Association of Depression and Suicidality with Electronic and Conventional Cigarette Use in South Korean Adolescents

Background: The prevalence of Korean adolescents with depression was 25.1% in 2017, and the suicide rate among Korean teens increased from 4.2 deaths per 100,000 in 2015 to 4.9 deaths per 100,000 in 2016, suggesting that a high prevalence of depression and suicide among adolescents is a serious social problem in South Korea. Owing to the rapid growth of e-cigarettes in the last several years, it is important for research on smoking and mental health to distinguish different uses of tobacco products. Objectives: To examine the relationship between depression and suicidality among Korean adolescents, classified into nonusers, conventional-cigarette-only users, e-cigarette-only users, and dual users. Methods: Data were examined from the 2017 Korean Youth Risk Behavior Web-based Survey. The study included 62,276 students. A multivariate logistic regression was performed to assess the association of depression and suicidality with electronic and conventional cigarette use. Results: There were significant differences among the users: dual users had a higher prevalence of depression and suicidality for both lifetime and current use; e-cigarette-only users had higher levels of depression and suicidality than nonusers; and among female adolescents, conventional-cigarette-only users, e-cigarette-only users, and dual users had a higher prevalence of depression and suicidality than male adolescents. Conclusions: This is the first study to assess the association of depression and suicidality with conventional and e-cigarette use using a nationally representative Korean adolescent sample. These findings suggest an urgent need for evaluation of and intervention for e-cigarette use by health professionals providing smoking cessation programs for adolescents.     

Tobacco Use,Heavy Use,and Dependence Among Adolescents and Young Adults in the United States

Tobacco involvement among US youth was investigated in a national survey conducted in 2005–2007 of 2,274 respondents aged 14–21, including those not in school. Logistic regressions predicted tobacco involvement. Males had higher rates of tobacco use than females, but males and females had equal rates of heavy use and dependence. Tobacco involvement increased with age. Whites were more tobacco involved than minorities. Tobacco involvement declined with increasing socioeconomic status. Reduced tobacco use was associated with being married and with being a student. Smokeless tobacco use was associated with being male, older, white, and lower socioeconomic status. The implications of these results are discussed.     

Sense of Coherence and Tobacco Use Myths Among Adolescents as Predictors of At-Risk Youth Cigarette Use

We examined the association between a general construct of wellness beliefs, sense of coherence, and a specific measure of tobacco-related beliefs, tobacco use myths, as predictors of two smoking-related outcome measures—next year smoking expectation and last 30-day smoking. Self-report questionnaires were administered to 710 adolescents attending California continuation high schools at baseline and at 1-year follow-up between 2006 and 2008. Cross-sectionally, predictor and outcome measures were correlated. However, in longitudinal analyses, only tobacco use myths predicted change in outcome measures. We speculate that future smoking interventions among adolescents would achieve relatively efficacious outcomes by targeting specific health beliefs instead of global health beliefs. The study's limitations are noted.     

Relations Between Parental Distress Intolerance,Adolescent Motives for Cigarette Use,and Adolescent Cigarette Smoking Levels

Background: A relatively large body of evidence indicates that coping motives for cigarette smoking are associated with a number of problematic outcomes (e.g., greater smoking frequency) among adolescents. Evidence also indicates that lower distress tolerance (or higher distress intolerance) is related to higher levels of coping motives for cigarette smoking among adults and adolescents. Therefore, it is critical to improve our understanding of factors that may increase the likelihood of smoking to cope among adolescents. In addition, evidence suggests that a number of parenting behaviors may affect adolescent smoking behavior. No work to date, however, has examined the relation between parental distress intolerance and adolescent smoking motives, or adolescent smoking behavior. Objective/methods: The current study involving adolescents (n?=?46) and one of their parents aimed to address this gap in the literature by examining the association between parent-reported parental distress intolerance, self-reported adolescent motives for cigarette use, and self-reported adolescent cigarette smoking levels. Results: Results indicated that parental distress intolerance was related to greater adolescent coping motives for cigarette smoking, but not to other motives for adolescent cigarette use. Furthermore, results indicated that parental distress intolerance was indirectly associated with higher adolescent cigarette smoking levels through adolescent coping motives for cigarette smoking. Conclusions: Parental distress intolerance is associated with coping motives for adolescent cigarette smoking. This suggests parental emotional factors may be associated with adolescent cigarette use.     

The Need for Nationwide Electronic Cigarette Smoking Cessation Curricula Across the Healthcare Spectrum

Using electronic nicotine delivery systems (ENDS) has become a stepping stone for smokers in their cessation of tobacco use. Students within Doctor of Pharmacy and other health care programs have expressed varying responses as to how likely they are to recommend ENDS based on their knowledge of these devices. Because the amount of education on these products provided by PharmD programs varies, one study shows student pharmacists were less likely to recommend the use of ENDS to current cigarette smokers. This commentary suggests why some student pharmacists support such recommendations and therefore require more adequate ENDS education to better equip themselves for future patient education counseling sessions.     

The Moderating Role of Parental Monitoring on the Influence of Peer Pro-Drug Norms on Alcohol and Cigarette Use Among Adolescents in Mexico

This study utilized data drawn from a study of 980 adolescents living in Tijuana, Mexico, in February 2009 to examine whether parental monitoring had a moderating impact on the influence of peer pro-drug norms on lifetime and past-30-day alcohol and cigarette use among a group of adolescents living along the United States–Mexico border. The results of primary analyses indicated that parental monitoring did moderate the influence of peer pro-drug norms for past-30-day cigarette use for males but not for females. Research and practice implications for U.S. and Mexican culturally grounded prevention programs are discussed.     

Willingness to Try Electronic Cigarettes Among UK Adolescents

Purpose: To investigate factors that lead to willingness to try electronic cigarettes among UK adolescents. Methods: A sample of 16- to 19-year-old pupils (N = 256) completed a questionnaire. Results: Smoking status significantly predicted more than one-third of the variance of willingness to try an electronic cigarette and a further 7.8% was significantly predicted by a positive prototype of a smoker (e.g., stylish) and a negative prototype of an electronic cigarette user (e.g., unattractive). Moreover, tobacco-flavored electronic cigarettes were less favorable than alternative flavors such as fruit, chocolate, and mint. Conclusions: Findings provide evidence that flavored electronic cigarettes are more appealing to all; adolescents, smokers, non-smokers, current and past electronic cigarette users, and never users.     

The Prevalence and Marketing of Electronic Cigarettes in Proximity to At-Risk Youths: An Investigation of Point-of-Sale Practices Near Alternative High Schools

This study examines the point-of-sale marketing practices used to promote electronic cigarettes at stores near schools that serve at-risk youths. One hundred stores selling tobacco products within a half-mile of alternative high schools in Southern California were assessed for this study. Seventy percent of stores in the sample sold electronic cigarettes. Convenience stores heavily frequented by youths had the highest number of interior ads for e-cigarettes and were the most likely to employ in-store product placement strategies. Increased exposure to the promotion of these products at the point of sale poses a challenge for antismoking efforts directed toward vulnerable populations.     

The Role of Emotional Distress in Drug Use Among Latino Adolescents

The Latino population is one of the fastest growing populations in the country and, relative to other groups, it is a population which must cope with a number of immigration-related stressors. As a result, Latino adolescents may be at special risk for emotional distress and drug use in Latino adolescents. Comorbidity of emotional distress and drug use, the question of whether emotional distress is an antecedent or consequence of drug use, assessment issues, and the relationship between emotional distress, drug use, and high risk behaviors are among the issues addressed. In a survey of primarily 9th and 10th grade immigrant Mexican students, emotional distress was assessed using three abbreviated scales of depression, hostility, and anxiety based on the Hopkins Symptom checklist, a history of suicide attempts was also assessed. Frequency and quantity of ten substances including alcohol, cigarettes, and hard drugs also were assessed. Most types of drug use were significantly correlated with emotional distress and positive history of suicide attempt. A high frequency of alcohol use and inhalant use were associated with emotional distress and a positive history of suicide attempts. Hostility was most strongly correlated with drug use. It is suggested that hostility as well as moderate to high depression symptom levels be considered risk factors for drug use and suicidality in Latino adolescents. It is also recommended that emotional distress be explicitly addressed in the treatment of drug abuse and other problem behaviors in Latino adolescents.     

Waterpipe Use Predicts Progression to Regular Cigarette Smoking Among Danish Youth

Waterpipe smoking among Danish, Swedish, and German youth is increasing dramatically, indicating the emergence of a new health threat. This study assessed the association between waterpipe smoking and progression to regular cigarette smoking among Danish continuation school students during 2004–2005. All participants (N = 762) had smoked cigarettes on a nonregular basis at baseline. Among boys, waterpipe smoking frequency was predictive of being a regular cigarette smoker at follow-up eight months later. Further research should examine waterpipe smoking as a potential predictor of cigarette smoking. The study's limitations are noted.     

#Vapelife: An Exploratory Study of Electronic Cigarette Use and Promotion on Instagram

Background: The growth of social networking services has enabled the sharing of electronic cigarette opinions and experiences via user-generated content. Objectives: This exploratory study analyzed electronic cigarette content found on the visual social networking service, Instagram, in order to highlight public health challenges created by this content and support understanding of electronic cigarette promotion and usage. Methods: A qualitative content analysis was performed on Instagram posts made with the hashtags #ecig or #vape in October 2014. Images, text, and hashtags from 85 posts (43 #ecig, 42 #vape) were analyzed. In addition, the total number of posts made with eight key electronic cigarette hashtags was recorded at four points between March 2014 and October 2015. Results: The total number of #vape posts on Instagram grew by 4,163,274 during the study period, while #ecig posts increased by 741,916. Of the posts examined in-depth, corporate users made up over half of posts. No posts were critical of electronic cigarettes. Few mentioned electronic cigarettes in the context of health benefits. No posts included major brands, and mod style electronic cigarettes were mentioned or depicted in over half of posts. A majority of posts included hashtags expressing vaping identity and community. In addition, users mentioned novel practices such as sub-ohming. Conclusions/Importance: Instagram users in our sample characterized electronic cigarettes primarily as novel devices rather than equivalents to cigarettes. Further, hashtag communities and identities appear to be forming around vaping. Future research should consider the public health implications of these hashtags, as well as novel electronic cigarette practices.     

An Examination of Social Anxiety in Marijuana and Cigarette Use Motives Among Adolescents

Marijuana and nicotine are two of the most widely used substances among adolescents in the United States. Symptoms of social anxiety (SA) typically emerge during early adolescence, and elevated levels are associated with increased substance-related problems despite inconsistent links to frequency of use. Substance use motives, and in particular coping motives, have been found to play an important role in understanding the heightened risk for use problems among those with elevated SA. Importantly, work to date has been conducted almost exclusively with adult samples; thus the current study examined whether similar patterns would emerge among adolescents. The current project included 56 community-recruited adolescents (ages 12–17 years; 41% girls) with a positive history of lifetime marijuana and cigarette use. Consistent with the adult literature, SA was not positively associated with frequency of use across either substance. Further, SA was positively associated with conformity use motives and unrelated to social or enhancement motives for both substances. Unexpectedly, SA was unrelated to coping use motives for either marijuana or cigarettes. These preliminary data highlight the need for future research designed to forward developmentally sensitive models of substance use behaviors and etiology.     

The Role of Parenting in Drug Use Among Black,Latino and White Adolescents

Abstract

This study investigates the role of parenting in adolescent drug use for black, white and Latino adolescents. Parenting has been consistently identified as a crucial factor in drug use by adolescents. This study uses data from the National Longitudinal Study of Adolescent Health. Results show that parenting has a significant effect on drug use for these adolescents. The relationship between parenting and drug use is more strongly negative for the Latino adolescents, than for black and white adolescents. This indicates that greater parental warmth and family acceptance exert a stronger impact in reducing drug use for Latino adolescents than is the case for the black and white adolescents.     

Predictors of Alcohol Use Among Status-Offending Adolescents: Youth and Parent Perspectives

Research exploring parent–child relationships suggests parents often have divergent perspectives from their adolescent children. Understanding youths' and parents' reports in predicting alcohol use is particularly important among detained youths who are at elevated risk for substance-related problems. This exploratory study queried youth entrants to a juvenile detention center (N = 150) and their parents (N = 89) on a host of individual and familial factors to determine risks associated with youths' drinking from youth and parent perspectives. Findings suggest that, in addition to assessing youths' self-reports at juvenile detention admission, parents' divergent views of their teens' alcohol use offer a valuable perspective.     

Alcohol and Cigarette Use Among Warsaw Adolescents: Factors Associated With Risk and Resilience

Background: Youth in Poland are at notable risk for substance use. Guided by resiliency theory, we examine if developmental risk and promotive factors are associated with substance abuse risk. Objectives: We examined the association between adolescent cigarette and alcohol use and related risk and promotive factors including maternal support, neighbors' informal social control, friends' acceptance of substance use, and alcohol and cigarette use by nonparental adults. Method: Data were collected from a random sample of 13- to 14-year-old students attending Warsaw middle schools (N = 3029). We used hierarchical regression models and examined compensatory and protective models of resilience, controlling for sociodemograhic factors. Results: Our results indicated that friends' acceptance of substance use and perceived drug use among nonparental adults was associated with increased risk cigarette and alcohol use among youth. We found that maternal support moderated the relationship between friends' acceptance of substance use and cigarette use (protective model of resilience). Thus, mother support buffered the negative effects of friends' acceptance of substance use on youths' cigarette use. Neighbor's informal social control and maternal support were associated with reduced risk of alcohol use (compensatory model of resilience). Conclusion: Collectively, results of the study support compensatory and protective models of resilience in a large representative sample of Warsaw adolescents.     

The Importance of Peers in Alcohol Use Among Latino Adolescents: The Role of Alcohol Expectancies and Acculturation

Abstract

The present study examined the potentially mediating effect of alcohol expectancies and moderating effect of acculturation on the relationship between peer alcohol use and Latino adolescent alcohol use. Participants were 115 adolescents recruited through alternative schools, community events, a community psychologist, and Latino groups at a midwestern university. Questionnaires in this study assessed adolescents' perceptions about both their own and their peers' alcohol use in addition to their expectancies about the effects of alcohol, and their level of acculturation. Demographic characteristics of the sample were also assessed in order to control for their possible effects (e.g., age, gender). Results from the present study indicated that a higher level of peer alcohol use was associated with a higher level of adolescent alcohol use. Additionally, adolescents' expectancies about the effect of alcohol on their social behavior mediated the relationship between peer alcohol use and adolescent alcohol use. Results support previous research suggesting the importance of peers as role models for Latino adolescent alcohol use. Acculturation did not moderate the relationship between peer and adolescent alcohol use. The present study adds understanding as to how Latino adolescents' beliefs regarding alcohol use may influence the relationship between peer alcohol use and adolescent alcohol use.     

Pathways from Acculturation Stress to Substance Use Among Latino Adolescents

The purpose of this study was to examine the link between acculturation stress and substance use among Latino adolescents. In-home interviews were completed with the participants at four time-points between 2005 and 2007. Path analysis was completed using longitudinal data from 286 Latino adolescents living in North Carolina and Arizona (65% foreign-born). Results indicate that acculturation stress influences family and friend relationships, which in turn affect adolescent mental health problems, and finally, substance use. Key mediators in the pathway from acculturation stress to substance use were parent–adolescent conflict, internalizing, and externalizing problems. Implications for practice and research have been discussed here.