Author Interviews, COVID -19 Coronavirus, JAMA, Pediatrics, Smoking, Stanford, Tobacco, Tobacco Research / 03.12.2020
Surprising Impact of COVID-19 Impact on Youth E-Cigarette Use
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:
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. Al Rifai[/caption]
Mahmoud Al Rifai, MD, MPH
Cardiovascular Disease Fellow
Baylor College of Medicine Houston, TX
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Dr. Virani[/caption]
Salim S. Virani, MD, PhD, FACC, FAHA, FASPC
Professor, Section of Cardiovascular Research
Director, Cardiology Fellowship Training Program
Baylor College of Medicine
Staff Cardiologist, Michael E. DeBakey Veterans Affairs Medical Center
Co-Director, VA Advanced Fellowship in Health Services Research & Development at the Michael E. DeBakey VA Medical Center
Investigator, Health Policy, Quality and Informatics Program
Michael E. DeBakey Veterans Affairs Medical Center HSR&D Center of Innovation Houston, TX
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: E-cigarettes have gained popularity since their introduction in the U.S. market nearly 20 years ago and their use has increased especially among younger adults. On the other hand, public health efforts aimed at curbing tobacco use over the past few decades have resulted in a decrease in cigarette use. However, state-specific laws and regional cultural differences with regards to perception of these products may result in variability in tobacco use patterns. We therefore evaluate temporal changes in e-cigarette and cigarette use in each U.S. state between the years 2016 to 2018.
Dr. Al Rafai[/caption]
Mahmoud Al Rifai MD MPH
Section of Cardiology, Department of Medicine
Baylor College of Medicine Houston
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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. 
Dr. Lanza[/caption]
Isabella Lanza, PhD
Associate Professor of Human Development
California State University, Long Beach
MedicalResearch.com: What is the background for this study? What are the main findings? Response: This is the first study to examine both nicotine vaping and cannabis vaping trajectories across adolescence and young adulthood, which allowed us to assess whether poly-substance vaping is common among adolescents and young adults. Poly-substance vaping (nicotine and cannabis vaping) was reported among a significant proportion of participants in the study (25% were identified as poly-substance vapers). For those that either escalated to frequent nicotine vaping use in adolescence or initiated frequent nicotine vaping use in young adulthood, the probability of engaging in cannabis vaping was very high (85%+).
Dr. Bandi[/caption]
Priti Bandi PhD
Principal Scientist, Risk Factors Surveillance Research
American Cancer Society, Inc.
Atlanta, GA 30303
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Trends in e-cigarette prevalence and population count of users according to cigarette smoking histories are unknown. These data are needed to inform public health actions against a rapidly changing U.S. e-cigarette market.
Dr. Hollingsworth[/caption]
Alex Hollingsworth PhD
Assistant Professor
O'Neill School of Public and Environmental Affairs
Indiana University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: I've been working with Coady Wing and Ashley Bradford on a few different studies of the effects of recreational marijuana laws on drug and alcohol use.
Soon after EVALI became a major issue, the prevailing theory from the CDC and others was that EVALI was caused by the use of vitamin E acetate in illegal THC vaping products.
Our group read about this and we thought about some of the things that often happen in black markets for illegal drugs. For instance, during the alcohol prohibition era, bootleg alcohol producers often made and sold alcohol products that were not that safe to drink. In more recent years, there are cases where black market sellers of illegal drugs like heroin try to increase profit margins by adding other substances, which can be harmful.
We thought that maybe something like that could be happening in EVALI. Perhaps people in states where recreational marijuana is legal tended to purchase marijuana products from the legal market and the legal market was not selling any marijuana vaping products that included vitamin E acetate.
Dr. Hongying (Daisy) Dai[/caption]
Hongying (Daisy) Dai, PhD
Associate Professor
Department of Biostatistics | College of Public Health
University of Nebraska Medical Center
Omaha, NE
MedicalResearch.com: What is the background for this study?
Response: E-cigarette use increased dramatically from 11.7% to 27.5% for high school students and from 3.3% to 10.5% for middle school students during the periods of 2017 - 2019. In September 2018, the Food and Drug Administration (FDA) warned that youth e-cigarette use is reaching an epidemic proportion.
Exposure to secondhand aerosol (SHA) from e-cigarettes is not harmless as e-cigarettes aerosol contains nicotine and potentially harmful substances, including carbonyl compounds, TSNAs, heavy metals, and glycols. This study analyzed the 2015-2018 National Youth Tobacco Survey (NYTS) and the main findings are:
