1. Study suggests smoking, binge drinking and unsafe tanning may be linked in men

    November 11, 2017 by Ashley

    From the University of Connecticut press release:

    Even though men use tanning beds at lower rates than women, men who tan tend to do it in riskier ways, according to a study by researchers at the University of Connecticut. The findings should help public health officials rethink how, and to whom, they’re targeting anti-tanning messages.

    Because the stereotypical tanning salon client is a young woman, almost all the research and health messaging on tanning has focused on that demographic. But the new research in press in the Journal of the American Academy of Dermatology found that one in three people who use tanning beds in the U.S. are male.

    Men who tan report using tanning beds with about the same frequency as women, but smoke and binge drink at higher rates than their female counterparts, and they also tend to treat tanning more like an addiction than women do, say the authors. A full 49 percent of men who used tanning beds fit a pattern of addictive behavior around tanning.

    “That was really surprising,” says lead author Sherry Pagoto, a clinical psychologist and director of the UConn Center for mHealth and Social Media. “If they tan with the same frequency as women, why would tanning in men be more addictive?”

    Pagoto and her colleagues conducted a national survey of 636 people who answered “yes” when asked whether they had ever used a tanning bed. They queried the participants about frequency of use, preferred locations to tan, how they felt about tanning, and why they did it.

    The differences between men and women were marked. Women preferred to tan in salons, and said they valued low cost, cleanliness, and convenience. Men who tanned preferred less regulated settings, such as gyms or private homes. They said they liked to tan to accentuate the appearance of their muscles, or as a reward after working out. They also reported smoking tobacco, binge drinking alcohol, and drinking soda significantly more often than women who tan.

    Men also answered “yes” when asked if they ever felt anxious if they weren’t able to tan, tanned to relieve stress, or spent money on tanning even when they couldn’t afford it. They agreed with statements such as “I’d like to quit but I keep going back to it.”

    There’s a population of men who tan and engage in other risky behaviors and are very unlike the young women that health educators assume are at risk of tanning bed health impacts, says Pagoto.

    Pagoto and her team are pursuing another study to delve more deeply into who tans, asking questions about sexual orientation, given that recent research has revealed that homosexual men are just as likely to use tanning beds as young women. The research should help health officials trying to warn the public of the very real connection between tanning beds and skin cancer, she says.

    Sun lamps and tanning beds are legal for adult use in all 50 states, even though the Food and Drug Administration (FDA) classifies them as a Class 1 carcinogen like tobacco, radon, and arsenic, and the use of tanning beds has been linked to melanoma, the deadliest form of skin cancer.

    Most current marketing messaging is targeted to teen- and college-aged women, according to Pagoto. Men who tan are unlikely to relate to that type of message. Pagoto is now applying social media marketing principles to develop prevention messages that resonate with specific audience segments.

    “We’re also hoping to spread the message on college campuses, since the tanning industry heavily markets to college students,” she says.


  2. Study looks at how gut and gender may affect ease of quitting smoking

    November 6, 2017 by Ashley

    From the American Chemical Society:

    Many people who smoke or chew tobacco can’t seem to escape nicotine’s addictive properties. Studies show that women in particular seem to have a harder time quitting, even with assistance, when compared to men. Now, scientists report in a mouse study published in ACS’ journal Chemical Research in Toxicology that the difference in gender smoking patterns and smoking’s effects could be due to how nicotine impacts the brain-gut relationship.

    Cigarette smoking has long been a major public health issue. It’s related to one out of every five deaths in the U.S., according to the U.S. Centers for Disease Control and Prevention. When a person smokes tobacco, nicotine is delivered mainly to the lungs. But with skin patches and chewing tobacco, nicotine crosses the skin and into the gastrointestinal tract, respectively. Previous research has shown that nicotine and the nervous system interact, producing a number of effects including the release of the “feel-good” chemical dopamine. Studies have also shown that the effects of nicotine are gender-dependent. To more fully understand why this is, Kun Lu and colleagues wanted to explore how nicotine affects male and female gut microbiomes.

    The researchers set up a 13-week experiment during which they administered nicotine-infused water to mice. An analysis of the animals’ fecal samples showed major differences in the composition of the microbiomes in male and female mice. Levels of compounds and bacterial genes associated with the nervous system and body weight were altered in different ways in male and female mice. For example, the mice exposed to nicotine, especially the males, had lower concentrations of glycine, serine, and aspartic acid, which could weaken the addictive effect of nicotine. In addition, nicotine-treated female mice had reduced amounts of Christensenellaceae bacteria, while the treated male mice had increased levels, which are associated with a lower body mass index. The team says future efforts will focus on exploring the relationship of the nicotine-gut-brain interactions on a molecular level to further understand the communication paths involved.


  3. Study suggests effectiveness of online social networks designed to help smokers quit

    November 1, 2017 by Ashley

    From the University of Iowa press release:

    Online social networks designed to help smokers kick the tobacco habit are effective, especially if users are active participants, according to a new study from the University of Iowa and the Truth Initiative, a nonprofit anti-tobacco organization.

    The study examined the tobacco use of more than 2,600 smokers who participated in BecomeAnEX.org, Truth Initiative’s online smoking cessation community designed in collaboration with the Mayo Clinic. The study found that 21 percent of those classified as active users after their first week in the community reported that they quit smoking three months later. Those who were less active in the community were less likely to quit.

    Kang Zhao, assistant professor of management sciences in the UI Tippie College of Business and the study’s co-author, says the results show that online interactions can predict offline behavior.

    How central you become in the online social network after the first week is a good indicator of whether you will quit smoking,” says Zhao. “This is the first study to look at smokers’ behaviors in an online community over time and to report a prospective relationship between social network involvement and quitting smoking.”

    The BecomeAnEX website enables members to share information and support through blogs, forums, and messages. Although the site is focused on smoking cessation, users can post on any topic. More than 800,000 users have registered since the site launched in 2008, resulting in a large, active community of current and former tobacco users supporting each other.

    Funded by the National Cancer Institute, the study constructed a large-scale social network based on users’ posting habits. Zhao says a key finding was that increasing integration into the social network was a significant predictor of subsequent abstinence. Three months after joining the BecomeAnEX social network, users who stayed involved on the site were more likely to have quit smoking when researchers contacted them to assess their smoking status.

    After three months, 21 percent of active users — or those who actively contributed content in the community — quit smoking; 11 percent of passive users — those who only read others’ posts — quit smoking; and only 8 percent of study participants that never visited quit smoking.

    The study did not examine why greater community involvement had such a positive effect on smoking cessation. Researchers speculate it may be because of powerful social network influences.

    “Spending time with others who are actively engaged in quitting smoking in a place where being a nonsmoker is supported and encouraged gives smokers the practical advice and support they need to stay with a difficult behavior change,” says Amanda Graham, senior vice president, Innovations, of Truth Initiative and lead author. “We know that quitting tobacco can be extremely difficult. These results demonstrate what we hear from tobacco users, which is that online social connections and relationships can make a real difference.”


  4. E-cigarette use by high school students linked to cigarette smoking

    October 30, 2017 by Ashley

    From the Canadian Medical Association Journal press release:

    Use of e-cigarettes by high school students was strongly associated with later cigarette smoking, according to a large study conducted in 2 Canadian provinces and published in CMAJ (Canadian Medical Association Journal).

    “While our study provides strong evidence that e-cigarettes are associated with smoking initiation among youth, the association is unclear,” says Dr. David Hammond, School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario. “E-cigarettes may help to re-normalize smoking; however, the association between e-cigarettes and smoking may simply reflect common factors rather than a causal effect: the same individual and social risk factors that increase e-cigarette use may also increase the likelihood of youth smoking.”

    The study included 44 163 students in Grades 9-12 at 89 schools in Ontario and Alberta, Canada, who participated in the ongoing COMPASS study. In the current study, researchers looked at e-cigarette use at the start of the study in phase 1 (2013/14) and at follow-up (2014/15, with 87 schools). They classified students into 6 categories: current daily smokers, current occasional smokers, former smokers, experimental smokers, puffers and those who had never tried smoking.

    Among students in both study phases, youth who used e-cigarettes in the 30 days prior to the start of the study were more likely to start smoking cigarettes and to continue smoking after 1 year, a finding consistent with other similar study types. At the same time, the prevalence of smoking decreased slightly over time: therefore, if e-cigarettes are promoting youth smoking, the overall impact has been modest to date.

    “Youth may be trying e-cigarettes before smoking because they are easier to access: until recently, youth could legally purchase e-cigarettes without nicotine, whereas regular cigarettes cannot be sold to young people under 18 years of age,” says Dr. Hammond.

    This is a large longitudinal study, meaning it collects information on the same subjects over time. Similar studies have been conducted in the US, although tobacco regulation in Canada is different. Unlike the US, Canada has not approved nicotine-containing e-cigarettes for sale in conventional retail outlets such as supermarkets, although they are widely available online and in vape stores. Non-nicotine e-cigarettes do not require prior approval and make up a larger part of the e-cigarette market in Canada compared with many other countries. Canada is expected to announce new federal regulations on e-cigarettes shortly.

    As the study was conducted in only 2 provinces, extrapolation of the findings nationally is unwise. As well, the study only looked at smoking initiation related to e-cigarettes and not the possible impact of e-cigarettes on smoking cessation.

    The authors note that “the findings from our study provide support for both sides of the debate. It is highly plausible that ‘common factors’ account for a substantial proportion of increased cigarette-smoking initiation among e-cigarette users. At the same time, it would be foolhardy to dismiss the likelihood that early exposure to nicotine via e-cigarettes increases smoking uptake. Attributing the relative importance of these 2 factors will not be straightforward, and represents a critical challenge to the research community.”

    The authors suggest further research should be conducted on the link between smoking initiation and nicotine e-cigarettes compared with non-nicotine e-cigarettes.


  5. Managing negative emotions can help pregnant smokers quit

    September 28, 2017 by Ashley

    From the University at Buffalo press release:

    A new study by scientists in the University at Buffalo’s Research Institute on Addictions has shown that pregnant smokers are more likely to quit if they can learn to manage negative emotions that lead to smoking.

    Smoking during pregnancy is a matter of serious concern, says Clara Bradizza, PhD, senior research scientist at RIA.

    “It’s well-documented that smoking cigarettes while pregnant leads to a range of negative health effects on fetuses, including increased risk of low birth weight and preterm delivery, and greater rates of asthma and learning disabilities,” she says.

    The research involved 70 pregnant women who wanted to quit smoking and reported smoking in response to stress, anger and anxiety. “These women use smoking as a way to manage their negative feelings,” Bradizza says. “Many experience poverty, insecure housing and unemployment, along with the stress of pregnancy, which increases negative emotions. All these factors make it more difficult to quit.”

    Half of the women took part in a smoking cessation program consisting of emotion regulation treatment (ERT) combined with standard cognitive-behavioral therapy (CBT), while the others received CBT and a control treatment consisting of health and lifestyle education.

    “ERT is an exposure-based therapy where counselors help participants imagine stressful situations that elicit strong urges or cravings to smoke, and then allow them to experience these feelings in session, without smoking. The women were also taught mindfulness skills and effective ways to cope with urges to smoke,” Bradizza says.

    The women who took part in the ERT program showed significantly higher rates of smoking cessation, with 23 percent remaining smoke-free two months after beginning ERT treatment, compared to none in the control group. They also reported feeling more confident they could remain abstinent from smoking. In addition, the women in the ERT program who did not quit smoking showed improvement, as they smoked less than half the number of cigarettes daily as those in the control group.

    Because smoking cessation medications such as Chantix (varenicline) are not recommended for use in pregnancy, there is a greater reliance on behavioral treatments to help pregnant smokers quit. Bradizza plans a larger trial of the ERT program to help further develop a new approach that is critically needed to help pregnant women quit.


  6. Study examines impact of nicotine reduction on vulnerable smokers

    September 7, 2017 by Ashley

    From the Larner College of Medicine at the University of Vermont press release:

    The FDA is right — when it comes to disease culprits, cigarette smoking tops the list. While recognized as the number-one cause of preventable disease and death, it’s an incredibly tough habit to break due to the addictiveness of nicotine. New research from the University of Vermont (UVM) and colleagues suggests that reducing nicotine content in cigarettes may decrease their addiction potential in especially vulnerable populations and suggests how regulatory policies could shift preferences to less-harmful tobacco products.

    The study appears in JAMA Psychiatry.

    The Vermont Center on Behavior and Health (VCBH) at UVM focuses on the relationship between behavior and health, particularly in disadvantaged populations, a group that is “overrepresented” among smokers, according to the study’s authors. In their latest study, the research team, led by Stephen Higgins, Ph.D., professor of psychiatry and VCBH director, examined the addiction potential of cigarettes with reduced nicotine content in three vulnerable populations of smokers — individuals with psychiatric disorders (i.e., affective disorders, opioid-use disorder), and socioeconomically disadvantaged women.

    Evidence in relatively healthy and socially stable smokers indicates that reducing the nicotine content of cigarettes reduces their addictiveness,” says Higgins. “Whether that same effect would be seen in populations highly vulnerable to tobacco addiction was unknown.”

    The multi-site, double-blind study is “the first large, controlled study to examine the dose-dependent effects of cigarettes with reduced nicotine content on the reinforcing effects, subjective effects, and smoking topography of vulnerable populations,” say the study’s authors.

    The study ran between March 2015 and April 2016 and included 169 daily smokers, including 120 women and 49 men. Participating centers included UVM, Brown University, Johns Hopkins University School of Medicine and the University of Kansas. A total of 56 of the participants were diagnosed with affective disorders, 60 with opioid dependence, and 53 were socioeconomically disadvantaged women. Each study participant completed fourteen 2- to 4-hour sessions, abstaining from smoking for 6 to 8 hours before each of the sessions, which were organized in 3 phases. Phase 1 included sessions 1 to 5 and included sampling of the research cigarettes in double-blind conditions, beginning with the smoking of the participant’s regular brand cigarette in session 1 and then smoking 1 research cigarette of identical appearance, but varying doses of nicotine in sessions 2 to 5. Participants were required to use a plastic cigarette holder when smoking research cigarettes, in order to measure smoking topography — number of puffs, length and speed of each puff.

    A Cigarette Purchase Task (CPR) was completed after each smoking session to measure the effects of cost on the participant’s rate of smoking. Additional questionnaires assessed research cigarette evaluation, nicotine withdrawal, smoking urges, and nicotine dependence.

    The Phase 2 sessions (6-11) provided participants with an opportunity to select which cigarette they preferred to smoke among 6 different dose combinations and used a computer program, which recorded which of two cigarettes participants preferred for that session and whether or not they wanted to continue to smoke that selection after two puffs or abstain. The final phase 3 (sessions 12-14) followed the same protocol, but measured only the highest and lowest doses of nicotine.

    While participants tended to prefer the higher nicotine dose content research cigarettes, the researchers found that the low-nicotine dose cigarettes could serve as economic substitutes for higher-dose commercial-level nicotine cigarettes when the cost of the latter was greater.

    Among the limitations of the study is its brief exposure to the research cigarettes. The authors report that field testing of extended exposure with these vulnerable populations to determine feasibility under “naturalistic smoking conditions” is underway.

    “This study provides a very encouraging indication that reducing the nicotine content of cigarettes would help vulnerable populations,” Higgins says. “We need more research, but this is highly encouraging news with tremendous potential to improve U.S. public health.”


  7. Smokers 20 percent more likely to quit when cigarettes cost $1 more

    September 3, 2017 by Ashley

    From the Drexel University press release:

    Older smokers are usually more set in their ways, but a dollar increase in cigarette prices makes them 20 percent more likely to quit, a new Drexel University study found.

    The study, published in Epidemiology, used 10 years of neighborhood-level price data to determine how it affected nearby smokers, focusing on those who skewed older.

    Older adult smokers have been smoking for a long time and tend to have lower rates of smoking cessation compared to younger populations, suggesting deeply entrenched behavior that is difficult to change,” said Stephanie Mayne, PhD, the lead author of the study who is a former doctoral student at Drexel and now a fellow at Northwestern. “Our finding that increases in cigarette prices were associated with quitting smoking in the older population suggests that cigarette taxes may be a particularly effective lever for behavior change.”

    Taking a look at the local relationship between smoking habits and cigarette prices is an understudied but important area to look at, according to the senior author on the study, Amy Auchincloss, PhD, associate professor in the Dornsife School of Public Health.

    “Results on this topic primarily have come from population surveillance,” she said. “But we had neighborhood tobacco price data and could link that to a cohort of individuals who were followed for about 10 years.”

    Smoking cessation remains an important focus of public health efforts since it remains the largest preventable cause of death and disease in not just the United States, but the world.

    The cohort Mayne and Auchincloss looked at included smokers ranging in age from 44 to 84 and stretched across six different places, including the Bronx, Chicago, and the county containing Winston-Salem, North Carolina. Data were taken from the study population between 2002 and 2012 as a part of the Multi-Ethnic Study of Artherosclerosis (MESA).

    In addition to finding that current smokers were 20 percent more likely to quit smoking when pack prices went up by a dollar, Mayne and Auchincloss’ team showed that there was a 3 percent overall reduction in smoking risk.

    However, when the data was narrowed to heavy smokers (defined as smoking more than half a pack a day), there was a 7 percent reduction in risk. When prices increased by a dollar, heavy smokers also showed a 35 percent reduction in the average number of cigarettes they smoked per day, compared to 19 percent less in the overall smoking population.

    “Since heavy smokers smoke more cigarettes per day initially, they may feel the impact of a price increase to a greater degree and be more likely to cut back on the number of cigarettes they smoke on a daily basis,” Mayne said.

    While the data focused on a population older than 44, Mayne believes the price effect may be “similar or possibly stronger in a younger population.”

    “Some research suggests younger adults may be more price-sensitive than older adults,” she pointed out.

    Something she found, though, was that smoking bans in bars and restaurants did not appear to have any effect on smoking behavior in the study population. Although more research is likely necessary to see why that is and whether it’s true — Mayne will soon publish a study devoted to that — one possible explanation is that the economic pressures of a cigarette price increase provide a stronger incentive to quit than placing limits on smoking in public places.

    Mark Stehr, PhD, an associate professor in Drexel’s School of Economics who also served as a co-author on the study, also had a thought on the bans’ effect.

    “A ban may be circumvented by going outside or staying home, whereas avoiding a price increase might take more effort,” he pointed out.

    Based on results from this study, raising cigarette prices appears to be a better strategy for encouraging smoking cessation across all ages.

    “More consistent tax policy across the United States might help encourage more older adults to quit smoking,” Mayne said.

    “Given our findings, if an additional one dollar was added to the U.S. tobacco tax, it could amount to upwards of one million fewer smokers,” Auchincloss said. “Short of federal taxes, raising state and local taxes and creating minimum price thresholds for tobacco should be essential components of a comprehensive tobacco control strategy — particularly in places with high tobacco prevalence.


  8. Peer influence doubles smoking risk for adolescents

    September 2, 2017 by Ashley

    From the University of Pennsylvania press release:

    The way things stand now, tobacco use will kill one billion people in the 21st century. In the United States, 90 percent of smokers pick up the habit by age 18, making adolescence a critical time for smoking-prevention efforts.

    Peer influence has long been known as a major risk factor for adolescent smoking, but findings have varied about how big the risk is or how this dynamic unfolds. A new, rigorous meta-analysis of 75 longitudinal teen smoking studies published today in the journal Psychological Bulletin finds that having friends who smoke doubles the risk that children ages 10 to 19 will start smoking and continue smoking. It also found that peer influence is more powerful in collectivist cultures than in those where individualism is the norm.

    There has been a great deal of research about peer influences on adolescents, says the study’s senior author, Dolores Albarracín, PhD, a professor of psychology at the University of Illinois at Urbana-Champaign, but often findings rely on individual studies. “Meta-analysis is a summary of all we know,” she says, “giving us a more reliable, robust number that is better supported by the facts.”

    “One of our most intriguing findings is that culture actually matters in how much influence adolescents have on their peers,” says the study’s lead author, Jiaying Liu, PhD, a recent graduate of the Annenberg School for Communication at the University of Pennsylvania. “Meta-analysis allowed us to examine studies from across the globe. We predicted that people in collectivistic cultures would be more likely to be influenced by peers around them, and that held true. In those most collectivistic countries, adolescents whose peers smoke are 4.3 times more likely to pick up smoking compared to people who have no peers smoking. By contrast, having peers who smoke made adolescents from those most individualist countries 1.89 times more likely to smoke.”

    The study included data from 16 countries, both collectivistic — for example, China, South Korea, Jordan and Portugal — and individualistic like the United States, Australia, Canada, the Netherlands and the United Kingdom.

    The authors also examined the ethnic origins of the adolescents in each study, regardless of nationality. “We found that peer influence was much weaker in samples with higher proportions of adolescents with a European background, but much stronger in samples with higher proportions of adolescents with an Asian background,” Liu says.

    This finding about ethnic and cultural background may also explain why the results of teen smoking studies have varied in how big an effect peer influence has.

    In addition, the study found that closer friends were more likely to influence peers to start smoking when compared to more distant friends. The closeness of peer friendships did not impact whether adolescents who smoke continued to smoke, however, indicating that perhaps the addictive nature of tobacco was an overriding factor.

    The study was also able to better avoid what is often seen as the “chicken or the egg” problem of peer influence smoking studies: Do teens influence one another to smoke, or do those who smoke simply tend to become friends?

    “By including only longitudinal studies, where peer influence was measured at an earlier time and adolescent smoking outcomes at a later date, we were better able to establish that peer influence led to the adolescent smoking outcomes, rather than the other way around,” says Liu, who will be starting in the fall as an assistant professor in the University of Georgia’s Department of Communication Studies.

    The researchers hope that by providing a better understanding of the risk factors for teen smoking, they can help inform more targeted prevention efforts. By knowing who is most at risk, parents and public health officials alike can give teenagers the tools to resist tobacco.

    “It’s not enough just to say, ‘Don’t smoke it’s bad for you,'” says Albarracín. “How are teenagers going to deal with temptation on a daily basis? We need much more specific campaigns dealing with normative influence — for example, pointing out how many adolescents don’t smoke. There can be more messaging in schools and training for parents on how to build refusal skills in their children.”

    Peer influence is particularly strong in the adolescent years, as children reduce the amount of time spent with parents and increase the amount of unsupervised time spent with peers.

    “This work highlights the importance of considering the networks that surround teens, not just thinking about individuals in isolation,” says co-author Emily Falk, PhD, associate professor at Penn’s Annenberg School for Communication and director of its Communication Neuroscience Lab. “Behaviors spread from person to person, and keeping that in mind is essential for prevention and cure.”

    “The burden of smoking-caused morbidity is heavy around the world,” Liu adds. “If social influence is a crucial factor in adolescents’ decisions to start smoking and keep smoking, we want to understand how to leverage its power for better smoking prevention. It’s always easier to stop people from starting to smoke than to change their behavior later in life.”


  9. E-cigarette use may encourage experimentation with tobacco

    August 13, 2017 by Ashley

    From the University of Stirling press release:

    Young people who have tried an e-cigarette may be more likely to go on to smoke cigarettes compared with those who have not, a study led by University of Stirling researchers has suggested.

    The research found a link between e-cigarette use in “never smokers” — those who have never tried smoking — and their subsequent first experimentation with cigarettes in the following year.

    Dr Catherine Best, Research Fellow at the University of Stirling, said: “Our findings are broadly similar to those from eight other US studies; however, this is the first study to report from the UK.

    “Uniquely, we also found that e-cigarette use had a greater impact on the odds of cigarette experimentation in young never smokers who had a firm intention not to smoke and/or whose friends didn’t smoke. Traditionally, this is the group of young people least likely to take up smoking.”

    The research, conducted by the DISPLAY Team, a collaboration between the Universities of Stirling, St Andrews and Edinburgh, and ScotCen, focused on pupils at four Scottish secondary schools. Young people aged between 11 and 18 years old were surveyed in February/March 2015 and then again 12 months later. The initial 2015 survey found that among the 2,125 never smokers, 183 (8.6%) said that they had tried an e-cigarette and 1,942 had not.

    The 2016 survey found that 74 (40.4%) of those who had tried an e-cigarette in the initial 2015 survey, went on to smoke a cigarette in the following 12 months — compared to only 249 (12.8%) of young people who had not tried an e-cigarette.

    The effect remained statistically significant even after adjusting for other factors that influence smoking uptake including smoking susceptibility, having friends who smoke, whether family members smoke, age, sex, family affluence, ethnic group and school.

    Young never smokers are more likely to experiment with cigarettes if they have tried an e-cigarette,” the study concluded.

    The research paper, Relationship between trying an electronic cigarette and subsequent cigarette experimentation in Scottish adolescents: a cohort study, has been published in the British Medical Journal’s Tobacco Control journal.

    Sally Haw, Professor of Public and Population Health at Stirling, added: “The greater impact of e-cigarette use on young people thought to be at lower risk of starting smoking is of particular concern.

    “Further research is required to discover how experimentation with e-cigarettes might influence attitudes to smoking in young people traditionally at lower risk of becoming smokers; and importantly how many of this group who do experiment with cigarettes go on to smoke regularly.”

    The study was funded by the National Institute for Health Research (NIHR) Public Health Research Programme.


  10. Perceptions about body image linked to increased alcohol, tobacco use for teens

    July 9, 2017 by Ashley

    From the University of Missouri-Columbia press release:

    How teenagers perceive their appearance, including their body image, can have significant impacts on health and wellness. Prior body image research has shown that people with negative body image are more likely to develop eating disorders and are more likely to suffer from depression and low self-esteem. Now, Virginia Ramseyer Winter, a body image expert and an assistant professor in the University of Missouri’s School of Social Work, found negative body image also is associated with increased tobacco and alcohol use, with implications for both young men and women. Notably, she also found relationships between substance use and perceived attractiveness, with girls who believe they are very good looking being more likely to drink.

    “We know alcohol and tobacco can have detrimental health effects, especially for teenagers,” Ramseyer Winter said. “I wanted to see if the perception of being overweight and negative body image leads to engaging in unhealthy or risky substance use behaviors. Understanding the relationship means that interventions and policies aimed at improving body image among teenage populations might improve overall health.”

    Ramseyer Winter and her co-authors, Andrea Kennedy and Elizabeth O’Neill, used data from a national survey of American teenagers to determine the associations between perceived size and weight, perceived attractiveness, and levels of alcohol and tobacco use. The researchers found that perceived size and attractiveness were significantly related to substance use. Adolescent girls who perceived their body size to be too fat were more likely to use alcohol and tobacco. Boys who thought they were too skinny were more likely to smoke, and boys who considered themselves fat were more likely to binge drink.

    “While poor body image disproportionately affects females, our findings indicate that body image also impacts young males,” Ramseyer Winter said. “For example, it’s possible that boys who identified their bodies as too thin use tobacco to maintain body size, putting their health at risk.”

    In addition to body size, the researchers looked at the connection between perceived attractiveness and substance use. Girls who thought they were not at all good looking were more likely to smoke. Girls who thought they were very good looking were more likely to binge drink. Ramseyer Winter suggests this is because attractiveness may be associated with popularity, which is related to increased alcohol use.

    To improve body image awareness, Ramseyer Winter suggested that parents, schools and health providers need to be aware of body shaming language and correct such behavior to help children identify with positive body image messages. Body shaming language can affect teenagers who have both positive and negative perceptions of themselves.

    “Adolescent tobacco and alcohol use: the influence of body image,” recently was published in the Journal of Child and Adolescent Substance Abuse. Kennedy is a doctoral candidate at the University of Southern California and O’Neill is a doctoral candidate at the University of Kansas. The MU School of Social Work is in the College of Human Environmental Sciences.