptoms. SGM and racial minority youth had a higher prevalence of ever-combustible tobacco use but were less likely to be current vape users compared to non-SGM white respondents. In examining specific group differences, results revealed that SGM teens had the highest risk of ever combustible tobacco use. This disparity was amplified for those belonging to multiple marginalized groups, with black or AA SGM teens evidenced to be at the highest risk of current combustible tobacco. Information from this study has useful implications for SGM measurement in surveillance systems and highlights the usefulness of adopting an intersectional approach to inform equity-driven public health policy and intervention. This representative study of California youth supports that identifying as a sexual and/or gender minority (SGM) is an important risk factor for combustible tobacco use. Particularly, observed SGM disparities were magnified for the youth belonging to marginalized groups, as black or African American SGM teens were shown to be at the highest risk of current combustible tobacco use. Findings support that Intersectionality Theory represents a useful framework for examining tobacco-related disparities and underscores the importance of assessing how the intersection of multiple social categories impacts youth tobacco use.

E-cigarette aerosol exposure of pulmonary surfactant impairs its surface tension reducing function.

E-cigarette (EC) and vaping use continue to remain popular amongst teenage and young adult populations, despite several reports of vaping associated lung injury. One of the first compounds that EC aerosols comes into contact within the lungs during a deep inhalation is pulmonary surfactant. Impairment of surfactant's critical surface tension reducing activity can contribute to lung dysfunction. Currently, information on how EC aerosols impacts pulmonary surfactant remains limited. We hypothesized that exposure to EC aerosol impairs the surface tension reducing ability of surfactant. Bovine Lipid Extract Surfactant (BLES) was used as a model surfactant in a direct exposure syringe system. BLES (2ml) was placed in a syringe (30ml) attached to an EC. The generated aerosol was drawn into the syringe and then expelled, repeated 30 times. Biophysical analysis after exposure was completed using a constrained drop surfactometer (CDS). Minimum surface tensions increased significantly after exposure to the EC aerosol across 20 compression/expansion cycles. Mixing of non-aerosolized e-liquid did not result in significant changes. Variation in device used, addition of nicotine, or temperature of the aerosol had no additional effect. Two e-liquid flavours, menthol and red wedding, had further detrimental effects, resulting in significantly higher surface tension than the vehicle exposed BLES. Menthol exposed BLES has the highest minimum surface tensions across all 20 compression/expansion cycles. Alteration of surfactant properties through interaction with the produced aerosol was observed with a basic e-liquid vehicle, however additional compounds produced by added flavourings appeared to be able to increase inhibition. EC aerosols alter surfactant function through increases in minimum surface tension. This impairment may contribute to lung dysfunction and susceptibility to further injury.

An Investigation of Age-Differentiated Conversations About Electronic Nicotine Delivery Systems on Reddit

This study analyzes age-differentiated Reddit conversations about ENDS. This study combines 2 methods to (1) predict Reddit users' age into 2 categories (13-20 years [underage] and 21-54 years [of legal age]) using a machine learning algorithm and (2) qualitatively code ENDS-related Reddit posts within the 2 groups. The 25 posts with the highest karma score (number of upvotes minus number of downvotes) for each keyword search (i.e., query) and each predicted age group were qualitatively coded. Of 9, the top 3 topics that emerged were flavor restriction policies, Tobacco 21 policies, and use. Opposition to flavor restriction policies was a prominent subcategory for both groups but was more common in the 21-54 group. The 13-20 group was more likely to discuss opposition to minimum age laws as well as access to flavored ENDS products. The 21-54 group commonly mentioned general vaping use behavior. Users predicted to be in the underage group posted about different ENDS-related topics on Reddit than users predicted to be in the of-legal-age group.

Co-substance use of nicotine vaping and non-cigarette tobacco products among U.S. grade 12 students from 2017-2019

BackgroundNicotine vaping among U.S. adolescents has risen rapidly over the past decade, particularly for youth in grade 12. While previous studies examined the relationship between nicotine vaping and combustible cigarette use, less is known about the co-occurrence between vaping and other tobacco products. MethodsUsing Monitoring the Future grade 12 data (2017-2019), we investigated associations between past 30-day nicotine vaping and non-vaping, non-cigarette tobacco use (smokeless tobacco, large cigars, cigarillos, hookah). Population prevalences of four categories were assessed: neither, vaping only, non-vaping of non-cigarette tobacco only, or both. We further investigated these relationships with logistic regressions accounting for the complex survey design (unadjusted, demographic-adjusted, and further adjusted for other substance use). Finally, analyses were stratified by combustible cigarette use. ResultsDepending on the non-cigarette tobacco product, 2.5% to 5.4% of grade 12 students vaped nicotine and used a non-cigarette tobacco product. Controlling for demographics, cigarillo use was associated with nicotine vaping (adjusted RR = 3.44, 95% CI: 3.08, 3.84), as was hookah use (aRR = 3.51, 95% CI: 2.92, 4.23), smokeless tobacco (aRR = 2.97, 95% CI: 2.51, 3.52), and cigar use (aRR = 2.90, 95% CI: 2.49, 3.37). Controlling for cannabis and all non-cigarette tobacco products simultaneously attenuated associations. Associations were stronger among students who did not use cigarettes. DiscussionNicotine vaping is associated with use of many non-cigarette tobacco products, including smokeless tobacco, cigarillos, cigars, and hookah. As prevalence of nicotine vaping remains high among adolescents, we should monitor co-use of vaping and other tobacco products.

Factors associated with post-COVID-19 confinement vape use in young adults

Abstract Introduction The use of Vape has increased during the pandemic due to the changes generated by it. Currently we have finished the conditions of confinement, so it is important to identify Objective: To determine the factors associated with post-COVID-19 confinement vape consumption in young adults Methods A cross-sectional, prospective study was carried out between January and April 2022, including men and women residents of Veracruz aged between 18 and 35 years, excluding participants with addiction treatment or with a diagnosis of a lung disease. A survey was applied through Google Forms to identify the factors associated with Vape consumption after confinement by COVID-19, including depression, anxiety and stress evaluated with the DASS-21 instrument (Cronbach’s alpha between 0.79 and 0.87). For data analysis, SPSS v22 software was used, X2 test with Odds Ratio (OR) and 95% confidence interval (CI95%) and MannWhitney U test, assigning statistical significance with p &amp;lt; 0.05. Results 514 participants were included, with a prevalence of vape use of 28.5%. Physical activity, cigarette consumption by a family member, levels of anxiety, depression and stress showed a value of p &amp;gt; 0.05 for Vape consumption, while other factors (OR/95%CI) such as being female (0.6/0.4-0.9), identifying vape advertising on Facebook (0.35/0.19-0.65), having a family member who vapes (2.4/1.5-3.6), consuming cigarettes (4.2/2.7-6.4) and identifying vape advertising on Instagram (1.5/ 1.0-2.3) had values of p &amp;lt; 0.05 Conclusions Post-pandemic vape use is not affected by anxiety, stress or depression, identifying other factors that favor its use such as the environment in which it develops, such as being someone with a history of tobacco use, in addition to the family smoker and advertising on Instagram, which is a social network that often works as an aspirational image for users, a situation contrary to what is shown on Facebook. Key messages • Vape consumption continues to be a post-pandemic public health problem, so it is necessary to reinforce educational measures on the subject and the post-Covid complications of its use. • It is necessary to regulate vape advertising on social networks, as has been done with tobacco in different countries, since it can become a risk factor by showing aspirational images for users.

LEFT SIDE PREDOMINANT E-CIGARETTE OR VAPING USE-ASSOCIATED LUNG INJURY (EVALI): A CHALLENGING DIAGNOSIS OF EXCLUSION

LEFT SIDE PREDOMINANT E-CIGARETTE OR VAPING USE-ASSOCIATED LUNG INJURY (EVALI): A CHALLENGING DIAGNOSIS OF EXCLUSION

Editorial: Vaping and Cardiovascular health � An opportunity or a risk?

The history of smoking dates back to the ancient times and mankind has been smoking different plant materials for the leisure and addiction. One of its kind, tobacco cigarette smoking was introduced in the 19th century and its use increased exponentially by the mid of 20th century. Initially it was thought that the tobacco cigarette smoking had some medicinal properties but as the rate of tobacco smoking increased, the adverse effects started appearing and by the end of 20th century it was a well-known fact that tobacco cigarette smoking was a health hazard and a major risk factor for the fatal diseases like cancer and cardiovascular diseases1. With the emergent side effects and health hazards tobacco cigarette smoking was discouraged on a larger scale in the society and the search for the alternative to it led to the creation of E-cigarettes in the early 21st century.&#x0D; Since the introduction of vaping i.e., use of E-cigarettes, E-hookahs, vape pens or Electronic Nicotine Delivery Systems (ENDS), it is taken as a safe alternative of tobacco cigarettes smoking and a way to help in smoking cessation2. The perception of less harmful tobacco smoking substitute, extensive marketing and a vogue of vaping have resulted in an explosive increase in the use of vaping devices among the former smokers, current smokers and even in never smoker adolescents and young adults in the past two decades. According to the National Health Interview Survey (NIHS), the number of E-cigarette users increased to 8.1 million in United States in 20183 and according to National Youth Tobacco Survey in US 19.6% of high school students and 4.7% of middle school students are regular users of E-cigarettes4.&#x0D; Most vaping devices are made up of four components, including: a cartridge or pod containing e-liquid, a metallic heating coil, a battery and a mouthpiece. The e-liquid contains chemicals like propylene glycol, vegetable glycerin, flavoring substance and varying amount of nicotine. Propylene glycol and vegetable glycerin act as solvent carriers. When a person puffs/inhales, it activates the heating coil that causes the e-liquid to vaporize that is inhaled by the person. The vapors or aerosols that are inhaled deliver certain chemicals into the body that are mainly:&#x0D; &#x0D; Nicotine&#x0D; Organic volatile compounds generated by heating of solvent carriers such as glycols, glycerin, toluene that cause irritation to the eyes, oral and laryngeal mucosa.&#x0D; Carbonyls such as acetaldehyde, formaldehyde, acrolein and glyoxal which are carcinogenic and cause extensive damage to the lungs.&#x0D; Chemical present in flavoring agents like Diacetyl, acetyl propionyl and acetoin cause severe asthma and bronchiolitis obliterans&#x0D; The contaminants that may be the tobacco derived alkaloids and nitrosamines&#x0D; Metal particles from the heating coils like chromium, cadmium, nickel, lead; and particles of copper, nickel, and silver&#x0D; &#x0D; These chemicals are responsible for the injuries to the respiratory mucosa, skin and are considered as carcinogens.&#x0D; The cardiovascular effects of vaping are mediated by:&#x0D; &#x0D; Nicotine, it has been demonstrated that activation of nicotinic Ach receptors causes release of catecholamines and promotes hemodynamic alterations, endothelial dysfunction, insulin resistance, dyslipidemia and arrhythmogenesis5.&#x0D; Increased oxidative stress that is produced due to aerosolized chemicals, metals, particulates and acrolein. It causes generation of oxygen derived free radical species causing inflammation and damage to the endothelial cells, reduced bioavailability of NO, plaque destabilization, platelet activation and thrombus formation causing myocardial infarction, stroke and cardiovascular events5.&#x0D; &#x0D; Though tobacco cigarette smoking is 3 times more harmful than vaping6 the studies have shown that the vaping is associated with increased risk of cardiovascular events as compared to non-users and the use of tobacco cigarette smoking along with vaping cause the highest number of cardiovascular events as compared to non-users, vaping or tobacco cigarette smoking alone7.&#x0D; The vaping epidemic and its potential hazards can be controlled by certain measures:&#x0D; &#x0D; Regulating the advertisements of e-cigarettes&#x0D; Reducing the access of adolescents and young adults to the vaping products&#x0D; Public awareness campaigns to educate children and adults about the harmful effects of vaping&#x0D; Reducing the second-hand exposure to vaping aerosols by precluding its use in the indoors and public spaces.&#x0D; &#x0D; The studies so far have not proved vaping to be an effective tool for smoking cessation, instead the user who start vaping for smoking cessation often end up using both and the use of vaping among adolescents increases the propensity of them to become tobacco cigarette smoker. In the author�s opinion the use of vaping should not be recommended, and its use should be discouraged owing to its adverse effects on health.

An evaluation of a New Zealand "vape to quit smoking" programme.

To compare the use of smoking cessation aids across different ethnic groups and age groups within a large New Zealand cohort and to assess the uptake and effectiveness of e-cigarettes for smoking cessation via a "vape to quit" initiative. Retrospective analysis of Te Hā - Waitaha smoking cessation service, including a telephone interview of a subgroup, who opted into the "vape to quit" programme. The uptake of different smoking cessation aids, including the use of medications and other products, was evaluated and the self-reported quit rate in a "vape to quit" cohort was evaluated. The final dataset analysed consisted of 1,118 participants: 66.6% NZ European; 28.1% Māori; 3.1% Pacific; and 2.2% Asian. Māori participants were younger on average and had increasing vaping use. Māori were less likely to receive varenicline to assist with smoking cessation. Vaping use increased over time in all groups. Nicotine containing e-cigarettes were the most common smoking cessation products used, with >65% of each ethnic cohort utilising these products. Of the 100 participants in the "vape to quit" cohort 16% were smokefree and vapefree, 31% were smokefree and vaping, 31% were smoking and not vaping, and 22% were smoking and vaping. The Te Hā - Waitaha service was successful in engaging Māori in their smoking cessation programme. Nicotine containing e-cigarette products were popular in all cohorts. Nicotine containing e-cigarettes are showing potential in smoking cessation programmes in support of the Smokefree Aotearoa 2025; however, 22% of those in the "vape to quit" programme became dual users.

Differentiating Patterns of Vaping, Alcohol, and Cannabis Use Among Early Adolescents

The current study assessed whether risk factors associated with vaping were distinct from risk factors associated with other substance use (e.g., alcohol, cannabis) during adolescence. Participants ( N = 848, ages 10–16 years) completed a self-report survey to assess frequency and age of onset of substance use, risk perceptions of use, risk factors (depressive symptoms, sensation seeking, and parent-reported factors), and vape nicotine content. Groups were created to differentiate types of substance use, and frequency of substance use. Overall, adolescents who only vaped had lower depressive symptoms and indicated less nicotine vape use than adolescents who vaped and used other substances. Experimental vapers perceived other substances (but not vaping) as risky and endorsed vaping nicotine less often than regular vapers. Early initiation of vaping was not associated with polysubstance use. Taken together, our findings offer important implications for how vaping can be differentiated from other substance use during adolescence.

A Comparison of Vaping Behavior, Perceptions, and Dependence among Individuals Who Vape Nicotine, Cannabis, or Both.

Background: Electronic delivery systems (e.g., vapes, e-cigarettes) are now popular modes of cannabis and nicotine administration that are often used by the same individuals; however, we still know little about dual nicotine and cannabis vaping. Materials & Methods: An online convenience sample of adult nicotine and/or cannabis vape users residing in the United States completed a 60 min survey on sociodemographic characteristics, cannabis and/or nicotine vape use behaviors and dependence, reasons for vape use, and perceptions of benefits and harms. After data cleaning, we compared dual vs. nicotine-only and cannabis-only vape users with univariate statistics and step-wise hierarchical linear regression analyses. Additionally, we assessed the factor structure, internal consistency, and criterion and convergent validity of the Penn State Cannabis Vaping Dependence Index (PSCVDI). Results: The final sample included 357 dual, 40 cannabis, and 106 nicotine vape users. Compared to nicotine- and cannabis-only vapers, dual vapers started using their nicotine and cannabis vapes at a younger age (p < 0.001), used them for more years (p < 0.001), and were less likely to use their nicotine vape to replace combustible cigarettes (p = 0.047). Dual users vs. single-substance users did not have significantly higher nicotine or cannabis vape dependence scores after controlling for sociodemographic and use behaviors. The PSCVDI showed adequate validity for measuring cannabis vape dependence. Conclusions: This survey is the first to highlight important differences in vape use behaviors and reasons for use between dual vs. cannabis- and nicotine-only vape users.

Experienced Effects on Well-Being following Smoking Cessation: Findings from the 2020 ITC Four Country Smoking and Vaping Survey.

Background and Aims: There has been limited research addressing changes in subjective well-being as a result of quitting smoking. This paper examines recent ex-smokers’ well-being related experiences overall and as a function of (1) duration of cessation and (2) continued nicotine use from vaping. Methods: A sample of 1379 ever-daily smoking ex-smokers (quit for up to 5 years) from the 2020 ITC Four Country Smoking and Vaping Survey (Australia, Canada, the UK, and the US), of which 27.1% currently vaped daily. Well-being measures were perceived changes post-quitting in emotion coping (stress and negative emotions), enjoyment of life, and day-to-day functioning. We also assessed the level of persisting worry about past smoking leading to future health problems. Results: Overall, among those answering all four well-being measures, 51.8% of the ex-smokers reported positive effects and no negatives, but 27.3% reported at least one negative effect, with the remainder reporting no change in any measure. Positive effects were greater among those who had quit more than 1 year prior. The largest improvement (56.3%) was for daily functioning, which showed improvement over time since having quit. Current daily vapers reported similar well-being as those not vaping; however, fewer daily vapers reported worsening ability to cope with stress (10.2% vs. 20.7%). Overall, 84% reported being worried about future negative health effects of smoking, with no clear differences by quitting duration or vaping status. Conclusions: Most ex-smokers reported changes in their well-being since quitting, with more reporting improvements than declines. Well-being improved with duration of time since quitting, but did not appear to be influenced by daily vaping use, but stress coping may be better among vapers. Persisting worries about possible future health effects from smoking may be reducing the experienced benefits of quitting smoking for some.

Revised Guidelines for smoking cessation in New Zealand, 2021.

To summarise the literature underpinning key recommendations made in the 2021 revision of the Ministry of Health's New Zealand Guidelines for Helping People to Stop Smoking. A comprehensive literature review of smoking cessation interventions was undertaken in July 2021. Recommendations were formulated from the findings of the literature review and expert advice. Healthcare professionals should ask and briefly advise all people who smoke to stop smoking, regardless of whether they say they are ready to stop smoking or not. They should offer smoking cessation support, which includes both behavioural and pharmacological (e.g., nicotine replacement therapy, nortriptyline, bupropion or varenicline) interventions. The Guidelines also include advice around the use of vaping in smoking cessation. Recommendations are also formulated for priority populations of smokers: Māori, Pacific, pregnant women, and people with mental illness and other addictions. The guidelines will assist healthcare professionals in providing evidence-based smoking cessation support to people who smoke. To be effective and equitable, the ABC model requires organisational commitment, integration into routine practice, and increased attention to the upstream determinants of smoking and quitting.

Associations between eating disorder symptoms and smoking and vaping use and motives in college students

A positive association between eating disorder (ED) symptoms and cigarette use exists. However, little is known about the association between ED symptoms and e-cigarette use, as well as how these symptoms are related to motives for using cigarettes and e-cigarettes. In this study, 716 college students (M age = 19.23, SD = 1.65; 61 % female) completed an online survey that included the Eating Pathology Symptoms Inventory, smoking and vaping questionnaires, and the Drinking Motives Questionnaire-Revised, which was modified for smoking and vaping. We examined mean differences in ED symptoms in lifetime (and past-month) cigarette and e-cigarette users versus non-users, and investigated correlations between ED symptoms and smoking and vaping motives. Finally, we evaluated whether biological sex influenced the results. Overall, 30.4 % of students reported lifetime smoking, 10.5 % reported past-month smoking, 23 % reported lifetime vaping, and 9.5 % reported past-month vaping. With the exception of higher mean scores for negative attitudes toward obesity in students reporting lifetime smoking versus never smoking after adjusting for sex (M = 5.97 vs. M = 4.52, t[713] = −3.76, q = 0.004), no significant mean differences emerged between those who used nicotine and those who did not, which reflected small to moderate effect sizes. Few associations were observed between ED symptoms and nicotine use motives. These findings suggest that the comorbidity between ED symptoms and smoking and vaping in a non-clinical sample is minimal, although additional research with larger sample sizes of males and females is needed.

COVID-19 and Tweets About Quitting Cigarette Smoking: Topic Model Analysis of Twitter Posts 2018-2020.

BackgroundThe risk of infection and severity of illness by SARS-CoV-2 infection is elevated for people who smoke cigarettes and may motivate quitting. Organic public conversations on Twitter about quitting smoking could provide insight into quitting motivations or behaviors associated with the pandemic.ObjectiveThis study explored key topics of conversation about quitting cigarette smoking and examined their trajectory during 2018-2020.MethodsTopic model analysis with latent Dirichlet allocation (LDA) identified themes in US tweets with the term “quit smoking.” The model was trained on posts from 2018 and was then applied to tweets posted in 2019 and 2020. Analysis of variance and follow-up pairwise tests were used to compare the daily frequency of tweets within and across years by quarter.ResultsThe mean numbers of daily tweets on quitting smoking in 2018, 2019, and 2020 were 133 (SD 36.2), 145 (SD 69.4), and 127 (SD 32.6), respectively. Six topics were extracted: (1) need to quit, (2) personal experiences, (3) electronic cigarettes (e-cigarettes), (4) advice/success, (5) quitting as a component of general health behavior change, and (6) clinics/services. Overall, the pandemic was not associated with changes in posts about quitting; instead, New Year’s resolutions and the 2019 e-cigarette or vaping use–associated lung injury (EVALI) epidemic were more plausible explanations for observed changes within and across years. Fewer second-quarter posts in 2020 for the topic e-cigarettes may reflect lower pandemic-related quitting interest, whereas fourth-quarter increases in 2020 for other topics pointed to a late-year upswing.ConclusionsTwitter posts suggest that the pandemic did not generate greater interest in quitting smoking, but possibly a decrease in motivation when the rate of infections was increasing in the second quarter of 2020. Public health authorities may wish to craft messages for specific Twitter audiences (eg, using hashtags) to motivate quitting during pandemics.

Examining smoking and vaping behaviors, expectancies, and cessation outcomes between bisexual and heterosexual individuals

Prior research indicates bisexual individuals have higher smoking and vaping rates and heightened vulnerability to negative health outcomes. Thus, we compared adult bisexual (n = 294) and heterosexual (n = 2412) participants enrolled in a smoking cessation trial on baseline smoking and vaping use behaviors, motivations, and expectancies/beliefs as well as follow-up smoking and vaping status. This is a secondary analysis of a large randomized controlled trial testing a smoking cessation intervention for dual users of combustible and electronic cigarettes (e-cigarettes) in the United States. Self-reported 7-day point prevalence smoking and vaping abstinence were collected at 3-, 12-, and 24-month assessments. Bisexual and heterosexual participants did not differ in sociodemographic variables or baseline smoking and vaping history and behavior. We found significant differences among bisexual and heterosexual individuals in smoking and vaping beliefs/expectancies. Specifically, bisexual participants expressed overall greater positive expectancies regarding smoking and vaping, such as smoking and vaping to reduce negative affect and stress. There were no differences in smoking at any follow-up assessment. Only at 3 months were bisexual individuals more likely to be abstinent from vaping and less likely to be dual users than heterosexual individuals. Despite similar smoking and vaping status over time, bisexual individuals reported greater positive expectancies regarding smoking and vaping. Our findings revealed few targets for tailoring cessation interventions to bisexual individuals; thus, it is possible that there may be greater utility in targeting the disparities in prevalence (i.e., via prevention efforts).

Nicotine vaping for relaxation and coping: Race/ethnicity differences and social connectedness mechanisms

The current study examined race- and ethnicity-based differences in the reasons that youth report for vaping, with an emphasis on understanding the relationship between race/ethnicity and vaping for relaxation and stress/anxiety coping. This work also sought to go beyond examining race-based differences as a cause of tobacco-use disparities by assessing social connectedness factors that mediate relationships between race/ethnicity and vaping for relaxation and coping. Research questions were tested using data from the 2019–2020 California Student Tobacco Survey, a representative school-based survey of 10th and 12th grade public school students throughout schools in California. Overall, 7.78% of the sample reported using nicotine vapes in the past 30 days. The final sample included 11,112 high school student current vape users. The most important reason that youth vaped was for relaxation and stress/anxiety coping, with racial and ethnic minorities most likely to report this vaping motivation. Analyses of the structural mechanisms underlying the relationship between race/ethnicity and vaping reasons showed that minority youth reported lower school, peer, and family connectedness when compared to White youth. Lower school and family connectedness were in turn correlated with being motivated to vape to relax or relieve stress and anxiety, and lower overall mental health. Findings imply that future intervention efforts might profitably focus on reducing stressors associated with relaxation and stress/anxiety coping motivations and highlight the importance of connectedness for indirectly decreasing vape use risk by improving negative mood and mental health.

Antibody Duration After Infection From SARS-CoV-2 in the Texas Coronavirus Antibody Response Survey.

Understanding the duration of antibodies to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus that causes COVID-19 is important to controlling the current pandemic. Participants from the Texas Coronavirus Antibody Response Survey (Texas CARES) with at least 1 nucleocapsid protein antibody test were selected for a longitudinal analysis of antibody duration. A linear mixed model was fit to data from participants (n = 4553) with 1 to 3 antibody tests over 11 months (1 October 2020 to 16 September 2021), and models fit showed that expected antibody response after COVID-19 infection robustly increases for 100 days postinfection, and predicts individuals may remain antibody positive from natural infection beyond 500 days depending on age, body mass index, smoking or vaping use, and disease severity (hospitalized or not; symptomatic or not).