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Open Access Publications from the University of California

Scholarly Works (44 results)

  • Article
  • Peer Reviewed
UC San Diego Previously Published Works (2017)

Introduction

Understanding factors that influence hookah use among young adults is important given its increasing popularity and health risks. The purpose of this study was to examine whether young adult non-daily cigarette smokers use hookah for stress regulation. We hypothesized that greater perceived stress and greater stressful life events would predict probability and frequency of recent hookah use.

Methods

Participants (n=598, 50.7% male) were non-daily smokers aged 18-24years (M=20.5, SD=1.8), who completed a baseline assessment online or via mobile phone as part of a longitudinal study. Participants had been non-daily smokers for at least six months but had never been daily smokers.

Results

Thirty-one percent of participants reported using hookah over the past 14days. Full-time students were more likely to have used hookah recently. More stressful life events and more frequent alcohol use predicted likelihood and frequency of hookah use (ps<0.05). Perceived stress was not associated with hookah use.

Conclusions

Findings suggest that hookah tobacco use is related to frequency of stressful life events but not perceived stress among non-daily cigarette smokers. Tobacco prevention and intervention programs should address hookah use and should include adaptive strategies for coping with stressful events.
    Cover page: Hookah tobacco use and stressful life events in a sample of young non-daily cigarette smokers
    • Article
    • Peer Reviewed
    UC San Diego Previously Published Works (2016)

    Introduction

    Understanding predictors of e-cigarette and hookah use among young adults is important in light of their increasing prevalence, particularly in younger populations. The purpose of this study was to test the hypothesis that young adult non-daily cigarette smokers' use of e-cigarettes and hookah would be positively associated with their expectancies about these products.

    Methods

    Young adults (n=377, 58.0% male) aged 18-24years (M=20.5, SD=1.8) who had been non-daily smokers for at least six months but had never been daily smokers completed a baseline assessment online or via mobile phone as part of a larger, longitudinal study.

    Results

    Approximately one in three participants reported any e-cigarette (34.0%) and/or hookah (33.4%) use in the past 14days; 37% of those who used either product reported using both. More positive e-cigarette expectancies were associated with higher odds of any e-cigarette use and with heavier use in the past two weeks. Similarly, more positive expectancies for hookah use predicted greater odds of any use as well as more frequent use of hookah (all ps<0.001). Cigarette expectancies were correlated with ANTP expectancies, but did not account for the latter's association with ANTP use.

    Conclusions

    Findings suggest that expectancies play a role in determining whether young adult cigarette smokers also use these nicotine products. These data also suggest use of e-cigarettes and/or hookah may be as common as not among young adult nondaily smokers.
      Cover page: Expectancies for and use of e-cigarettes and hookah among young adult non-daily smokers
      • Article
      • Peer Reviewed
      UC San Diego Previously Published Works (2024)
      Vaccines are one component to the public health strategies to alleviate the COVID-19 pandemic. Hesitancy regarding COVID-19 vaccines in the United States has been problematic, which is not surprising given increasing overall vaccine hesitancy in recent decades. Most vaccines are administered during childhood years. Consequently, understanding hesitancy toward administration of vaccines in this age group may provide insight into possible interventions to reduce vaccine hesitancy. The present study analyzed a subset of over 130,000 public comments posted in response to a notice of meeting of the vaccine advisory group to the Food and Drug Administration. The meeting addressed whether to recommend Emergency Use Authorization (EUA) of the COVID-19 vaccine for children ages 5-11. The results of the study demonstrate that most comments opposed EUA and these comments were associated with statements that indicated misperceptions of risk. Findings provide interesting insights regarding the role of public comments generally but also suggest that the public participation process in notice and comment can be modified to serve as an intervention to align individual perceptions of risk more closely with evidence-based assessment of risk. In addition, the findings provide opportunities to consider strategies for public health messaging.
        Cover page: COVID-19 pediatric vaccine authorization, FDA authority, and individual misperception of risk.
        • Article
        • Peer Reviewed
        UC San Diego Previously Published Works (2022)
        Decreasing smoking initiation remains a public health priority. In 2016, California, in the United States, enacted the Tobacco 21 law, which raised the minimum age for the purchase of tobacco products from age 18 to age 21. This paper evaluates whether the enactment and implementation of the Tobacco 21 law changed how young adults perceive the risk(s) of smoking. Data were drawn from a cohort of emerging adults (n = 575) in California who were non-daily smokers at enrollment and followed quarterly for 3 years. Data were collected during 2015-2019. Piecewise multilevel regression models were used to test for changes in smoking status and perceived risks of cigarettes after Tobacco 21 enforcement began. Findings indicated that the prevalence of current smoking and perceived risks of smoking both declined following Tobacco 21 implementation (ps < 0.001). Post-hoc analyses suggested that post-implementation changes in perceived risk occurred primarily among ongoing smokers. Findings suggest that Tobacco 21 and associated public health measures have been effective, but additional research is needed to disentangle the effects of specific components. Understanding the impact and efficacy of tobacco laws provides great social value to research and implement policies that create intervention(s) on reducing tobacco use initiation.
          Cover page: Evaluation of Risk Perception of Smoking after the Implementation of California’s Tobacco 21 Law
          • Article
          • Peer Reviewed
          UC San Diego Previously Published Works (2015)

          Background

          Young adult use of alternative nicotine and tobacco products (ANTPs) has increased dramatically since 2000. While recent studies address ANTP prevalence, relatively little is known about predictors of use. This secondary analysis examined demographic, personality, and other substance use factors as predictors of past month ANTP use.

          Methods

          Community participants (n=319; 51% female) completed an online survey during the initial stage of a larger study, for which all were required to have smoked cigarettes and consumed alcohol in the past month. The survey assessed demographics, impulsivity, and past-month frequency of cigarette, alcohol, and marijuana use.

          Results

          The majority (61%) of participants endorsed ANTP use in the past 30days. The odds of ANTP use were associated with Caucasian ethnicity, younger age, more frequent alcohol use, and with the sensation seeking and positive urgency components of impulsivity.

          Conclusion

          These data suggest that ANTP use among young adults is a substantial problem, and that there is a need for interventions that target tobacco use generally rather than cigarette smoking only.
            Cover page: Correlates of other tobacco use in a community sample of young adults
            • Article
            • Peer Reviewed
            UC San Diego Previously Published Works (2017)

            Introduction

            Understanding factors that influence non-cigarette tobacco use is important given these products' prevalence and health risks. The goal of this study was to test the hypothesis that personality traits related to affect regulation would be associated with greater frequency of other tobacco product (OTP) use in a sample of young adult non-daily smokers.

            Methods

            Participants (n=518, 51% male) aged 18-24 were non-daily cigarette smokers recruited from the community for a longitudinal study of tobacco use. Personality characteristics (impulsivity, anhedonia, and negative affectivity) were measured at baseline, and participants reported recent tobacco use at baseline and 3, 6, and 9months later. Assessments were conducted online or via mobile phone.

            Results

            Across the 4 assessments, 33-52% of participants reported recent OTP use, with frequency of use decreasing over time. Longitudinal negative binomial regression models indicated that greater sensation seeking and lack of premeditation were associated with more frequent OTP use (ps<0.05). These effects were consistent over time.

            Conclusions

            Findings suggest that young adult non-daily cigarette smokers with greater propensity for immediately rewarding behaviors may use OTPs more frequently. Young, non-daily cigarette smokers with high levels of sensation seeking and/or lack of premeditation may be at increased risk for harms related to OTP use and may benefit from prevention and cessation strategies that specifically address affect.
              Cover page: Do personality traits related to affect regulation predict other tobacco product use among young adult non-daily smokers?
              • Article
              • Peer Reviewed
              UC San Diego Previously Published Works (2019)

              Introduction

              Despite effective treatments, relapse to smoking remains a vexing global health problem. One predictor of relapse is depressive symptoms. Medications such as varenicline reduce withdrawal-related symptoms of depression, reducing relapse. This study examined whether varenicline moderated the effect of depressive symptoms on relapse, and whether this varied by region of enrollment.

              Methods

              Adult smokers (n = 525; 37% male) with past or current, stable major depressive disorder recruited from United States (n = 255), and European (n = 270) sites participated in a randomized, double-blind cessation treatment trial including 12 weeks of varenicline or placebo, with 40-week nontreatment follow-up.

              Results

              Longitudinal and binary logistic regressions were used to model the probability of sustained abstinence by end of treatment and point-prevalence abstinence in follow-up. The association between depression symptoms and abstinence was moderated by intervention group at end of treatment, and by region during follow-up: more severe symptoms were associated with end-of-treatment relapse for placebo (odds ratio [OR] = 0.91, p = .003), but not varenicline (OR = 0.99, p = .568). During follow-up, increased symptoms of depression predicted greater likelihood of smoking for European (p = .009) but not US participants. Europeans were more likely to be abstinent for both outcomes (p < .01).

              Conclusions

              These results extend studies demonstrating varenicline is associated with less withdrawal-related depression, and suggest it aids cessation even in smokers with depressive symptoms. Findings also suggest regional differences in the relationship between depressive symptoms and cessation that may be related to differences in prevalence.

              Implications

              This study indicates varenicline may aid cessation partially by reducing withdrawal-related symptoms of depression. It also suggests that the impact of depressive symptoms on cessation varies regionally, and that this variation may be related to differences in smoking prevalence.
                Cover page: Effects of Varenicline, Depressive Symptoms, and Region of Enrollment on Smoking Cessation in Depressed Smokers
                • Article
                • Peer Reviewed
                UC San Diego Previously Published Works (2017)
                E-cigarettes have been suggested as a strategy for reducing harm from cigarettes. Although e-cigarettes could be a less-harmful alternative to cigarettes for those trying to quit, there may also be costs that outweigh any benefits of reduction. The purpose of the present study was to prospectively investigate perceptions of e-cigarettes, cigarette smoking intentions, and their associations with e-cigarette use over time. Community participants (N = 348, 57% male) aged 18 to 24 years were recruited for a longitudinal study of tobacco use. Inclusion criteria included nondaily cigarette smoking for ≥ 6 months with no history of daily smoking. Participants reported e-cigarette use over the past 14 days at baseline, and for the past 9 days at 3, 6, and 9 months. Assessments were completed online or via mobile phone. Across the 4 assessments, 22% to 33% of participants reported recent e-cigarette use. Intent to quit smoking cigarettes and intent to maintain smoking were unrelated to e-cigarette frequency. E-cigarette frequency was positively associated with perceiving e-cigarettes as less harmful than cigarettes and more positive e-cigarette expectancies (ps < .05). E-cigarette use was also more frequent among those who smoked cigarettes frequently and who used e-cigarettes to circumvent cigarette bans more often (ps < .05). The combination of these findings suggests that, at least among nondaily smoking young adults, other factors may influence frequency of e-cigarette use more than harm reduction. Findings instead seem consistent with the hypothesis that e-cigarettes are more often used to complement ongoing cigarette smoking. (PsycINFO Database Record
                  Cover page: E-Cigarette Use, Perceptions, and Cigarette Smoking Intentions in a Community Sample of Young Adult Nondaily Cigarette Smokers
                  • Multimedia
                  Symposium 2024 (2024)

                  Background:

                  Mental health (MH) engagement after discharge from hospitalization is considered an important outcome measure for MH patients. The VA San Diego Healthcare System (VASDHS) has implemented mental health aftercare calls (MHACs) for psychiatric patients discharged from the emergency department, the psychiatric unit, and the medical floors. While every patient discharged from the medical floors receives a primary care aftercare call, only a subset of patients admitted to the medical floors receive MHACs. These patients are identified by a mental health admission diagnosis. In this quality improvement study and innovation, we assess the association between MHACs and the probability of post-discharge MH visits in patients discharged from the medical floors who were seen by the inpatient consult-liaison (CL) psychiatry service.

                  Description of the Project:

                  This project is a retrospective review based on encounter codes of an electronic health record for patients admitted to the medical floors at the VASDHS between January-December 2022 who were also seen by the inpatient CL service. The patients who were seen by the CL service were grouped into those who received MHACs and those who did not. Cox regression was used to evaluate the relationship between MHAC and post-discharge likelihood of mental health visit.

                  Lessons Learned/Expected Outcomes:

                  386 patients seen by the CL service were identified for analysis. 362 patients did not receive a call and 24 patients did.  After controlling for gender, age, and the number of CL encounters, we found that 51% of patients without a call had a MH visit within 6 months post-discharge, compared with 75% in those patients who were called (HR = 1.3, p>0.05). We found that 33% of patients without a call had a MH visit in the first month post-discharge, compared with 54% in those patients who were called. While these findings were not statistically significant, likely due to low power, this may indicate an increased probability of a MH visit with aftercare calls. 

                  Recommendations/Next Steps:

                  Our findings support further analysis and utilization of MHACs for psychiatric patients discharged from the medical floors. The availability of trained mental health nursing staff to conduct MHACs is currently a highly limited resource. Our plan is to develop a systematic protocol for the inpatient CL service to identify patients who they’ve seen who may benefit from a MHAC. This protocol would be used in conjunction with the existing systems-based metrics used to identify patients for MHACs and allow for conscientious utilization of MHACs in post-discharge engagement for psychiatric patients admitted to the medical floors. To identify patients most likely to benefit from MHACs, this protocol should account for patient characteristics such as age, number of recent admissions, MH diagnoses, and/or treatment complexity. Further analysis to assess the efficacy and conscientious use of this valuable staff resource can then be repeated after protocol implementation.

                  • 1 supplemental PDF
                  • Article
                  • Peer Reviewed
                  UC San Diego Previously Published Works (2019)
                  Use of electronic cigarettes, or e-cigarettes, has increased exponentially in recent years. Mechanisms that might underlie this increase include expectancies and reasons for e-cigarette use. This study was designed to identify and evaluate changes in expectancies and reasons for e-cigarette use among young adults over time and to determine whether such changes were associated with changes in e-cigarette use. Data for these analyses were collected from a sample of 137 young adult e-cigarette users who completed electronic surveys 5 times over a 12-month period. Results yielded five e-cigarette use expectancy and reason factors: Affect-Related Reasons, Social Reasons, Positive Social Expectancies, Positive Internal Expectancies, and Negative Expectancies. Linear mixed models showed that Negative Expectancies significantly increased over time (p = .004), whereas Affect-Related Reasons significantly decreased over time (p = .001). Additional linear mixed models indicated that, whereas both frequency and quantity of e-cigarette use decreased over time, changes in Positive Internal Expectancies were positively associated with changes in frequency of e-cigarette use (p = .032) and changes in Positive Social Expectancies were positively associated with changes in both frequency (p = .007) and quantity (p = .026) of e-cigarette use. These findings suggest that young adults' expectancies and reasons for using e-cigarettes fluctuate over time, and changes in expectancies seem to be longitudinally associated with changes in e-cigarette use. Positive expectancies for e-cigarette use represent targets for clinical, prevention, and intervention efforts. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
                    Cover page: Expectancies and Reasons for Use of E-Cigarettes Among Young Adults: A Longitudinal Analysis
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