The Associations Between E-Cigarettes and Binge Drinking, Marijuana Use, and Energy Drinks Mixed With Alcohol

doi:10.1016/j.jadohealth.2016.10.011

Journal of Adolescent Health

Volume 60, Issue 3, March 2017, Pages 320-327

https://doi.org/10.1016/j.jadohealth.2016.10.011 Get rights and content

Abstract

Purpose

Use of e-cigarettes by youth is proliferating worldwide, but little is known about the behavioral profile of youth e-cigarette users and the association of e-cigarette use with other health-risky behaviors. This study examines the associations between e-cigarette use and tobacco, marijuana, and alcohol use among a large sample of Canadian youth.

Methods

Using Canadian data from 39,837 grade 9 to 12 students who participated in year 3 (2014–2015) of the COMPASS study, logistic regression models were used to examine how current use of e-cigarettes were associated with tobacco, marijuana, binge drinking, and energy drinks mixed with alcohol. Pearson's chi-square tests were used to examine subgroup differences by sex.

Results

Overall, 9.75% of respondents were current e-cigarette users. Current cigarette smokers (odds ratio [OR] = 3.009), current marijuana users (OR = 5.549), and noncurrent marijuana users (OR = 3.653) were more likely to report using e-cigarettes than noncigarette smokers and nonmarijuana users. Gender differences among males and females showed higher risk of e-cigarette use among female current marijuana users (OR = 7.029) relative to males (OR = 4.931) and female current smokers (OR = 3.284) compared to males (OR = 2.862). Compared to nonbinge drinkers, weekly (OR = 3.253), monthly (OR = 3.113), and occasional (OR = 2.333) binge drinkers were more likely to use e-cigarettes. Similarly, students who consume energy drinks mixed with alcohol (OR = 1.650) were more likely to use e-cigarettes compared to students who do not consume them.

Conclusions

We identify that youth who binge drink or use marijuana have a greater increased risk for using e-cigarettes compared to cigarette smokers. These data suggest that efforts to prevent e-cigarette use should not only be discussed in the domain of tobacco control.

Section snippets

Design

This study uses data from the COMPASS study which is an established school-based system designed to effectively guide and improve youth prevention research and practice. The COMPASS study is an ongoing cohort study (2012–2021) collecting hierarchical and linked longitudinal behavioral and program/policy data from a sample of 50,000+ grade 9 to 12 students and the 89 secondary schools they attended in Ontario (n = 79) and Alberta (n = 10) [32]. While the first wave of data for COMPASS was

Descriptive statistics

Table 1 describes the sample (full and stratified by sex). As shown in Table 1, 9.75% of respondents reported using e-cigarettes in the past 30 days (12.40% of males and 7.09% of females). Among all respondents in our final sample, 6.01% were current smokers, 15.87% were classified as current marijuana users, 16.20% were occasional binge drinkers, 16.81% were monthly binge drinkers, 5.91% were weekly binge drinkers, and 13.69% reported consuming energy drinks mixed with alcohol. When we

Discussion

This study identified that almost 1 in 10 Canadian youth from Ontario and Alberta in grades 9 to 12 in the COMPASS study were considered current e-cigarette users in the 2014–2015 school year, representing a 35% relative increase in current e-cigarette use compared to the results identified just 1 year earlier with the year 2 COMPASS data [6]. Our results identify that co-occurring substance use behaviors are common among youth who are current e-cigarette users and that co-occurring substance

Funding Sources

The COMPASS study was supported by a bridge grant from the Canadian Institutes of Health Research (CIHR) Institute of Nutrition, Metabolism and Diabetes (INMD) through the “Obesity—Interventions to Prevent or Treat” priority funding awards (OOP-110788; grant awarded to ST. Leatherdale) and an operating grant from the Canadian Institutes of Health Research (CIHR) Institute of Population and Public Health (IPPH) (MOP-114875; grant awarded to ST. Leatherdale). Dr. Leatherdale is a Chair in Applied

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To update an earlier review, published in 2016, on the health and other outcomes associated with children and young people's consumption of energy drinks (EDs).
Review article.
Systematic searches of nine databases (ASSIA, CINAHL, Cochrane Library, DARE, Embase, ERIC, MEDLINE, PsycINFO and Web of Science) retrieved original articles reporting the effects of EDs experienced by children and young people up to the age of 21 years. Searches were restricted by publication dates (January 2016 to July 2022) and language (English). Studies assessed as being weak were excluded from the review. Included studies underwent narrative synthesis.
A total of 57 studies were included. Boys consumed EDs more than girls. Many studies reported a strong positive association between ED consumption and smoking, alcohol use, binge drinking, other substance use and the intentions to initiate these behaviours. Sensation-seeking and delinquent behaviours were positively associated with ED consumption, as were short sleep duration, poor sleep quality and low academic performance. Additional health effects noted in the updated review included increased risk of suicide, psychological distress, attention-deficit hyperactivity disorder symptoms, depressive and panic behaviours, allergic diseases, insulin resistance, dental caries and erosive tooth wear.
This review adds to the growing evidence that ED consumption by children and young people is associated with numerous adverse physical and mental health outcomes. Where feasible and ethical, additional longitudinal studies are required to ascertain causality. The precautionary principle should be considered in regulatory policy and restriction of ED sales to this population.
CRD42021255484.
Gendered associations between e-cigarette use, cigarette smoking, physical activity, and sedentary behaviour in a sample of Canadian adolescents
2022, Dialogues in Health
To examine associations between e-cigarette use, cigarette smoking, physical activity, and sedentary behaviour among a large sample of Canadian adolescents (Grades 9–12) by sex.
Cross-sectional data from 55,629 students who participated in COMPASS Year 6 (2017–2018) were used. Exposures included e-cigarette use and cigarette smoking. Outcomes included meeting recommendations for moderate- to vigorous- physical activity (MVPA;≥60 min/d), muscular strengthening exercises (MSE;≥3 time/wk), and recreational screen time (ST;≤2 h/day) and participating in intramurals or competitive team sports. Logistic regressions were performed after adjusting for relevant covariates.
Male adolescents showed higher prevalence of e-cigarette use (40.0% vs 31.3%) and cigarette smoking (4.4% vs 2.9%) than females. Both males and females who used e-cigarettes were more likely to meet MVPA and MSE recommendations, but less likely to meet the ST recommendation than those who did not use e-cigarettes. E-cigarette use was also consistently associated with more sport participation in males, however, among females the results were mixed. Current cigarette use was associated with meeting the MVPA recommendation and less participation in intramurals in males; however, in females, current cigarette smoking was consistently associated with less participation in any sports. Former cigarette use was associated with participation in competitive team sport within school and meeting the MSE recommendation in females only.
This study found that associations between e-cigarette use and cigarette smoking with physical activity, sedentary behaviour, and sport participation are largely gendered. Identifying differential co-occurrence of risk behaviours by gender is important for future health promotion efforts targeting physical activity among adolescents.
Recreational Marijuana Legalization and Adolescent Use of Marijuana, Tobacco, and Alcohol
2021, Journal of Adolescent Health
Given the rapid expansion of recreational marijuana legalization (RML) polices, it is essential to assess whether such policies are associated with shifts in the use of marijuana and other substances, particularly for adolescents, who are uniquely susceptible to negative repercussions of marijuana use. This analysis seeks to provide greater generalizability, specificity, and methodological rigor than limited prior evidence.
Youth Risk Behavior Survey data from 47 states from 1999 to 2017 assessed marijuana, alcohol, cigarette, and e-cigarette use among adolescents (14–18+ years; N = 1,077,938). Associations between RML and adolescent past-month substance use were analyzed using quasi-experimental difference-in-differences zero-inflated negative binomial models.
Controlling for other state substance policies, year and state fixed effects, and adolescent demographic characteristics, models found that RML was not associated with a significant shift in the likelihood of marijuana use but predicted a small significant decline in the level of marijuana use among users (incidence rate ratio = .844, 95% confidence interval [.720–.989]) and a small increase in the likelihood of any e-cigarette use (odds ratio of zero use = .647, 95% confidence interval [.515–.812]). Patterns did not vary over adolescent age or sex, with minimal differences across racial/ethnic groups.
Results suggest minimal short-term effects of RML on adolescent substance use, with small declines in marijuana use and increase in the likelihood of any e-cigarette use. Given the delayed rollout of commercial marijuana sales in RML states and rapid expansion of RML policies, ongoing assessment of the consequences for adolescent substance use and related health and behavioral repercussions is essential.
Vaping while high: Factors associated with vaping marijuana among youth in the United States
2020, Drug and Alcohol Dependence
Citation Excerpt :
Existing evidence shows an association between e-cigarette use and subsequent marijuana use among youth (Dai et al., 2018). Indeed, existing evidence demonstrates that both e-cigarettes and marijuana use are prevalent among youth in the US (Dai and Hao, 2017; Trivers et al., 2018) and beyond (Milicic and Leatherdale, 2017). A 2016 National Youth Tobacco Survey (NYTS) study found that among e-cigarette users, around 30 % of high school students (estimated 1.7 million) and nearly 25 % of middle school students (estimated 425,000) had ever vaped marijuana (Trivers et al., 2018).
The use of e-cigarette and other vaping devices have become popular among youth in US. In addition to nicotine, vaping devices can be used to vaporize marijuana. However, factors associated with vaping marijuana among youth remain unexplored. This study examined the rates of vaping marijuana and its correlates among youth in the US.
We conducted a cross-sectional analysis of survey data from the 2018 National Youth Tobacco Survey of middle-and high-schoolers who provided information regarding ever use of vaping devices to vape marijuana (n = 10,680). Multivariable regression model was conducted to assess factors associated with vaping marijuana.
Overall, 26.2 % of participants reported ever vaping marijuana. High-schoolers [vs middle-schoolers; aOR = 2.16,95 %CI:1.76−2.67], Hispanics [vs Whites; aOR = 2.30,95 %CI:1.90−2.80], and Blacks [vs Whites; aOR = 1.42,95 %CI:1.04−1.92] were more likely to ever vape marijuana. Those who perceived e-cigarette as equally addictive to cigarettes, were less likely to ever vape marijuana [aOR = 0.79, 95 %CI:0.65−0.97]. In addition, those who reported ever trying cigarettes [aOR = 1.63,95 %CI:1.29−2.06], cigars [aOR = 2.62, 95 %CI:2.08−3.30], or hookah [aOR = 2.88,95 %CI:2.14−3.89] were more likely to ever vape marijuana. Lifetime frequency of e-cigarette use was associated with greater odds of ever vaping marijuana (p-values <0.001).
Large numbers of youth in the US have ever vaped marijuana. Our findings indicate that sociodemographic characteristics, tobacco product use, frequency of e-cigarette use are important factors associated with vaping marijuana. Tobacco control campaigns targeted at curbing the use of e-cigarette and other vaping devices among youth in the US should be extended to address vaping substances other than nicotine such as marijuana.
Trends and predictors of exclusive e-cigarette use, exclusive smoking and dual use among youth in Canada
2020, Addictive Behaviors
Few studies have examined predictors of exclusive e-cigarette use, exclusive smoking and dual use among youth. We investigated whether frequency of e-cigarette use and cigarette smoking predicted involvement in different usage groups after a 1- and 2-year follow-up among a sample of Canadian youth.
A longitudinal sample of youth who participated in three waves of COMPASS [Wave 1 (W₁) 2015/16, Wave 2 (W₂) 2016–17, Wave 3 (W₃) 2017/18] was identified (N = 5,704). Multinomial logistic regression was used to examine whether frequency of e-cigarette use and cigarette smoking at W₁ predicted involvement in different usage groups at W₂ and W₃. Similarly, we examined whether changes in frequency of e-cigarette use and cigarette smoking between W₁ and W₂ predicted involvement in different usage groups at W₃.
E-cigarette users reporting use on 4 or more days per month at W₁ had greater odds of dual use at W₂, compared to non-users (aOR = 11.22, p < 0.0001). Those who reduced their frequency of e-cigarette use between W₁ and W₂ had lower odds of exclusive e-cigarette use and dual use at W₃ (aOR = 0.18 and 0.17 respectively; both p < 0.05). Those who increased their frequency of cigarette smoking between W₁ and W₂ had higher odds of exclusive smoking and dual use at W₃ (aOR = 22.65 and aOR = 9.92 respectively; both p < 0.0001).
Reductions in frequency of e-cigarette use appeared to have a protective effect of reducing exclusive e-cigarette use and dual use at follow-up. Increases in frequency of cigarette smoking were a significant predictor of exclusive smoking and dual use.
Electronic nicotine delivery system use is related to higher odds of alcohol and marijuana use in adolescents: Meta-analytic evidence
2020, Addictive Behaviors
Research suggests that electronic nicotine delivery system (ENDS) use is associated with other substance use in adolescents; however, the magnitude of this association and whether this differs between adolescents and adults is not yet well understood. This meta-analysis aimed to quantify the extent to which ENDS use is associated with alcohol and marijuana use among adolescents and to compare the odds across adolescent samples and a comparison group of adult samples. A comprehensive literature review was conducted examining the relationship between ENDS use and alcohol (adolescent k = 40 from 19 independent studies; adult k = 35 from 12 independent studies) and marijuana (adolescent k = 24 from 14 independent studies; adult k = 6 from 3 independent studies) use. Adolescents who use ENDS had greater odds of reporting co-occurring alcohol use (OR = 4.50, p < .001), particularly binge drinking (OR = 4.51), and marijuana use (OR = 6.04, p < .001) than adolescent who did not use ENDS. Adults who use ENDS were also more likely to use alcohol (OR = 1.57, p < .001) and marijuana (OR = 2.04, p < .001) than those who did not use ENDS. ENDS use was associated with significantly greater odds of alcohol use (log odds ratio; LOR = 0.96 (OR = 2.61), p < .001) and a trend of greater marijuana use (LOR = 0.93 (OR = 2.53), p = 0.08) in adolescents than in adults. Effects were large in adolescents and small in adults. Findings suggest that ENDS use should be assessed in adolescents in both research and clinical settings. Importantly, ENDS use is strongly associated with co-occurring alcohol or marijuana use in adolescents.

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: Conflicts of Interest: The authors have no conflicts of interest to disclose.

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Original articleThe Associations Between E-Cigarettes and Binge Drinking, Marijuana Use, and Energy Drinks Mixed With Alcohol

Abstract

Purpose

Methods

Results

Conclusions

Section snippets

Design

Descriptive statistics

Discussion

Funding Sources

J Adolesc Health

Prev Med (Baltim)

J Adolesc Health

J Adolesc Heal

J Adolesc Health

J Adolesc Heal

Addict Behav

J Adolesc Heal

J Adolesc Heal

Addict Behav

J Adolesc Heal

BMC Public Health

The renormalization of smoking? E-Cigarettes and the tobacco “endgame”

N Engl J Med

Monitoring the future study: Trends in prevalence of various drugs for 8th graders, 10th graders, and 12th graders

E-cigarettes in Canada - Tobacco use in Canada: Patterns and trends, 2015 edition, special supplement

Electronic cigarettes: Human health effects

Tob Control

Associations between e-cigarette access and smoking and drinking behaviours in teenagers

BMC Public Health

Electronic cigarettes: Vulnerability of youth

Are electronic nicotine delivery systems an effective smoking cessation tool?

Can J Respir Ther

Original article
The Associations Between E-Cigarettes and Binge Drinking, Marijuana Use, and Energy Drinks Mixed With Alcohol