Socio-temporal Contextual and Community Factors Associated with Daily Exclusive ENDS Use and Dual Us
Thursday, January 5, 2023
Posted by: Natalia Gromov
Abadi
MH, Shamblen SR, Thompson K, et al.
Socio-temporal Contextual
and Community Factors Associated with Daily Exclusive ENDS Use and Dual Use
with Tobacco Cigarettes among Adolescent Vapers: an Ecological Momentary
Assessment Study.
BMC Public Health. 2022;22(1):2289. Published 2022 Dec 7.
doi:10.1186/s12889-022-14787-1
Background. Adolescents
who dual use ENDS with tobacco cigarettes are more likely to have an increased
risk of developing dependence. Yet, little is understood about the factors
driving dual use among adolescents. The current study sought to reveal the
day-to-day socio-temporal contextual and community factors associated with
adolescents' use of electronic nicotine delivery systems (ENDS), and how these
factors predict dual use with tobacco cigarettes.
Methods. We
collected ecological momentary assessments (EMA) from a sample of 50 adolescent
past two-week vapers (ages 14-17 years old) over 14 days. Daily EMA data were
collected on ENDS and tobacco cigarette use, as well as a range of contextual
(i.e., motivations to vape, location of vaping, who with when vaping) and
community factors (i.e., exposure to peers vaping, to adults vaping, to ENDS
advertising, to ENDS warning messages). Our primary analyses were multilevel
regressions, accounting for daily observations nested within individuals (N =
700 observations).
Results. Participants
used ENDS exclusively on 44% of days and dual used ENDS and tobacco cigarettes
on 8% of the days. Dual use days (versus exclusive ENDS use days) were
associated with "vaping because tobacco use was prohibited" (OR =
34.65, p < .05). Also, dual use days (versus no use days) were associated
with greater exposure to adults vaping (OR = 5.59, p < .05), peers vaping
(OR = 7.48, p < .05), and (c) ENDS advertisements or promotions (OR = 2.12,
p < .01), whereas exclusive use days (versus no use days) were only
associated with greater exposure to peers vaping (OR = 2.58, p < .01).
Conclusions. Results
showed that exposure to peers and adults vaping and exposure to ENDS marketing
were associated with same day dual use behaviors. And, that adolescents who
dual used were motivated to use ENDS because they were easy to conceal.
Findings support stricter regulation of ENDS marketing and for smoke-free air
laws that include ENDS. In addition, these findings support prioritizing
family- and school-based prevention programming that effectively communicates
risk associated with ENDS use, including heightened risk of dual use and
dependence. Such efforts can reduce the number of adolescents who use ENDS as
well as the number who transition to tobacco cigarette use.
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