03 Dec Surprising Impact of COVID-19 Impact on Youth E-Cigarette Use
Posted at 17:45h
in Author Interviews, COVID -19 Coronavirus, JAMA, Pediatrics, Smoking, Stanford, Tobacco, Tobacco Research
MedicalResearch.com Interview with:
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Dr. Halpern-Felsher[/caption]
Bonnie Halpern-Felsher, PhD, FSAHM (pronouns: she/her)
Professor of Pediatrics
Taube Endowed Research Faculty Scholar
Professor (by courtesy), Epidemiology and Population Health
Professor (by courtesy), Psychiatry and Behavioral Sciences
Director of Fellows’ Scholarship, Department of Pediatrics
Director of Research, Division of Adolescent Medicine
Co-leader, Scholarly Concentrations, Pediatrics Residency Program
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: To examine adolescent and young adult e-cigarette use during the COVID-19 pandemic.
There were 4 main findings:
- About 2/3 of adolescent and young adult ever-e-cigarette users reported either quitting or cutting back on e-cigarette use since COVID-19 began.
- Users least likely to quit or cut back e-cigarette use were those showing higher levels of nicotine dependence and those who had used e- cigarettes a large number of times.
- Adolescent and young adult e-cigarette users found it harder to access e-cigarettes, but unlike studies before COVID-19, the dominant source of purchasing e-cigs was online instead of brick-and-mortar during COVID-19 pandemic.
- Youth below 21 years were able to purchase e-cigarettes without any age verification, and those whose age was verified were asked to physically show ID or provided an email, which are less effective means to prevent underage youth use.
Dr. Goyal[/caption]
Dr. Monika K. Goyal, MD
Associate Division Chief, Emergency Medicine
Children’s National Hospital
Department of Pediatrics, School of Medicine and Health Sciences
The George Washington University
Washington, District of Columbia
MedicalResearch.com: What is the background for this study?
Response: There has been growing attention to the disproportionate use of police force in communities of color. Therefore, we sought to investigate whether Black and Hispanic teenagers have higher rates of death due to police shootings when compared to white youth.
Dr. Flaherty[/caption]
Michael R. Flaherty, DO
Attending, Pediatric Critical Care Medicine
Co-Director, Trauma and Injury Prevention Outreach Program, MGH
Instructor in Pediatrics,
Harvard Medical School
Boston, MA 02114
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This study was a joint collaboration between Massachusetts General Hospital and Boston Children’s Hospital. The Consumer Product Safety Commission (CPSC) found an increasing incidence of rare earth magnet ingestions by children causing serious injury; Injuries are particularly serious when a child ingests two of these small magnets, or a magnet with another metal object – this can lead to bowel walls becoming attached and kinked, leading to catastrophic bowel injury and/or death.
The Consumer Product Safety Commission initiated campaigns to limit sales in 2012 with voluntary recalls and safety standards, as well as public awareness campaigns, legislative advocacy, and lawsuits. In October 2014, the CPSC published their final rule, “Safety Standard for Magnet Sets,” which prohibited the sale of magnets based on a pre-specified size and power scale, essentially eliminating the ability to sell SREMs. This rule was appealed by largest manufacturer of these magnets, Zen Magnets, LLC., and in November 2016 this rule was legally reversed by the U.S. Court of Appeals Tenth Circuit resulting in a resurgence of these magnets on the market. 
Dr. Kubik[/caption]
Martha Kubik, Ph.D., R.N.
Professor and director of the School of Nursing
College of Health and Human Services at George Mason University
USPSTF Task Force Member
MedicalResearch.com: What is the background for this study? What are the main findings? Has the recommendation changed over the last decade?
Response: High blood pressure is becoming more common among children and teens in the United States and can have serious negative health effects in childhood and adulthood, such as kidney and heart disease. However, there is not enough research to know whether treating high blood pressure in young people improves cardiovascular health in adulthood.
The Task Force continued to find that there is not enough evidence to recommend for or against screening for high blood pressure in children and teens who do not have signs or symptoms. 
Prof. Pottel[/caption]
Prof. Dr. Hans Pottel PhD
Professeur Invité (titre honorifique)
Faculté de Médecine
Université de Liège
KULeuven-KULAK, Kortrijk, Belgium
MedicalResearch.com: What is the background for this study? Why do we need a new GFR?
Response: The currently recommended equations have flaws, mainly because there is one equation (CKiD) recommended for children, and one recommended (CKD-EPI) for adults (by KDIGO). When transitioning from pediatric nephrology care to adult nephrology care, the switch from CKiD to CKD-EPI causes implausible jumps (of more than 50%), mainly because CKD-EPI largely overestimates GFR in young adults (18-30 years). The new equation overcomes this problem as it applies for all ages (for children and adults) and overcomes the known flaws of the currently most used equations. The new equation is less biased and more precise across the full age spectrum and for the full range of serum creatinine concentrations.
The equation was developed in 11 251 participants from 7 cohorts (development and internal validation datasets) and validated in 8 378 participants from 6 cohorts (external validation dataset). Data were coming from European and American nephrology centers. No patients of African-American ancestry were included. Actually, the previously published FAS-equation served as the basic mathematical form for the equation, but we adjusted the power coefficients for serum creatinine (very much like it was done in the CKD-EPI equation). You could say that we used properties of both the FAS and CKD-EPI equation to come to an improved equation to estimate GFR. 
Dr. Ganson[/caption]
Kyle T. Ganson, PhD, MSW
Assistant Professor, Factor-Inwentash Faculty of Social Work
University of Toronto
Toronto, Canada
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Dr. Nagata[/caption]
Jason Nagata, MD, MSc
Assistant Professor of Pediatrics
University of California, San Francisco
San Francisco, California, USA
MedicalResearch.com: What is the background for this study?
Response: A quarter of young adults in the US have reported being unemployed during the COVID-19 pandemic. Young adults may be especially affected by employment loss as they often work in industries most adversely affected by social distancing.
MedicalResearch.com: What are the main findings?
Response: Among a sample of nearly 5,000 young adults age 18 to 26 in the US, we found that since March 2020, young adults who lost their job or were part of a household that experienced employment loss were more likely than those with secure employment to experience four common symptoms of anxiety and depression. This was also true of young adults who expected an employment loss in the next four weeks. The study also found that symptoms of anxiety and depression were common among the sample of young adults. In the seven days prior to the survey, 75% reported being nervous, anxious or on edge, 68% reported not being able to stop or control worrying, 67% reported having little interest or pleasure in doing things, and 64% reported feeling down, depressed, or hopeless.
Dr. Bragg[/caption]
Marie Bragg, PhD
Assistant Professor, Department of Population Health on Health Choice
NYU College of Global Public Health
MedicalResearch.com: What is the background for this study?
Response: We know from previous research that children who see food advertisements eat significantly more calories than children who see non-food advertisements. Those studies led the World Health Organization and National Academy of Medicine to issue reports declaring that exposure to food advertising is a major driver of childhood obesity.
What we don’t know is how frequently unhealthy food and beverage brands are appearing in YouTube videos posted by Kid Influencers. Kid influences are children whose parents film videos of the child playing with toys, unwrapping presents, eating food, or engaging in other family-friendly activities. The parents then post the videos to YouTube for other children and parents to view for entertainment. 
Response: The background for this study involves the associations of household rules and parental awareness with youth tobacco use using data from the Population Assessment Tobacco and Health Study. Health concerns regarding non-cigarette tobacco products, specifically e-cigarettes, have been on the rise. We wanted to explore whether parents are up to date with the trends of popular tobacco products today and what role they may play in youth tobacco cessation and prevention.
The main findings of the study revealed that parents less often suspected their children’s tobacco use if their children reported using only e-cigarettes, and other non-cigarette tobacco products, when compared with cigarettes. Additionally, we found that youth who agreed with their parents that their home has strict rules for tobacco use were less likely to initiate of tobacco use compared to youth who had different understanding of the rules from their parents or youth from households with more permissive household rules. 
Melanie Leung[/caption]
Melanie Leung, M.D.,C.M. candidate 2021
4th-year medical student at McGill University
Division of Allergy and Clinical Immunology
Department of Pediatrics, Montreal Children’s Hospital
McGill University Health Centre, Montreal, QC, Canada
Dr. Moshe Ben-Shoshan, MD, MSc
Pediatric allergist and immunologist at the MCH (Montreal Children’s Hospital) and
Scientist at the Research Institute of the MUHC (McGill University Health Center)
MedicalResearch.com: What is the background for this study?
Response: In Canada, up to 9% of children have at least 1 food allergy. Anaphylaxis is the most severe and potential life-threatening manifestation of food allergy. Peanuts and tree nuts are the main culprits in food-induced anaphylaxis and account for most fatal cases in North America.
Public awareness about peanut and nut anaphylaxis can help to prevent and to act promptly, in the case of anaphylactic reaction. However, the best timing for public awareness campaigns remained unknown, as no previous study looked at the potential association between specific times of the year, such as public holidays, and the incidence of peanut and tree nut anaphylaxis. Our aim was to evaluate the risk of peanut and tree nut-induced anaphylaxis on Halloween, Christmas, Easter, Diwali, Chinese New Year, and Eid al-Adha.
Data was collected from 1390 pediatric cases of peanut or nut-induced anaphylaxis across Canada (Newfoundland & Labrador, Quebec, Ontario, and British Columbia), from 2011 to 2020. 62% of children were boys and the median age was 5.4 years. We compared the average daily number of cases during each holiday and compared it to the rest of the year (i.e.: non-holiday period). 
Dr. Lara-Corrales[/caption]
Irene Lara-Corrales, MD
Associate Professor of Pediatrics at the University of Toronto
Staff physician in Pediatric Dermatology at the
Hospital for Sick Children in Toronto, Canada
She is a member of the 
Dr. Auger[/caption]
Katherine A. S. Auger, MD, MSc
Division of Hospital Medicine
James M. Anderson Center for Health Systems Excellence,
Cincinnati Children’s Hospital Medical Center
Department of Pediatrics, University of Cincinnati College of Medicine
Pediatric Research in Inpatient Settings Network
Cincinnati, Ohio
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: All states closed schools in the spring of 2020 to try to mitigate the spread of COVID-19. Our study demonstrated a large, significant association between school closure and fewer COVID-19 cases and deaths even when accounting for other state policies.
Dr. Ellingson[/caption]
Jarrod Ellingson PhD
Assistant Professor
Department of Psychiatry
Anschutz Medical Campus
University of Colorado Denver
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We know that cannabis use is associated with many negative outcomes, but there could be many of reasons for that. For example, socioeconomic factors and peer influences both affect adolescent cannabis use and poorer cognitive functioning. To account for some of those risk factors, we studied nearly 600 sibling pairs with moderate to heavy cannabis use. We found that, as a person uses more cannabis than their sibling, they tend to have worse memory recall than their sibling. 
Dr. Shoaff[/caption]
Jessica Shoaff, MPH, PhD
Postdoctoral Research Fellow and
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Dr. Korrick[/caption]
Susan A. Korrick, MD
Pulmonary and Critical Care
Assistant Professor in the Department of Environmental Health
Harvard Medical School · Harvard T. H. Chan School of Public Health
Brigham and Women's Hospital
Channing Laboratory Boston, MA 02115
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Our study posed the question: Do teenagers’ exposures to chemicals that are often found in consumer products increase behaviors that are common among individuals diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD)? Our results suggest that teenagers exposed to chemicals often found in consumer products (particularly phthalates) may have increased behaviors that are common among individuals diagnosed with ADHD. However, we did not study the diagnosis of ADHD (most of our study teens did not have ADHD). This means our results cannot answer the question of whether these chemical exposures increase the likelihood of being diagnosed with ADHD. Also, in our study design, chemical exposures and ADHD-related behaviors were measured at the same time, so it is not possible to know with certainty whether the chemical exposures altered behavior or behavior altered chemical exposures. 
Dr. Yonker[/caption]
Lael Yonker, MD
Pediatric Pulmonology
Director, MGH Cystic Fibrosis Center
Principal Investigator, Pediatric COVID biorepository
Mucosal Immunology and Biology Research Center
Massachusetts General Hospital
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Children were initially felt to be spared from the COVID-19 pandemic. Here, we show that children can become sick from SARS-CoV-2 infection, and even if the initial illness is mild, some go on to develop a severe inflammatory illness after the initial illness. We also show that children can carry very high levels of virus early in the course of infection, suggesting they may play a larger role in spreading the virus than previously thought.
Dr. Ratnasiri[/caption]
Anura Ratnasiri PhD
Senior Research Scientist
(Epidemiology and Biostatistics) Benefits Division
Department of Health Care Services
Sacramento, CA 95899-7417
MedicalResearch.com: What is the background for this study?
Response: Infant mortality rate (IMR) is a widely-reported indicator of population health and is used as a standardized measurement of deaths in the first year of life per thousand live births. While IMR has been steadily declining in the United States, it remains relatively high compared with other developed countries.
Even though significant improvements have been made in the quality and access to neonatal and infant care during the past decade, large educational, socioeconomic, racial, ethnic, geographic and behavioral disparities persist, and appear to be responsible for significant differences in IMR among different subgroups. Certain maternal and infant characteristics have important associations with IMR, and this study attempted to quantify major maternal and infant predictors, and trace associated mortality trends during the study period.
There were no recent studies on infant mortality using a large data set such as California State. Moreover, gestational age based on obstetric estimates from fetal ultrasound, prepregnancy obesity, and smoking during pregnancy were not available in prior population-based studies in California.
Dr. Walline[/caption]
Jeffrey J. Walline, OD PhD
Associate Dean for Research
The Ohio State University
Columbus, OH 43210-1240
MedicalResearch.com: What is the background for this study?
Response: Greater amounts of nearsightedness are related to higher risks of sight-threatening complications in adulthood, so anything we can do to slow the progression of nearsightedness in childhood can have meaningful benefits in the future.
As the prevalence of nearsightedness increases worldwide and affects approximately 1/3 of the people in the United States, a treatment that provides clear vision AND slows the progression of nearsightedness can have a profound effect.