Marijuana and e-cigarette use in a US national sample of 8th and 10th grade never-smokers of conventional cigarettes

Introduction: E-cigarette use remains a controversial topic in public health and medicine. Historically, cigarette smoking was identified as a gateway to marijuana use among adolescents. Recently, the prevalence of adolescent cigarette smoking has declined, but that of e-cigarette use continues to increase. As e-cigarettes eclipse cigarettes among adolescents, e-cigarette use may predispose adolescents to marijuana use. This study examines the relationship between e-cigarette use and marijuana use in a national sample of adolescents who have never smoked conventional cigarettes. Methods: A national sample of 8th and 10th grade never-smokers of conventional cigarettes (N=12,743) was obtained from 2014-2015 Monitoring the Future surveys. The dependent variable was past 30-day marijuana use (dichotomized Yes/No), and the independent variables were past 30-day e-cigarette use (dichotomized Yes/No), perceived availability of marijuana, peer marijuana use, parental monitoring, and religiosity. A multivariable logistic regression was conducted with marijuana use regressed on e-cigarette use, and other independent variables while controlling for covariates such as paid employment, risk-taking propensity, and sociodemographic variables. Additional regression analysis was conducted on e-cigarette users only. Results: Among adolescent never-smokers of conventional cigarettes, 5.2% and 5.6% had used marijuana and e-cigarettes, respectively, in the past 30 days. Among never-smokers who are current e-cigarette users, 24.2% had used marijuana at least once in the past 30-days, compared to 3.9% of non-e-cigarette users. Logistic regression analyses showed that e-cigarette users were three times more likely than non-users to be current marijuana users after adjusting for other variables. Perceived availability of marijuana and peer marijuana use increased the likelihood of marijuana use, while parental monitoring and religiosity were protective against marijuana use. Among e-cigarette users, the predictors of marijuana use were peer marijuana use and perceived availability of marijuana. Conclusion & Implications: A significant proportion of adolescents who have never smoked conventional cigarettes are current marijuana users. Among these adolescents, e-cigarette use is associated with a threefold increase in odds of marijuana use, suggesting a link between e-cigarette and marijuana use that is independent of conventional cigarette smoking. Among e-cigarette users, peer marijuana use and perceived availability of marijuana are particularly predictive of marijuana use and are potential foci for targeted interventions focused on reducing dual e-cigarette and marijuana use among adolescents

Adolescent E-Cigarette Users’ Perceptions of the Harm and Addictiveness of Conventional Cigarette Smoking

As the popularity of e-cigarettes continues to rise and their link with conventional cigarette smoking becomes clearer, it is important to understand how e-cigarette users compare with non-users, conventional cigarette smokers, and dual users on perceptions of addiction risk of conventional cigarette smoking as well as on other risk factors associated with smoking. PRC graduate student trainee Olusegun Owotomo, PRC faculty research associate Julie Maslowsky, and co-author Alexandra Loukas found that adolescent e-cigarette users endorsed a number of attitudes, perceptions, and characteristics that are risk factors for conventional cigarette smoking. These perceptions may leave them vulnerable to becoming conventional cigarette smokers or dual users in the future and potentially increase their risk for nicotine addiction.Population Research Cente

Answering Developmental Questions Using Secondary Data

Secondary data analysis of large longitudinal and national data sets is a standard method used in many social sciences to answer complex questions regarding behavior. In this article, we detail the advantages of using these data sets to study developmental questions across the life span. First, we provide an overview of how using secondary data can increase studies' scientific integrity. Then, we detail where and how data sets can be obtained that answer specific questions. Finally, we discuss methodological issues related to using longitudinal, population data sets. These data sets can enhance science and test theories by increasing the rigor and generalizability of research to the general population, making secondary data analysis an important method to consider.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/115923/1/cdep12151.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/115923/2/cdep12151_am.pd

Effects of postpartum mobile phone‐based education on maternal and infant health in Ecuador

ObjectiveTo evaluate the effects of a mobile phone‐based intervention on postnatal maternal health behavior and maternal and infant health in a middle‐income country.MethodsA prospective evaluation enrolled consecutive postpartum women at two public hospitals in Quito, Ecuador, between June and August 2012. Inclusion criteria were live birth, no neonatal intensive care admission, and Spanish speaking. Intervention and control groups were assigned via random number generation. The intervention included a telephone‐delivered educational session and phone/text access to a nurse for 30 days after delivery. Maternal and infant health indicators were recorded at delivery and 3 months after delivery via chart review and written/telephone‐administered survey.ResultsOverall, 102 women were assigned to the intervention group and 76 to the control group. At 3 months, intervention participants were more likely to attend the infant’s postnatal check‐up (P = 0.022) and to breastfeed exclusively (P = 0.005), and less likely to feed formula (P = 0.016). They used more effective forms of contraception (more implants P = 0.023; fewer condoms P = 0.036) and reported fewer infant illnesses (P = 0.010). There were no differences in maternal acute illness or check‐up attendance.ConclusionMobile phone‐based postnatal patient education is a promising strategy for improving breastfeeding, contraceptive use, and infant health in low‐resource settings; different strategies are needed to influence postpartum maternal health behavior.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135151/1/ijgo93.pd

Neural Correlates of Treatment in Adolescents with Generalized Anxiety Disorder: A Preliminary Investigation

Objective: Generalized anxiety disorder (GAD) is a prevalent and debilitating psychiatric condition in adolescence. Two effective forms of treatment are cognitive behavioral therapy (CBT) and selective serotonin reuptake inhibitors. This pilot study examined changes in brain function following each type of treatment in GAD. Method: Subjects were 14 youth with GAD (7 had CBT, 7 received fluoxetine) and 10 age- and gender-matched healthy peers. FMRI scans were acquired before and after treatment for patients, and over two comparable time points for controls. During fMRI acquisition, a probe detection task with emotional (angry, happy) and neutral faces allowed for assessment of neural response to threat. Following previous research, region of interest analyses were performed in the right ventrolateral prefrontal cortex (VLPFC). Results: FMRI results showed increased VLPFC activation, relative to controls, in the medication (t(15) = 3.01, p \u3c 0.01) and CBT (t(15) = 3.22, p \u3c 0.01) groups following treatment. Conclusions: This study shows significant increase in VLPFC activation in response to angry faces following treatment with CBT or fluoxetine for GAD. This is consistent with previous research indicating that the VLPFC may facilitate effective responding to underlying neural correlates of anxiety in other brain regions, such as the amygdala

Engaging Patients via Mobile Phone Technology to Assist Follow-Up After Hospitalization in Quito, Ecuador

Abstract Objective: Disease management following hospital discharge is difficult in most low-resourced areas, posing a major obstacle to health equity. Although mobile phones are a ubiquitous and promising technology to facilitate healthcare access, few studies have tested the acceptability and feasibility of patients themselves using the devices for assisting linkages to healthcare services. We hypothesized that patients would use mobile phones to help manage postdischarge problems, if given a communication protocol. We developed a mobile phone-based program and investigated its acceptability and feasibility as a method of delivering posthospitalization care. Subjects and Methods: A consecutive cohort of adult patients in a public hospital in Quito, Ecuador was enrolled over a 1-month period. A hospital-based nurse relayed patients' discharge instructions to a community-based nurse. Patients corresponded with this nurse via text messaging and phone calls according to a protocol to initiate and participate in follow-up. Results: Eighty-nine percent of eligible patients participated. Ninety-seven percent of participants completed at least one contact with the nurse; 81% initiated contact themselves. Nurses completed 262 contacts with 32 patients, clarifying discharge instructions, providing preventive education, and facilitating clinic appointments. By this method, 87% of patients were successfully linked to follow-up appointments. Conclusions: High levels of patient participation and successful delivery of follow-up services indicate the mobile phone program's acceptability and feasibility for facilitating posthospitalization follow-up. Patients actively used mobile phones to interact with nurses, enabling the provision of posthospitalization medical advice and facilitate community-based care via mobile phone.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98493/1/tmj%2E2011%2E0156.pd

What Is a Representative Brain? Neuroscience Meets Population Science

The last decades of neuroscience research have produced immense progress in the methods available to understand brain structure and function. Social, cognitive, clinical, affective, economic, communication, and developmental neurosciences have begun to map the relationships between neuro-psychological processes and behavioral outcomes, yielding a new understanding of human behavior and promising interventions. However, a limitation of this fast moving research is that most findings are based on small samples of convenience. Furthermore, our understanding of individual differences may be distorted by unrepresentative samples, undermining findings regarding brain–behavior mechanisms. These limitations are issues that social demographers, epidemiologists, and other population scientists have tackled, with solutions that can be applied to neuroscience. By contrast, nearly all social science disciplines, including social demography, sociology, political science, economics, communication science, and psychology, make assumptions about processes that involve the brain, but have incorporated neural measures to differing, and often limited, degrees; many still treat the brain as a black box. In this article, we describe and promote a perspective—population neuroscience—that leverages interdisciplinary expertise to (i) emphasize the importance of sampling to more clearly define the relevant populations and sampling strategies needed when using neuroscience methods to address such questions; and (ii) deepen understanding of mechanisms within population science by providing insight regarding underlying neural mechanisms. Doing so will increase our confidence in the generalizability of the findings. We provide examples to illustrate the population neuroscience approach for specific types of research questions and discuss the potential for theoretical and applied advances from this approach across areas

Substance Use Consequences of Adolescent Mental Health Problems: Integrating National and High-Risk Samples.

The risk for substance use posed by conduct problems (CP) and depressive symptoms (DS) during adolescence has been documented in the developmental psychopathology and epidemiological literatures. However, several crucial questions remain regarding the associations of CP, DS, and alcohol, marijuana, and cigarette use during adolescence. First, research to date has yielded inconsistent evidence regarding the association of DS and substance use, with evidence for positive, negative, and null associations. Second, despite the fact that CP and DS commonly co-occur, the role of their interaction in substance use has not been well characterized. Third, additional research is needed to specify how the associations between CP, DS, and substance use vary by specific substance and between and within demographic subgroups. This dissertation used data from national and high-risk adolescent samples to address these critical questions. Results indicated that, cross-sectionally and longitudinally, CP was a strong predictor of substance use, DS was a weak but positive predictor, and the interaction of CP and DS was a strong predictor, particularly among younger adolescents, such that adolescents with high levels of both CP and DS used substances most frequently. A within-group analysis of African American adolescents revealed that parental support inversely related to adolescent CP, DS, and alcohol and marijuana use, and that the parent support-substance use association was mediated by CP. Overall, the results of this work demonstrate that, although CP is often thought to be a primary predictor of substance use, DS can potentiate the relation of CP to substance use. The generalizability of these results is enhanced by the use of both national and high-risk samples and their consistency across multiple samples. The results indicate that substance use prevention efforts should target both CP and DS in early adolescence. In addition, increasing parental support may help to reduce both mental health problems and substance use during adolescence. Strategic investment in prevention of substance use can yield drastic reductions in morbidity and mortality and improvements in health. This work suggests that consideration of the contributions of mental health to adolescent substance use should be integrated into such efforts.PHDPsychologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/93883/1/jmaslow_1.pd

Developmental Trends in Sleep Duration in Adolescence and Young Adulthood: Evidence From a National United States Sample

PurposeTo present normative values of mean sleep duration from adolescence through young adulthood (ages 13-32 years), prevalence of short (<6 hours) and long (>10 hours) sleep durations, and differences in each by sex and race/ethnicity.MethodsMean sleep duration and prevalence of extremely short and long sleep were estimated using data from the United States National Longitudinal Study of Adolescent Health, Waves 1-4 (N = 15,701).ResultsSleep duration showed age-related trends, with decreases across the adolescent period from 8.5 hours per night at age 13 years to 7.3 hours at age 18 years, an increase through the emerging adulthood period to 8.5 hours at age 22, and a gradual decline across early adulthood to 7.7 hours at age 32 years. Prevalence of extremely long and short sleep followed similar developmental trends. Adolescent girls reported lower mean sleep duration than did boys, but women reported longer average sleep duration than did men from age 19 years onward. Short sleep duration was most common among African-Americans at all ages. Long sleep was most common among African-Americans in adolescence and emerging adulthood and among Hispanics in early adulthood.ConclusionsSleep duration is developmentally patterned from adolescence through early adulthood. Mean and extreme sleep durations vary systematically by sex and race/ethnicity as well as age. These normative data on sleep duration will inform studies of the role of sleep in the etiology of a wide range of health conditions affecting adolescents and young adults