Use of ‘Elf Bar’ among youth and young adults who currently vape in England:cross-sectional associations with demographics, dependence indicators and reasons for use

Background and aims: Elf Bar is currently the leading e-cigarette (vape) brand in Great Britain. This study examined youth and young adults’ use of Elf Bar, socio-demographic characteristics and dependence indicators and reasons for use over other brands. Design: Cross-sectional survey. Setting and participants: Online 2022 International Tobacco Control Project Youth Tobacco and Vaping Survey (N = 1355 16-29-year-olds in England who had vaped in the past 30 days). Measurements: Currently using Elf Bar most often (versus other brands) and associations with: socio-demographics, owning a vaping device, dependence indicators and reasons for brand choice. Logistic regressions were used. Findings: Among 16–29-year-olds who vaped in the past 30 days, 48.4% (n = 732) reported Elf Bar as the brand they used most often. Among 16–17-year-olds, 40.7% used Elf Bar over other brands; this was lower than among 18–19-year-olds (60.1%) and 20–29-year-olds (47.4%) (P ≤ 0.002). Using Elf Bar over other brands was higher among those who were female (55.2 versus 41.5% male), identified as White (53.1 versus 30.9% other/mixed), a student (54.5 versus 44.3% not), did not own a vape (66.7 versus 44.4% who did) and typically vaped 5–8 hours after waking (62.7 versus 36.8% within 5 min) (P ≤ 0.044). Most who vaped but had never smoked used Elf Bar (64.3%), although use did not significantly differ from those who currently (45.4%), formerly (42.3%) or experimentally (48.7%) smoked (all P ≥ 0.060). Popular reasons for choosing Elf Bar over other brands were better flavour/taste (47.5%), less expensive (28.7%), easier to get (26.1%), smoother to inhale (24.0%) and popularity (23.1%). ‘Better for quitting smoking’ (10.1%) was least frequently selected reason for choosing Elf Bar over other brands. Conclusions: Elf Bar brand e-cigarettes were used by approximately half of 16–29-year-olds who vaped in England in 2022 and was mainly chosen over other brands for subjective responses (e.g. flavour/taste), rather than for quitting smoking.</p

Evaluating the Outcomes of the Menthol Cigarette Ban in England by Comparing Menthol Cigarette Smoking Among Youth in England, Canada, and the US, 2018-2020

Importance: Menthol cigarettes were prohibited in England in May 2020 and nationally in Canada in October 2017 but remain permitted in the US. Evidence on the outcomes of menthol cigarette bans among youth outside of Canada, and the characteristics of youth smokers, is lacking. Objectives: To evaluate the outcomes of menthol cigarette bans on youth menthol cigarette smoking and to characterize youth menthol cigarette smokers in terms of demographics and cigarette consumption and dependence. Design, Setting, and Participants: This survey study uses data from online repeat cross-sectional International Tobacco Control Youth Tobacco and Vaping Surveys conducted in 2018, 2019, February 2020, and August 2020. Participants included past 30-day smokers aged 16 to 19 years. Data analysis was performed from March 2021 to January 2022. Main Outcomes and Measures: Usually smoke a brand of cigarettes that was menthol, including capsule. Exposures: Menthol cigarette ban, comparing 3 countries over time: Canada, where a ban already existed, England, where a ban was implemented during the study, and the US, where no national ban was present. Age, sex, race, and consumption and dependence were also examined by menthol smoking in each country, and in England before vs after the ban. Results: The analytical sample comprised 7067 participants aged 16 to 19 years, of whom 4129 were female and 5019 were White. In England, the weighted percentage of youth smokers who reported smoking a menthol or capsule cigarette brand was stable in the 3 survey waves before the menthol ban (2018 to February 2020, 9.4% vs 12.1%; adjusted odds ratio [AOR], 1.03; 95% CI, 0.99-1.06; P = .15) but decreased to 3.0% after the ban (February 2020 vs August 2020, AOR, 1.07; 95% CI, 1.04-1.10; P 5 vs 1, AOR, 1.10; 95% CI, 1.03-1.18; P = .007), or had urges to smoke every or most days (AOR, 1.08; 95% CI, 1.02-1.14; P = .006); and among smokers in Canada who perceived themselves as addicted to cigarettes (AOR, 1.02; 95% CI, 1.00-1.03; P = .01). Conclusions and Relevance: In this survey study, the proportion of youth smokers who smoke menthol (including capsule) cigarettes decreased substantially after the menthol ban in England. This association was consistent across all demographic groups. Perceived addiction among menthol smokers was also lower where menthol cigarettes were banned

Effectiveness of School Based Recruitment Procedures and Modular Data Collections

Purpose: The School Health Action, Planning and Evaluation System (SHAPES) is a school-based data collection and knowledge exchange system designed to improve the health of youth. This paper outlines the design of the SHAPES study, examines the impact of different school recruitment models on participation rates, and examines the impact of using two different research modules during data collection on the prevalence of core behaviours being measured. Methods: In total, 76 schools were recruited from seven health regions and data were collected using the SHAPES Tobacco (TM) and Physical Activity Modules (PAM). Results: It was found that school recruitment rates were higher when both the researchers and the health unit, worked together to recruit schools. Significant differences were found between students who completed the TM and students who completed the PAM with respect to body mass index, smoking susceptibility, the number of friends who smoke, and the number of active friends. Conclusions: This paper provides valuable real-world insight for future researchers interested in performing population-level school-based studies of youth risk behaviours. Our experience suggests that a modular approach to data collection is feasible and that recruitment rates are improved when researchers work in collaboration with health unit staff who have existing relationships with schools

Driving under the influence behaviours among high school students who mix alcohol with energy drinks

Published by Elsevier via http://dx.doi.org/10.1016/j.ypmed.2017.11.035 © 2017. Made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/Alcohol and energy drinks are commonly used substances by youth in Canada, and are often mixed (AmED). While several studies have shown that AmED can have dangerous effects, less well understood is how AmED is associated with driving under the influence of either alcohol or drugs. This study sought to determine whether youth who use AmED were more likely to engage in driving, or being a passenger of a driver, under the influence of alcohol or cannabis compared to youth who use either alcohol or energy drinks alone. This study used data from grade 10–12 students who took part in the 2014/2015 Canadian Student Tobacco, Alcohol and Drugs Survey (N=17,450). The association of past-year AmED use with past-30day: driving under the influence of alcohol or cannabis, and riding with an alcohol- or cannabis-influenced driver, was assessed using logistic regression. One in four youth had consumed AmED in the previous 12months. AmED users were more likely to engage in all risk behaviours except riding with a drinking driver, relative to youth who only consumed alcohol. No association was observed for youth who consumed alcohol and energy drinks on separate occasions. Youth who use AmED demonstrate a higher risk profile for driving under the influence of alcohol or cannabis, than youth who use alcohol alone. Future research should explore the biopsychosocial pathways that may explain why using energy drinks enhances the already heightened risk posed by alcohol on other health-related behaviours such as driving under the influence.Canadian Cancer Society (grant #2011-701019

Noticing education campaigns or public health messages about vaping among youth in the US, Canada, and England from 2018 to 2022

Purpose: Public health campaigns have the potential to correct vaping misperceptions. However, campaigns highlighting vaping harms to youth may increase misperceptions that vaping is equally/more harmful than smoking. Vaping campaigns have been implemented in the US and Canada since 2018, and in England since 2017, but with differing focus: youth vaping prevention (US/Canada) and smoking cessation (England). We therefore examined country differences and trends in noticing vaping campaigns among youth and, using 2022 data only, perceived valence of campaigns and associations with harm perceptions. Methods: Seven repeated cross-sectional surveys of 16–19-year-olds in US, Canada, England (2018-2022, N=92,339). Results: Over half of youth reported noticing vaping campaigns, and noticing increased from Aug’18-Feb’20 (US:55.2-74.6%,AOR=1.21,95%CI=1.18-1.24; Canada:52.6-64.5%,AOR=1.13,1.11-1.16; England:48.0-53.0%,AOR=1.05,1.02-1.08) before decreasing (Canada) or plateauing (England/US) to Aug’22. Increases were most pronounced in the US, then Canada. Noticing was most common on websites/social media, school, and television/radio. In 2022 only, most campaigns were perceived to negatively portray vaping and this was associated with accurately perceiving vaping as less harmful than smoking among youth who exclusively vaped (AOR=1.46,1.09-1.97). Conclusion: Consistent with implementation of youth vaping prevention campaigns in the US and Canada, most youth reported noticing vaping campaigns/messages, and most were perceived to negatively portray vaping

Trends in E-Cigarette and Tobacco Cigarette Purchasing Behaviors by Youth in the United States, Canada, and England, 2017–2022

Objectives: This paper describes trends in youth e-cigarette (EC) and tobacco cigarette (TC) purchasing behaviors in Canada, England, and the United States (US) in relationship to changing minimum legal age (MLA) laws.Methods: Data are from eight cross-sectional online surveys among national samples of 16- to 19-year-olds in Canada, England, and the US conducted from 2017 to 2022 (N = 104,467). Average wave percentage change in EC and TC purchasing prevalence and purchase locations were estimated using Joinpoint regressions.Results: EC purchasing increased between 2017 and 2022, although the pattern of change differed by country. EC purchasing plateaued in 2019 for the US and in 2020 for Canada, while increasing through 2022 for England. TC purchasing declined sharply in the US, with purchasing from traditional retail locations declining, while purchasing from social sources increased. Vape shops were the most common location for EC purchasing, although declining in England and the US.Conclusion: Trends in EC and TC purchasing trends in the US are consistent with the expected impact of the federal MLA law increasing the legal age to 21 years in December 2019

Roll-your-own tobacco use among Canadian youth: is it a bigger problem than we think?

Abstract Background Despite the apparent decline in the popularity of roll-your-own (RYO) cigarettes over the past few decades, RYO tobacco products are widely available and used by a substantial number of adult smokers. Considering research has yet to examine the prevalence of RYO tobacco use among youth populations, this manuscript examines the prevalence of RYO tobacco use and factors associated with RYO use in a nationally representative sample of youth smokers from Canada. Methods This study used data collected from 3,630 current smokers in grades 9 to 12 as part of the 2008-09 Canadian Youth Smoking Survey (YSS). Descriptive analyses of the sample demographic characteristics, smoking status, cigarettes per day, weekly spending money, and frequency of marijuana use were examined by RYO tobacco ever use and RYO tobacco current use. Two logistic regression models were used to examine factors associated with RYO tobacco ever use and RYO tobacco current use. Results We identified that 51.2% of current smokers were RYO ever users and 24.2% were RYO current users. The prevalence of RYO current users was highest in Atlantic Canada (40.1%) and lowest in Quebec (12.3%). RYO current users were more likely to be male (OR 1.27), to be daily smokers (OR 1.75), to use marijuana once a month or more (OR 2.74), and to smoke 11 or more cigarettes per day (OR 6.52). RYO current users were less likely to be in grade 11 (OR 0.65) or grade 12 (OR 0.40) and less likely to have between $20 to$100 (OR 0.44) or more than $100 (OR 0.45) of disposable income. Conclusions Developing a better understanding of RYO tobacco use among youth is important for advancing population-level tobacco control prevention strategies and cessation programs. We identified that RYO tobacco use is not a negligible problem among Canadian youth. Ongoing research is needed to continue monitoring the prevalence of RYO use among youth and the factors associated with its use, but to also monitor if this more affordable tobacco product is being targeted to price sensitive youth smokers.</p

Menthol cigarette smoking among youth in England, Canada, and the US between 2018 and 2020: Evaluating menthol bans and characterising menthol smokers

This project aims to: 1) Evaluate the impact of menthol cigarette bans among youth in England (where menthol cigarettes were banned in May 2020) and Canada (where menthol cigarettes were banned federally in January 2017) compared to the US (where menthol cigarettes are not banned federally); and 2) Characterise past 30-day menthol and capsule cigarette smokers in terms of cigarette consumption and dependence