scholarly journals Waterpipe tobacco package warning exposure’s impact on risk perceptions and use among young adults in the USA: a longitudinal analysis of the population assessment of tobacco and health study

2018 ◽  
Vol 28 (e1) ◽  
pp. e16-e23 ◽  
Author(s):  
Jessica L King ◽  
Beth A Reboussin ◽  
Jennifer Cornacchione Ross ◽  
Erin L Sutfin
Keyword(s):  
Young Adult ◽  
Risk Perceptions ◽  
Health Study ◽  
Regression Analyses ◽  
Population Assessment ◽  
High Exposure ◽  
Factors Associated ◽  
The Usa ◽  
Nationally Representative ◽  
Waterpipe Use

BackgroundAlthough Food and Drug Administration (FDA)-mandated waterpipe tobacco warnings were not required until August 2018, some waterpipe tobacco packaging (WTP) sold in the USA, contained warnings prior to this date. We examined the prevalence of WTP warning exposure and whether exposure influenced risk perceptions or use among young adult (aged 18–24 years) current waterpipe users.MethodsWe used data from waves 1 (2013–2014) and 2 (2014–2015) of the Population Assessment of Tobacco and Health Study, a nationally representative longitudinal study of US adults and youth. We conducted logistic regression analyses to identify factors associated with wave 1 warning exposure, and whether wave 1 WTP warning exposure predicted wave 2 relative risk perceptions and waterpipe use.ResultsMore than one-third of our sample (35.9%, 95% CI 33.5 to 38.4) reported past-month WTP warning exposure. Exposure was higher among males (adjusted OR (AOR)=1.34, 95% CI 1.04 to 1.72), those who usually do not share the waterpipe (AOR=3.10, 95% CI 1.45 to 6.60), those who purchased waterpipe tobacco (AOR=1.73, 95% CI 1.28 to 2.34), and those with a regular brand (AOR=1.84, 95% CI 1.26 to 2.68). Those exposed to WTP warnings at wave 1 were more likely than those not exposed to perceive waterpipe tobacco to be as or more harmful than cigarettes at wave 2 (AOR=1.35, 95% CI 1.02 to 1.78). There was no association between wave 1 WTP exposure and wave 2 waterpipe use.ConclusionsMore than one-third of US young adult current waterpipe users reported WTP warning exposure prior to FDA-mandated warning implementation. Findings suggest the mandated warning may result in high exposure among users; it will be critical to assess exposure’s impact on risk perceptions and behaviour after FDA-mandated warnings are implemented.

scholarly journals Perception of the relative harm of electronic cigarettes compared to cigarettes amongst US adults from 2013 to 2016: analysis of the Population Assessment of Tobacco and Health (PATH) study data

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Layla Malt ◽  
Thomas Verron ◽  
Xavier Cahours ◽  
Mengran Guo ◽  
Sarah Weaver ◽  
...  
Keyword(s):  
Electronic Cigarettes ◽  
Study Data ◽  
Health Study ◽  
Population Assessment ◽  
Current Smoking ◽  
Relative Risks ◽  
Health Agencies ◽  
The Usa ◽  
Former Smokers ◽  
Nationally Representative

Abstract Background Electronic cigarettes (e-cigarettes) have been characterised as significantly less harmful than cigarettes by many health agencies and regulators globally. In this study, we examined to what extent perceived relative harms of e-cigarettes compared to cigarettes have changed in the USA. Methods We analysed the data from the longitudinal and nationally representative, Population Assessment of Tobacco and Health Study to assess the relative perceived harm of e-cigarettes amongst US adults between 2013 and 2016. Results The proportion of US adults who correctly perceived e-cigarettes as less harmful than cigarettes decreased each year from 41.1% (CI 40.1–42.1%) in 2013–2014, 31.5% (CI 30.8–32.2%) in 2014–2015 and 25.3% (CI 24.6–26.0%) in 2015–2016. Concurrently, the proportion of US adults who perceived e-cigarettes as equally, or more, harmful than cigarettes increased from 53.7% (CI 52.3–55.1%), 64.9% (CI 63.6–66.2%) to 72.7% (CI 71.5–73.9%) respectively. The proportion of US adults who held negative relative harm perceptions of e-cigarettes increased regardless of current smoking or vaping status by 24.6% and 29.6% respectively within 3 years. In Wave 3, the proportion of current smokers who perceived the relative harm of e-cigarettes as less harmful was lower at 29.3% (CI 28.2–30.4%) compared to current e-cigarette users at 43.5% (CI 40.3–46.7%). Former smokers who used e-cigarettes and believed that they were equally, or more, harmful than cigarettes in 2014–2015 had significantly higher rates of smoking relapse in the following year, 29% and 37% (p < 2.2e−16), respectively, compared to those with positive relative harm perceptions who reported relapse rates of 19%. Conclusions In this study, the proportion of US adults who incorrectly perceived e-cigarettes as equal to, or more, harmful than cigarettes increased steadily regardless of smoking or vaping status. Current adult smokers appear to be poorly informed about the relative risks of e-cigarettes yet have potentially the most to gain from transitioning to these products. The findings of this study emphasise the urgent need to accurately communicate the reduced relative risk of e-cigarettes compared to continued cigarette smoking and clearly differentiate absolute and relative harms. Further research is required to elucidate why the relative harm of e-cigarettes is misunderstood and continues to deteriorate.

scholarly journals Transitions in hookah (Waterpipe) smoking by U.S. sexual minority adults between 2013 and 2015: the population assessment of tobacco and health study wave 1 and wave 2

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mary Rezk-Hanna ◽  
Ian W. Holloway ◽  
Joy Toyama ◽  
Umme Shefa Warda ◽  
Lorree Catherine Berteau ◽  
...  
Keyword(s):  
Multinomial Logistic Regression ◽  
Health Study ◽  
Chi Square ◽  
Population Assessment ◽  
Logistic Regression Models ◽  
Global Epidemic ◽  
Product Use ◽  
Hookah Smoking ◽  
Nationally Representative ◽  
And Gender

Abstract Background Tobacco smoking using a hookah (i.e., waterpipe) is a global epidemic. While evidence suggests that sexual minorities (SM) have higher odds of hookah use compared to heterosexuals, little is known about their hookah use patterns and transitions. We sought to examine transitions between hookah smoking and use of other tobacco and electronic (e-) products among SM adults aged 18 years of age and older versus their heterosexual counterparts. Methods We analyzed nationally representative data of ever and current hookah smokers from Wave 1 (2013–2014; ever use n = 1014 SM and n = 9462 heterosexuals; current use n = 144 SM and n = 910 heterosexuals) and Wave 2 (2014–2015; ever use n = 901 SM and n = 8049 heterosexuals; current use n = 117 SM and n = 602 heterosexuals) of the Population Assessment of Tobacco and Health Study. Comparisons between groups and gender subgroups within SM identity groups were determined with Rao-Scott chi-square tests and multivariable survey-weighted multinomial logistic regression models were estimated for transition patterns and initiation of electronic product use in Wave 2. Results Ever and current hookah smoking among SM adults (ever use Wave 1: 29% and Wave 2: 31%; current use Wave 1: 4% and Wave 2: 3%) was higher than heterosexuals (ever use Wave 1: 16% and Wave 2: 16%; current use Wave 1: 1% and Wave 2: 1%; both p < 0.0001). Among SM adults who reported hookah use at Wave 1, 46% quit hookah use at Wave 2; 39% continued hookah use and did not transition to other products while 36% of heterosexual adults quit hookah use at Wave 2 and 36% continued hookah use and did not transition to other products. Compared with heterosexuals, SM adults reported higher use of hookah plus e-products (Wave 2 usage increased by 65 and 83%, respectively). Conclusions Compared to heterosexuals, in addition to higher rates of hookah smoking, higher percentages of SM adults transitioned to hookah plus e-product use between 2013 and 2015. Results have implications for stronger efforts to increase awareness of the harmful effects of hookah as well as vaping, specifically tailored among SM communities.

Who Purchases Tobacco Online? Findings from Waves 1 and 4 of the Population Assessment of Tobacco and Health Study

2021 ◽  
Vol 7 (3) ◽  
pp. 155-169
Author(s):  
Jessica L. King ◽  
Julie W. Merten ◽  
Nicole E. Nicksic
Keyword(s):  
Black Youth ◽  
Health Study ◽  
Tobacco Products ◽  
Population Assessment ◽  
Factors Associated ◽  
The Us

Objectives: We examined the prevalence of and factors associated with usually purchasing tobacco online. Methods: We analyzed Waves 1 (2013-14) and 4 (2016-17) of the US Population Assessment of Tobacco and Health adult (18+) and youth (12-17) studies: 15,450 adults and 495 youth in 2013-14 and 15,037 adults and 465 youth in 2016-17. Z-tests compared the prevalence of usually purchasing tobacco online between waves and weighted multivariable regressions identified associations between purchasing online and sociodemographics. Results: The prevalence of usually purchasing tobacco online increased from 2.5% to 3.3% among adults (p < .05) and from 2.5% to 4.4% among youth (p < .05), generalizing to a US population of 2,000,000 adults and 35,000 youth. E-cigarettes and cigars and e-cigarettes and waterpipe tobacco were the most common products among adults and youth, respectively. Men, adults with greater education, adults with higher income, and non-Hispanic black youth had greater odds of purchasing tobacco online (p < .05). Conclusions: Usually purchasing tobacco online remains low, although ever purchasing was not assessed. Efforts should be made to expand Internet tobacco purchasing surveillance and extend and enforce restrictions broadly across tobacco products to reduce youth access.

scholarly journals Longitudinal transitions of exclusive and polytobacco electronic nicotine delivery systems (ENDS) use among youth, young adults and adults in the USA: findings from the PATH Study Waves 1–3 (2013–2016)

2020 ◽  
Vol 29 (Suppl 3) ◽  
pp. s147-s154 ◽  
Author(s):  
Cassandra A Stanton ◽  
Eva Sharma ◽  
Kathryn C Edwards ◽  
Michael J Halenar ◽  
Kristie A Taylor ◽  
...  
Keyword(s):  
Young Adults ◽  
Delivery Systems ◽  
Health Study ◽  
Cross Sectional ◽  
Electronic Nicotine Delivery Systems ◽  
Nicotine Delivery ◽  
The Us ◽  
The Usa ◽  
Nationally Representative ◽  
Reasons For Use

ObjectiveElectronic nicotine delivery systems (ENDS; including e-cigarettes) are rapidly evolving in the US marketplace. This study reports cross-sectional prevalence and longitudinal pathways of ENDS use across 3 years, among US youth (12–17 years), young adults (18–24 years) and adults 25+ (25 years and older).DesignData were from the first three waves (2013–2016) of the Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal cohort study of US youth and adults. Respondents with data at all three waves (youth, n=11 046; young adults, n=6478; adults 25+, n=17 188) were included in longitudinal analyses.ResultsWeighted cross-sectional ever use of ENDS increased at each wave. Across all three waves, young adults had the highest percentages of past 12-month, past 30-day (P30D) and daily P30D ENDS use compared with youth and adults 25+. Only about a quarter of users had persistent P30D ENDS use at each wave. Most ENDS users were polytobacco users. Exclusive Wave 1 ENDS users had a higher proportion of subsequent discontinued any tobacco use compared with polytobacco ENDS users who also used cigarettes.ConclusionsENDS use is most common among young adults compared with youth and adults 25+. However, continued use of ENDS over 2 years is not common for any age group. Health education efforts to reduce the appeal and availability of ENDS products might focus on reducing ENDS experimentation, and on reaching the smaller subgroups of daily ENDS users to better understand their reasons for use.

scholarly journals Longitudinal pathways of exclusive and polytobacco cigar use among youth, young adults and adults in the USA: findings from the PATH Study Waves 1–3 (2013–2016)

2020 ◽  
Vol 29 (Suppl 3) ◽  
pp. s163-s169 ◽  
Author(s):  
Kathryn C Edwards ◽  
Eva Sharma ◽  
Michael J Halenar ◽  
Kristie A Taylor ◽  
Karin A Kasza ◽  
...  
Keyword(s):  
Young Adults ◽  
Tobacco Use ◽  
Age Groups ◽  
Health Impact ◽  
Tobacco Product ◽  
Health Study ◽  
Longitudinal Analyses ◽  
Cross Sectional ◽  
The Usa ◽  
Nationally Representative

ObjectiveThe goal of this study is to examine the cross-sectional prevalence of use and 3-year longitudinal pathways of cigar use in US youth (12-17 years), young adults (18-24 years), and adults 25+ (25 years or older).DesignData were drawn from the first three waves (2013–2016) of the Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal cohort study of US youth and adults. Respondents with data at all three waves (youth, n=11 046; young adults, n=6478; adults 25+, n=17 188) were included in longitudinal analyses.ResultsWeighted cross-sectional prevalence of past 30-day (P30D) use was stable for adults 25+ (~6%), but decreased in youth (Wave 1 (W1) to Wave 3 (W3)=2.5% to 1.2%) and young adults (W1 to W3=15.7% to 14.0%). Among W1 P30D cigar users, over 50% discontinued cigar use (irrespective of other tobacco use) by Wave 2 (W2) or W3. Across age groups, over 70% of W1 P30D cigar users also indicated P30D use of another tobacco product, predominantly cigar polytobacco use with cigarettes. Discontinuing all tobacco use by W2 or W3 was greater in adult exclusive P30D cigar users compared with polytobacco cigar users.ConclusionsAlthough the majority of P30D cigar users discontinued use by W3, adult polytobacco users of cigars were less likely to discontinue all tobacco use than were exclusive cigar users. Tracking patterns of cigar use will allow further assessment of the population health impact of cigars.

scholarly journals Correlates of tobacco product initiation among youth and adults in the USA: findings from the PATH Study Waves 1–3 (2013–2016)

2020 ◽  
Vol 29 (Suppl 3) ◽  
pp. s191-s202 ◽  
Author(s):  
Karin A Kasza ◽  
Kathryn C Edwards ◽  
Zhiqun Tang ◽  
Cassandra A Stanton ◽  
Eva Sharma ◽  
...  
Keyword(s):  
Older Adults ◽  
Tobacco Product ◽  
Health Study ◽  
Product Use ◽  
Frequent Use ◽  
The Us ◽  
The Usa ◽  
Nationally Representative ◽  
Tobacco Initiation

ObjectiveTo report on demographic and tobacco product use correlates of tobacco product initiation (cigarettes, electronic nicotine delivery systems (ENDS), cigars, hookah and smokeless tobacco) among the US population.DesignData were from the first three waves (2013–2016) of the Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal cohort study of US youth (aged 12–17 years) and adults (aged 18+ years). Never users of at least one type of tobacco product at Wave 1 (W1, 2013/14) or Wave 2 (W2, 2014/15) were included (n=12 987 youth; n=25 116 adults). Generalised estimating equations were used to evaluate the association between demographic and tobacco product use characteristics at baseline, and tobacco product initiation at follow-up (ever, past 30 day (P30D), frequent (use on 20 or more of thepast 30 days)) over two 1-year periods (W1–W2 and W2–Wave 3).ResultsYouth aged 15–17 years were more likely than youth aged 12–14 years and adults aged 18–24 years were more likely than older adults to initiate P30D tobacco use across products; non-heterosexuals were more likely than heterosexuals to initiate P30D cigarette and ENDS use. Older adults were more likely than young adults, and males were more likely than females, to be frequent users of ENDS on initiation. Ever use of another tobacco product predicted P30D initiation of each tobacco product.DiscussionOther tobacco product use and age predict P30D tobacco initiation across products whereas associations with other demographic characteristics vary by product. Continued contemporary evaluation of initiation rates within the changing tobacco product marketplace is important.

scholarly journals Flavour types used by youth and adult tobacco users in wave 2 of the Population Assessment of Tobacco and Health (PATH) Study 2014–2015

2019 ◽  
pp. tobaccocontrol-2018-054852 ◽  
Author(s):  
Shyanika W Rose ◽  
Amanda L Johnson ◽  
Allison M Glasser ◽  
Andrea C Villanti ◽  
Bridget K Ambrose ◽  
...  
Keyword(s):  
Young Adult ◽  
Age Groups ◽  
Tobacco Product ◽  
Health Study ◽  
Age Group ◽  
Population Assessment ◽  
Product Use ◽  
Type 3

BackgroundMost youth and young adult (YA) tobacco users use flavoured products; however, little is known about specific flavours used.MethodsWe report flavour types among US tobacco users from the Population Assessment of Tobacco and Health Study, wave 2, 2014–2015. At wave 2, we examined (1) flavour use and type at past 30-day use; (2) new flavoured tobacco product use and type; (3) product-specific flavour patterns across youth (ages 12–17) (n=920), YA (18–24) (n=3726) and adult (25+) (n=10 346) past 30-day and new tobacco users and (4) concordance between self-coded and expert-coded brand flavour type among all adults (18+).ResultsPrevalence of flavoured tobacco product use was highest among youth, followed by YA and adult 25+ any tobacco users. Within each age group, flavoured use was greatest among hookah, e-cigarette and snus users. Overall, menthol/mint, fruit and candy/sweet were the most prevalent flavour types at first and past 30-day use across age groups. For past 30-day use, all flavour types except menthol/mint exhibited an inverse age gradient, with more prevalent use among youth and YAs, followed by adults 25+. Prevalence of menthol/mint use was high (over 50% youth, YAs; 76% adults 25+) and exhibited a positive age gradient overall, though the reverse for cigarettes. Brand-categorised and self-reported flavour use measures among adults 18+ were moderately to substantially concordant across most products.ConclusionsCommon flavours like menthol/mint, fruit and candy/sweet enhance appeal to young tobacco users. Information on flavour types used by product and age can inform tobacco flavour regulations to addess flavour appeal especially among youth.

scholarly journals Longitudinal pathways of exclusive and polytobacco smokeless use among youth, young adults and adults in the USA: findings from the PATH Study Waves 1–3 (2013–2016)

2020 ◽  
Vol 29 (Suppl 3) ◽  
pp. s170-s177 ◽  
Author(s):  
Eva Sharma ◽  
Kathryn C Edwards ◽  
Michael J Halenar ◽  
Kristie A Taylor ◽  
Karin A Kasza ◽  
...  
Keyword(s):  
Young Adults ◽  
Age Groups ◽  
Health Impact ◽  
Health Study ◽  
Longitudinal Analyses ◽  
Common Pathway ◽  
Cross Sectional ◽  
Youth And Young Adults ◽  
The Usa ◽  
Nationally Representative

ObjectiveUse of smokeless tobacco (SLT) with other tobacco products is growing, yet gaps in understanding transitions among SLT and other product use remain. The aim of this study is to examine cross-sectional prevalence and longitudinal pathways of SLT use among US youth (12–17 years), young adults (18–24 years) and adults 25+ (25 years and older).DesignData were drawn from the first three waves (2013–2016) of the Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal cohort study of US youth and adults. Respondents with data at all three waves (youth, n=11 046; young adults, n=6478; adults 25+, n=17 188) were included in longitudinal analyses.ResultsYoung adults had the highest current SLT use compared with other age groups. Among Wave 1 (W1) past 30-day youth and young adult SLT users, most were SLT and cigarette polytobacco users compared with adults 25+, who more often used SLT exclusively. Among W1 exclusive SLT users, persistent exclusive use across all three waves was more common among adults 25+, while transitioning from exclusive SLT use to SLT polytobacco use at Wave 2 or Wave 3 was more common among youth and young adults. Among W1 SLT and cigarette polytobacco users, a common pathway was discontinuing SLT use but continuing other tobacco use.ConclusionsOur results showed distinct longitudinal transitions among exclusive and SLT polytobacco users. Deeper understanding of these critical product transitions will allow for further assessment of population health impact of these products.

Factors associated with physicians' prescribing behavior for treatment of influenza in the USA

2014 ◽  
Vol 8 (1) ◽  
pp. 27-46 ◽  
Author(s):  
Payal Patel-Dovlatabadi
Keyword(s):  
Logistic Regression ◽  
Geographical Location ◽  
Fixed Effect ◽  
Metropolitan Statistical Area ◽  
Regression Analyses ◽  
Content Type ◽  
Prescribing Behavior ◽  
Factors Associated ◽  
The Usa ◽  
Antiviral Medications

Purpose – The aim of this paper is to identify factors (i.e. age, gender, ethnicity, type of medical facility, geographical location, etc.) associated with physicians' prescribing behavior when treating influenza in the USA. The study aims to examine why the number of antiviral prescriptions remains substandard. Design/methodology/approach – Data were obtained from the National Ambulatory Medical Care Survey for each influenza season between the years of 2005-2008. Bivariate analyses and two models of multivariate logistic regression analyses (one with no fixed effect and the other including year as a fixed effect) were used to analyze the data. Findings – The results from this study revealed that among family practice physicians, 40.5 percent prescribed antiviral medications to patients presenting with influenza while 59.5 percent prescribed another form of medication. Antibiotics comprised 41.3 percent of the prescriptions for treatment of influenza. Multivariable logistic regression analyses revealed that race (White; p=0.023), type of health setting (private solo/group practice; p=0.041), employment status (owner; p=0.046), and metropolitan location (metropolitan statistical area; p=0.032) were all significantly associated with prescribing antivirals. Patients' expected source of payment (private insurance) and geographical location (Midwest) of health facility were marginally associated with prescribing antivirals. Originality/value – By identifying factors associated with physicians' prescribing practices of antiviral medications, a more timely diagnosis and treatment of influenza can occur. Efforts should be targeted to improve physician education and awareness of the illness. Interventions may be implemented to improve the prescribing of antiviral medications and potentially inappropriate prescribing.

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