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Polytobacco and Alternative Tobacco Product Use in Young Adults

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Adolescents".

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 15664

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Special Issue Editor

Dr. Erin Mead-Morse

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Guest Editor

School of Medicine, University of Connecticut Health Center, Farmington, CT 06030, USA
Interests: tobacco control; tobacco regulatory sciences; health disparities; non-cigarette products; health behavior; health communication.

Special Issue Information

Dear Colleagues,

With the decline of cigarette smoking in the United States and many other countries, the tobacco marketplace and tobacco use behaviors have become more complex. Alternative tobacco products—including e-cigarettes, cigars, hookah, smokeless tobacco, and others—are gaining in popularity. The use of multiple tobacco products has also increased, and may increase nicotine exposure, dependence, and significant health risks and barriers to cessation. Young adults are more likely to use alternative products and to be polytobacco users than other age groups. Young adulthood is a key developtmental period in which tobacco initiation during youth transitions to more established use in adulthood. Additional work on alternative and polytoacco use is needed to help design effective prevention and cessation programs and policies for this age group. Therefore, this Special Issue invites studies that examine alternative and polytobacco use (including initiation and cessation), in the United States and globally, among young adults (ages 18–34), including: descriptions of alternative or polytobacco product use and changes over time; characteristics associated with use; human health effects; use among special population groups; and the impact of interventions or policies on use. We encourage a variety of work including but not limited to observational and intervenional studies, systematic reviews, mixed methods studies, and secondary data analysis.

Disclaimer: We will not accept research funded in part or full by any tobacco companies in this Special Issue. For more details, please check: https://www.mdpi.com/1660-4601/15/12/2831/htm.

Dr. Erin Mead-Morse
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

young adults
polytobacco use
alternative product use
tobacco use
smoking
tobacco prevention
tobacco cessation
health consequences
non-cigarette products

Published Papers (6 papers)

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Research

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14 pages, 756 KiB

Open AccessArticle

A Mixed-Methods Study on Use of Different Tobacco Products among Younger and Older Adults with Lower and Higher Levels of Nicotine Exposure in California in 2019–2020

by Arit Harvanko, Kimberly A. Koester, Gideon St. Helen, Sarah Olson, Hyunjin Cindy Kim and Pamela M. Ling

Int. J. Environ. Res. Public Health 2022, 19(9), 5563; https://doi.org/10.3390/ijerph19095563 - 03 May 2022

Cited by 1 | Viewed by 1620

Abstract

An increasing number of tobacco products are entering the market, offering a variety of options to attain desired nicotine intake. However, little is known about the effect of this diverse marketplace on the experiences and nicotine exposure among tobacco users. A mixed-methods study examined experiences with tobacco products among individuals with relatively lower or higher levels of biomarkers of nicotine exposure. Semi-structured interviews were conducted with younger and older adults to examine tobacco use behaviors, addiction to tobacco products, and nicotine effects. Younger and older adults provided similar narratives about addiction and nicotine effects, which were similar across age groups, product types (i.e., ENDS, combustible cigarettes, or oral tobacco products), and having lower or higher nicotine exposure. Some individuals with higher nicotine exposure who switched from combustible cigarettes to another product (e.g., ENDS) found similar or greater access and perceived addiction to nicotine. Adults with higher and lower levels of nicotine exposure provided narratives consistent with features of nicotine addiction, regardless of age and products used. Availability of multiple tobacco products may be associated with greater access and exposure to nicotine. Addiction may occur at low levels of use and with non-cigarette products. Full article

(This article belongs to the Special Issue Polytobacco and Alternative Tobacco Product Use in Young Adults)

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Figure 1

13 pages, 352 KiB

Open AccessArticle

Exclusive and Dual Cigarette and Hookah Smoking Is Associated with Adverse Perinatal Outcomes among Pregnant Women in Cairo, Egypt

by Omar El-Shahawy, Kareem Labib, Elizabeth Stevens, Linda G. Kahn, Wagida Anwar, Cheryl Oncken, Tom Loney, Scott E. Sherman and Erin L. Mead-Morse

Int. J. Environ. Res. Public Health 2021, 18(24), 12974; https://doi.org/10.3390/ijerph182412974 - 09 Dec 2021

Cited by 5 | Viewed by 2124

Abstract

This study assessed the prevalence of prenatal smoking, factors associated with prenatal smoking, and its association with birth outcomes in a sample of pregnant women in Egypt. Pregnant women were recruited during their last trimester from antenatal clinics in Cairo from June 2015 to May 2016. Participants completed an interviewer-administered survey that assessed tobacco use and attitudes, and exhaled carbon monoxide (CO) was measured. Gestational age at delivery and offspring birth weight were collected via a postnatal phone interview. Two hundred pregnant women ages 16–37 years participated. More than a quarter (29.0%) of women reported smoking (cigarettes, hookah, or both) during their current pregnancy, and hookah was more popular than cigarettes. Most women who smoked prior to their current pregnancy either maintained their current smoking habits (46.6%) or switched from dual to hookah-only smoking (46.6%). Current smokers during pregnancy had a higher mean (±SD) exhaled CO level (2.97 ± 1.45 vs. 0.25 ± 0.60 ppm, p < 0.001) and had babies with a lower mean birth weight (2583 ± 300 vs. 2991 ± 478 g, p < 0.001) than non-smokers. Smokers during pregnancy had greater odds of premature birth and/or low birth weight babies compared to non-smokers. Dual cigarette-hookah smokers had the highest risk. Additional focused programs are required to prevent women of childbearing age from initiating tobacco use and empower women to stop tobacco use during the preconception and gestational periods. Full article

(This article belongs to the Special Issue Polytobacco and Alternative Tobacco Product Use in Young Adults)

11 pages, 314 KiB

Open AccessArticle

Pilot Ecological Momentary Assessment Study of Subjective and Contextual Factors Surrounding E-Cigarette and Combustible Tobacco Product Use among Young Adults

by Deepa R. Camenga, Angela M. Haeny, Suchitra Krishnan-Sarin, Stephanie S. O’Malley and Krysten W. Bold

Int. J. Environ. Res. Public Health 2021, 18(21), 11005; https://doi.org/10.3390/ijerph182111005 - 20 Oct 2021

Cited by 7 | Viewed by 1945

Abstract

Background: Dual use of e-cigarettes and combustible tobacco products is common in young adults. We aimed to explore how ratings of subjective and contextual factors differed between discrete episodes of e-cigarette use vs. combustible tobacco product smoking among a sample of young adults. Methods: Young adults (N = 29, ages 18–30) who used e-cigarettes and ≥1 combustible tobacco product at least once weekly completed a 1-week smartphone-based ecological momentary assessment (EMA). Twice daily random prompts assessed past-15-min use of tobacco products, ratings of subjective factors (e.g., negative affect, craving), and contextual factors related to activity, location, and companionship. A multivariable GEE model assessed whether subjective or contextual factors were associated with e-cigarette vs. combustible tobacco product episodes. Results: 184 tobacco use episodes were reported (39.7% e-cigarette, 60.3% combustible tobacco product). High baseline cigarette dependence, as measured by the Fagerström Test for Cigarette Dependence, was associated with lower odds of e-cigarette vs. combustible tobacco product episodes (aOR 0.01, 95% CI (0.002–0.08); p < 0.001). Neither between- or within-subjects negative affect or craving scores were associated with e-cigarette use. Activities of eating/drinking (aOR 0.20, 95% CI (0.08–0.49); p = 0.001) and being in the companionship of a person who smoked cigarettes (aOR 0.13, 95% CI (0.04–0.43); p = 0.001) were associated with lower odds of e-cigarette vs. combustible tobacco product use episodes. However, traveling (aOR 12.02, 95% CI (3.77–38.26); p ≤ 0.001) and being in a public space (aOR 2.76, 95% CI (1.10–6.96); p = 0.03) were associated with higher odds of e-cigarette than combustible tobacco product use episodes. Conclusions: This pilot data suggests that unique contextual factors may be associated with e-cigarette use, compared to combustible tobacco smoking in a sample of young adults who use both e-cigarettes and combustible tobacco products. Future research with larger samples is needed to better characterize varying contexts and cues for tobacco use among young adults who are dual users. Full article

(This article belongs to the Special Issue Polytobacco and Alternative Tobacco Product Use in Young Adults)

13 pages, 325 KiB

Open AccessArticle

Cigar-Smoking-Cessation Interest and Experience among Black Young Adults: A Semi-Structured In-Depth Interview Investigation

by Aniruddh Ajith, Aaron Broun, Danielle A. Duarte, Bambi Jewett, Lilianna Phan, Erin L. Mead-Morse, Mignonne C. Guy, Kelvin Choi and Julia Chen-Sankey

Int. J. Environ. Res. Public Health 2021, 18(14), 7309; https://doi.org/10.3390/ijerph18147309 - 08 Jul 2021

Cited by 8 | Viewed by 2662

Abstract

Although Black/African American populations have high cigar-smoking prevalence, little is known about cigar-smoking cessation among this group. This study explored the perceptions and experiences of cigar-smoking cessation and assistance received from healthcare providers among forty Black young-adult cigar smokers (ages 21–29). Semi-structured in-depth phone interviews were transcribed and coded. Qualitative data were analyzed by using thematic analysis. Participants mostly smoked cigarillos, large cigars, and blunts. Overall, many regular cigarillo smokers reported interest in quitting eventually, while large-cigar and blunt smokers shared less interest in quitting because they perceived low harm from smoking these products. The reasons for cigar-smoking cessation were health concerns and financial constraints. Most of the participants who attempted to quit cigars did not use any cessation aids. The reasons for relapse included nicotine withdrawal, stress, and easy access. Additionally, most participants reported their healthcare providers did not ask whether they smoked cigars, and even when they knew, little assistance for cigar-smoking cessation was provided. Informing Black cigar smokers of the harm of cigar smoking and encouraging healthcare providers to screen for and assist with cigar-smoking cessation may alleviate the health burden of cigar smoking in this population. Full article

(This article belongs to the Special Issue Polytobacco and Alternative Tobacco Product Use in Young Adults)

13 pages, 309 KiB

Open AccessArticle

E-Cigarette Use in Young Adult Never Cigarette Smokers with Disabilities: Results from the Behavioral Risk Factor Surveillance System Survey

by Nkiruka C. Atuegwu, Mark D. Litt, Suchitra Krishnan-Sarin, Reinhard C. Laubenbacher, Mario F. Perez and Eric M. Mortensen

Int. J. Environ. Res. Public Health 2021, 18(10), 5476; https://doi.org/10.3390/ijerph18105476 - 20 May 2021

Cited by 2 | Viewed by 2768

Abstract

Young adult never cigarette smokers with disabilities may be at particular risk for adopting e-cigarettes, but little attention has been paid to these people. This study examines the associations between different types of disability and e-cigarette use in this population. Young adult never-smokers from the 2016–2017 Behavioral Risk Factor Surveillance System (BRFSS) survey who were either never or current e-cigarette users (n = 79,177) were selected for the analysis. The Least Absolute Shrinkage and Selection Operator (LASSO) algorithm was used to select confounders for multivariable logistic regression models. Multivariable logistic regression models were used to determine the associations between current e-cigarette use and different types of disability after incorporating BRFSS survey design and adjusting for confounders. Young adult never-smokers who reported any disability had increased odds (OR 1.44, 95% CI 1.18–1.76) of e-cigarette use compared to those who reported no disability. Young adult never-smokers who reported self-care, cognitive, vision, and independent living disabilities had higher odds of e-cigarette use compared to those who reported no disability. There was no statistically significant difference in the odds of e-cigarette use for those reporting hearing and mobility disabilities compared to those who reported no disability. This study highlights the need for increased public education and cessation programs for this population. Full article

(This article belongs to the Special Issue Polytobacco and Alternative Tobacco Product Use in Young Adults)

Other

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7 pages, 522 KiB

Open AccessBrief Report

College Student E-Cigarette Users’ Knowledge about E-Cigarettes: Ingredients, Health Risks, Device Modifications, and Information Sources

by Alison C. McLeish, Joy L. Hart and Kandi L. Walker

Int. J. Environ. Res. Public Health 2022, 19(4), 1962; https://doi.org/10.3390/ijerph19041962 - 10 Feb 2022

Cited by 4 | Viewed by 3568

Abstract

Although college students represent a growing demographic of e-cigarette users, it is unclear how knowledgeable they are about the product they use. The lack of such knowledge could result in unsafe practices and greater health risks. Therefore, the purpose of the current study was to examine college student e-cigarette users’ knowledge about e-cigarette ingredients and health risks, how often they modify their devices, and whether they utilize reputable sources when searching for information regarding e-cigarettes. The participants were 183 undergraduate e-cigarette users (M_age = 19.98, SD = 1.98; 71.6% female; 85.8% White). Most participants correctly recognized that e-cigarettes increase the risk of cardiovascular disease and lung disease, but fewer than half recognized the increased risk of seizures and depression. Only one-third to one-half of participants correctly identified the toxic compounds commonly found in e-cigarettes, and most indicated that they would consult Google or a friend with questions about e-cigarettes. College student e-cigarette users are well-informed about many health risks associated with e-cigarettes. However, they are relatively unaware of the harmful substances in e-cigarettes and are seeking information from less reliable sources. Targeted public health campaigns educating college students about e-cigarettes, including where to seek reliable information, are needed. Full article

(This article belongs to the Special Issue Polytobacco and Alternative Tobacco Product Use in Young Adults)

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