A UAB public health researcher suggests a new framework for tracking adolescent tobacco and nicotine use in the United States.
Smoking has declined steadily among adolescents in the United States over the past two decades. However, the use of e-cigarettes has increased significantly since 2014 and is the most common nicotine or tobacco product used by middle school and high school students, according to the Centers for Disease Control and Prevention.
Researchers at the University of Alabama at Birmingham analyzed cross-sectional data from the CDC’s National Youth Tobacco Survey from 1999 to 2020 to examine whether the decrease in smoking correlated with an overall decrease in consumption. nicotine and tobacco in adolescents. Their results indicate that the CDC’s measure of any tobacco product consumption, a binary measure that asks if someone has used a tobacco product in the past 30 days, does not accurately describe nicotine and tobacco consumption. tobacco or the associated risks in adolescents in the electronic cigarette age, especially in the context of different product mixes over time.
“The majority of cigarette brands contain similar ingredients, strengths and chemicals,” said Ruoyan Sun, Ph.D., assistant professor in the School’s Department of Health Care Organization and Policy. UAB Public Health Officer and Researcher. “Conversely, there is a wide variety of electronic cigarette products with different levels of chemicals and different makeup. To more precisely monitor nicotine and tobacco consumption habits and their associated risks, surveys must take into account the frequency of product use and the specific risks of the products.
The Birmingham Health District established in 2019 bans smoking on public property, including the UAB campus. Learn more about the health district here.
Nicotine, the main chemical responsible for addiction in smokers, is present in most electronic cigarettes. Although some studies suggest that e-cigarettes pose less of a health risk than cigarettes, there are concerns that the popularity of vaping may increase the likelihood that teens will switch to traditional cigarettes. There are also no definitive health and developmental risk assessments for adolescents who vape.
Sun and his team used data from the NYTS to develop a new metric to quantify nicotine and tobacco product use, called nicotine product days. The measurement tracks the frequency of use of nicotine-based products over a 30-day period. When using a non-risk-adjusted NPD measure, they found a decrease in nicotine and tobacco use from 1999 to 2013, followed by a large increase attributed only to vaping among adolescents.
Taking into account the frequency of use of nicotine products is the first of two adjustments needed to better assess tobacco and nicotine consumption, according to Sun. The second is to include the risks associated with the product in the metric. Risk-adjusted NPDs allow researchers to consider the health implications of different types and mixtures of electronic cigarette products, as well as other tobacco products such as cigars and hookah. Sun also acknowledges that with a low assessment of the long-term risks of vaping compared to those of smoking, risk-adjusted NPDs could show a continuing overall decline in health risks associated with tobacco and nicotine use. among adolescents from 2014 to 2020.
Read Ruoyan Sun, Ph.D.’s commentary on the study here.
“Taking into account the differential risks of nicotine and tobacco products can provide a clearer overall picture of adolescent risks,” Sun said. “Updating survey and measurement guidelines to better assess product details and consumption patterns is the first step in helping public health experts understand the risks associated with changing patterns of use. tobacco and nicotine in young people. ”
To learn more about trends in nicotine product use among American teens, 1999-2020, click here.