PURPOSE:Adolescent tobacco use prevention can prevent lifelong addiction. This study assesses adolescents' reports of tobacco discussions in the doctor's office setting. METHODS:Using 2023 Florida Youth Tobacco Survey, a statewide, anonymous, school-based survey (n = 3,898), the Rao-Scott chi-square test was used to examine whether the proportion of students who visited a doctor's office in the past 12 months and used electronic cigarettes (e-cigarettes), differed by demographic characteristics. We estimated adjusted odds ratios (aOR) using hierarchical logistic regression models with demographic variables and e-cigarette use to model whether students were told about the dangers of tobacco products in a doctor's office. RESULTS:Of those who visited a doctor's office in the past year, 27.9% reported a medical provider talked to them about the dangers of tobacco products, compared to 13.1% in a dentist's office, and 63.1% parents/guardians. Females were more likely than males to report these discussions (30.8% vs. 25.1%; p = .003). Females (aOR = 1.28) and those who ever used e-cigarettes (aOR = 1.29) were more likely to be talked to about tobacco dangers. Females (aOR = 1.34) were more likely to discuss e-cigarettes. Hispanic, non-Hispanic Black, and other race/ethnicities were less likely to discuss e-cigarettes compared to non-Hispanic White respondents. DISCUSSION:Over one in four respondents who visited a doctor's office in the past year reported that a medical provider talked to them about the dangers of tobacco products. A lack of alignment exists between adolescent and physician reports of tobacco discussions. The process of screening and tobacco intervention in the clinical setting should be further assessed, particularly for effectiveness in messaging.

Background: Research on substance use disorder (SUD) and intellectual and developmental disabilities (IDD) is limited. Literature suggests people with IDD are less likely to use substances; however, they are more susceptible to SUD if they do.Objectives: To better understand the relationship between IDD and SUD and identify best practices to improve adherence to treatment and health outcomes.Methods: A narrative review of English peer-reviewed sources published between January 2000-May 15, 2025 was conducted using CINAHL, Pubmed, Scopus, Web of Science, Academic Search Complete, and PsychINFO. Measures of interest included co-occurrence of SUD and IDD, and risk factors, treatment options, and barriers to receiving or adhering to treatment for adults with IDD and SUD.Results: Prevalence of substance use is lower in adults with IDD than without IDD. Adults with IDD and SUD are most commonly encountered in outpatient mental health settings. Cannabis, alcohol, and cocaine are the most frequent substances used by individuals with IDD. Risk factors for IDD and SUD include male gender, family history of SUD, exposure to peers who use substances, psychiatric comorbidities, and mild/borderline IDD as compared to no IDD. Approximately 42-54% of individuals with IDD and SUD have co-occurring psychiatric disorders. Staff who provide SUD treatment are not trained to work with IDD.Conclusions: Outcomes for individuals with IDD and SUD would improve with development of SUD and IDD specific training for providers and treatment protocols that account for risk factors such as peer relationships, family history of SUD, and co-morbid mental health diagnoses.

Introduction:Smoking is a leading preventable cause of death, with higher prevalence in certain occupations. Given the evolved work environment after COVID-19 and shifting tobacco use patterns, this study examines recent data to assess the associations between smoking status, employment status, and industry. Methods:The authors analyzed data from the 2023 National Health Interview Survey. Participants were aged ≥18 years, and their employment status was classified as employed or unemployed on the basis of the prior week's work; smoking status was classified as current, former, or never. The prevalence of employment and smoking was calculated. Weighted multinomial logistic regression was used to assess the associations between smoking status, employment status, and industry. Results:Among the 26,442 adults (50.8% male, 63.6% non-Hispanic Whites, mean age of 49.3 years, 69.7% employed), 11.0% were current smokers, 23.4% were former smokers, and 65.6% were never smokers. Current smoking was highest in wholesale trade (20.5%), information (16.9%), and mining (15.9%) industries. After adjustment, unemployed individuals, particularly those unable to work owing to health reasons, had 93% higher odds of being current smokers (AOR=1.93; 95% CI=1.64, 2.28) and 35% higher odds of being former smokers (AOR=1.35; 95% CI=1.16, 1.58) than those who were employed. Conclusions:This study highlights the current relationship between employment status, industry, and smoking behaviors in the U.S. Current smoking rates were highest in specific industries, underscoring the need for targeted interventions in these occupational settings. Tailored smoking cessation programs for high-risk industries and unemployed individuals, particularly those unable to work owing to health issues, are crucial. Public health policies should address the unique needs of both employed and unemployed populations to reduce smoking-related health disparities.

Human papillomavirus (HPV) vaccine rates are low in the USA, with additional disparities noted in and within states such as Texas. To increase HPV vaccine uptake, healthcare providers and clinical team members are essential agents in promoting HPV vaccination to their patients. The purpose of this study was to examine the knowledge, attitudes, and behaviors of clinic team members, stratified by clinicians (i.e., physicians, nurse practitioners, and physician assistants) and non-clinician staff (i.e., nurses and medical assistants) in North Texas. Survey data were collected as part of a quality improvement project to improve HPV vaccination in a safety-net health system and federally qualified health center. Knowledge items were related to guidelines for HPV vaccination by patient age and the types of cancer the HPV vaccine can prevent. Attitudes were related to the importance of recommending the HPV vaccine and self-efficacy in making vaccine recommendations, and behavioral items included current recommendation behaviors and barriers to recommendations. Data were stratified by role, clinicians and non-clinicians, and were analyzed in SAS. Participants (n = 125) were knowledgeable, but significant differences were noted by the individual's role (p < 0.05). Participants differed in their knowledge of the cancers the HPV vaccine can prevent. Common barriers reported were parental vaccine hesitancy (70% clinicians, 45% non-clinicians) and parents lacking information (49% clinicians, 58% non-clinicians). Given that HPV vaccination requires a clinic team approach to promote uptake, identification of the knowledge, attitudes, and barriers among these clinical team members can guide the development of tailored education strategies to improve vaccine uptake.

Environmental tobacco smoke (ETS) exposure remains a preventable cause of illness and death worldwide. Tobacco smoke bans reduce exposure, but enforcement in Central America has been slow. Workplaces can reduce ETS impact through policies. This study assessed ETS exposure across various industries in Central America. Data were drawn from II Central American Working Conditions and Health Survey administered between February and June of 2018. The prevalence of ETS and 95% CIs were calculated. Survey-weighted logistic regression models were used to estimate the associations of exposure to ETS with industry, socio-demographics, and working conditions. Among the 9,032 workers studied, 61.3% were male, 43.8% were aged 25-45, and 32.4% worked in agriculture. ETS exposure was highest in the transportation industry (40.1%) and lowest in education/healthcare (11.5%). Males (OR = 1.33; 95%CI: 1.01-1.76), workers with high psychological demands (OR = 1.92; 95%CI: 1.49-2.47), and current smokers (OR = 4.46; 95%CI: 3.27-6.08) had higher odds of ETS exposure. Exposure to ETS in Central American workplaces remains high, varying by industry. Despite policy changes in the region, the high ETS exposure indicates weak enforcement.

BACKGROUND:Despite declining rates of adolescent cigarette smoking, emerging products continue to pose a threat to youth. Oral health care professionals, who often see adolescents more frequently than other clinicians, are uniquely positioned to intervene. METHODS:Data (N = 3,898 survey responses) were analyzed from the 2023 Florida Youth Tobacco Survey, a statewide, school-based assessment of tobacco behaviors. Additional analyses focused on high school students who reported a dental visit in the previous 12 months (n = 2,835). The Rao-Scott χ2 test was used to examine whether the proportion of students who visited a dentist's office in the past 12 months differed by demographic characteristics. Logistic regression models were used to evaluate associations between demographic factors, electronic cigarette (e-cigarette) use, and reported discussion about the dangers of tobacco in dental settings. RESULTS:Although more than 70% of high school students visited a dental office within the past year, only 13.1% reported being told about tobacco dangers by dental personnel. No significant (P > .05) associations by demographics were found for tobacco-related discussions. However, Hispanic students had lower odds than non-Hispanic White students of reporting receiving e-cigarette discussion, even after adjustment for e-cigarette use. CONCLUSIONS:Adolescents do not report having discussions at the dental office about tobacco product use. These findings reveal a missed opportunity for oral health care providers to engage in prevention and early intervention for adolescents, a population at high risk of initial tobacco exposure. PRACTICAL IMPLICATIONS:Continuing dental education along with guidelines emphasizing prevention-focused discussions could substantially increase youth awareness of tobacco's harms and reduce future tobacco-related morbidity.

Distracted driving, the act of focusing on something else while operating a vehicle, is a significant health problem among adolescents. Although some studies have reported on prevalence among adolescents in the United States, limited studies have examined differences by sexual identity status. The purpose of the present study was to examine past 30-day distracted driving by sexual identity status among a large, national sample of adolescents ages 14 to 18 years. A secondary analysis was conducted on the 2019 Youth Risk Behavioral Surveillance System (YRBSS) data, and associations between distracted driving and demographics (e.g., biological sex, age, race/ethnicity) were assessed with weighted logistic regression analyses. A total of 13,590 adolescents ages 14 to 18 years were part of the final analytic sample. Twenty-three percent of adolescents reported distracted driving in the past 30 days. Compared with heterosexual adolescents, gay/lesbian (14.3%), bisexual (18.1%), and questioning (12.9%) adolescents reported lower distracted driving in the past 30 days. Findings through a health equity approach may inform harm reduction efforts and behavioral interventions.

Background Electronic nicotine delivery systems (“e-cigarettes”) are the nicotine product most commonly used by adolescents. Research, treatment, and policy could benefit from measures of adolescent e-cigarette beliefs about outcomes of use (ie, expectancies). In the current study, we developed and tested an adolescent electronic nicotine vaping expectancy measure. Methods A focus group with adolescents evaluated potential e-cigarette expectancy items. A panel of national experts assisted in revision of these items. Finally, items were administered to a sample of adolescents 14-17 years old (N = 267, Mean age 15.6, SD = 1.1, 50.9% Female, 50.2% Non-Hispanic White, 22.5% Non-Hispanic Black, 14.2% Hispanic) in a large Southeastern metropolitan area in the United States. Results Exploratory Factor Analysis revealed a four factor solution: Negative Consequences (Cronbach’s α = .92); Positive Reinforcement (α = .83); Negative Affect Reduction (α = .95); and Weight Control (α = .89). Subscales were significantly correlated with vaping susceptibility and lifetime vaping. Subscales successfully differentiated susceptible adolescents from confirmed non-susceptible adolescents, with susceptible adolescents reporting more positive expectancies, eg, Positive Reinforcement, M = 5.0, SD = 2.0 vs M = 3.0, SD = 2.1, P < .001, η 2 = 0.19, and less negative expectancies, M = 5.5, SD = 2.3 vs M = 6.5, SD = 2.6, P = .001, η 2 = 0.04. Similar results were found comparing adolescents who have never vaped nicotine with those who have vaped nicotine. Hierarchical linear regression demonstrated subscales were significant predictors of lifetime vaping after controlling for demographics, vaping ad exposure, and peer/family vaping. Conclusions A preliminary version of an adolescent expectancy measure appears reliable and valid based on expert input and pilot testing with adolescents. Promising results were found in the domains of concurrent validity, discriminant validity, and incremental validity. Future research and evaluation efforts will be able to use this tool to further prevention and treatment goals.

We conducted a narrative literature review to examine contributing factors of disparities in tobacco usage and outcomes affecting Black Americans. We propose potential solutions that can be used to effectively address these disparities. We identified historical factors; socioeconomic factors; targeted marketing/advertising; the influence of racism/discrimination; neighborhood socioeconomic disadvantage; and mass incarceration. We call for more thorough examinations of these factors as a key element of tobacco-focused research and interventions to eliminate the disproportionate burdens faced by Black Americans. We advocate for greater emphases on the impacts of personal and structural racism on tobacco usage and outcomes affecting Black Americans.

Background: Up-to-date (UTD) of the human papillomavirus (HPV) vaccine series has been low despite 2016 recommendations for 2 doses among initiators <15 years of age and 3 doses for 15+ year olds. This study examined how age at initiation affected the association between race/ethnicity and UTD among adolescent HPV vaccine initiators. We also examined how administration of other adolescent vaccines affected UTD. Methods: A secondary analysis of The National Immunization Survey - Teen data between 2016 and 2020 was conducted. Characteristics associated with initiation of the vaccine series was examined and used to evaluate UTD among initiators. All data were weighted. Associations between characteristics and HPV vaccine initiation were examined using Rao Scott chi-square tests and univariable logistic regression. Multivariable binary logistic regression models stratified by race/ethnicity calculated the strength of association between independent variables and odds of initiation and UTD among initiators. Results: The final sample size was 99,719 with 67,855 (68.1 %) initiating HPV vaccination. Among HPV vaccine initiators, Hispanic and black adolescents had lower odds of UTD. However, 9-10-year-old initiators had increased odds (aOR: 5.71; 95 %CI: 3.78-8.63) of UTD compared to 12-year-old initiators. Increased odds of UTD among initiators younger than 12 years were found across racial/ethnic groups. Flu vaccination was associated with decreased odds of UTD among white (aOR: 0.76; 95 %CI:0.65-0.88) and black adolescents (aOR: 0.67; 95 % CI: 0.46-0.96). Conclusion: Strong recommendations to ensure patients are UTD on the HPV vaccine series are essential to improving UTD among all adolescents and follow-up should occur when administering other vaccines to reduce missed opportunities.

OBJECTIVE:Electronic cigarettes are the most commonly used tobacco products by young adults. Measures of beliefs about outcomes of use (i.e., expectancies) can be helpful in predicting use, as well as informing and evaluating interventions to impact use. METHODS:We surveyed young adult students (N = 2296, Mean age=20.0, SD=1.8, 64 % female, 34 % White) from a community college, a historically black university, and a state university. Students answered ENDS expectancy items derived from focus groups and expert panel refinement using Delphi methods. Factor Analysis and Item Response Theory (IRT) methods were used to understand relevant factors and identify useful items. RESULTS:A 5-factor solution [Positive Reinforcement (consists of Stimulation, Sensorimotor, and Taste subthemes, α = .92), Negative Consequences (Health Risks and Stigma, α = .94), Negative Affect Reduction (α = .95), Weight Control (α = .92), and Addiction (α = .87)] fit the data well (CFI=0.95; TLI=0.94; RMSEA=0.05) and was invariant across subgroups. Factors were significantly correlated with relevant vaping measures, including vaping susceptibility and lifetime vaping. Hierarchical linear regression demonstrated factors were significant predictors of lifetime vaping after controlling for demographics, vaping ad exposure, and peer/family vaping. IRT analyses indicated that individual items tended to be related to their underlying constructs (a parameters ranged from 1.26 to 3.18) and covered a relatively wide range of the expectancies continuum (b parameters ranged from -0.72 to 2.47). CONCLUSIONS:A novel ENDS expectancy measure appears to be a reliable measure for young adults with promising results in the domains of concurrent validity, incremental validity, and IRT characteristics. This tool may be helpful in predicting use and informing future interventions. IMPLICATIONS:Findings provide support for the future development of computerized adaptive testing of vaping beliefs. Expectancies appear to play a role in vaping similar to smoking and other substance use. Public health messaging should target expectancies to modify young adult vaping behavior.

Blunt use (co-use of tobacco and marijuana) is a growing phenomenon among youth and disproportionately affects minority populations. LGBT+ populations are significantly more likely to use marijuana and tobacco, but this relationship has yet to be examined among LGBT+ adolescents. This analysis aimed to investigate past-year blunt use among a national sample of youth and delineate the differences between non-LGBT and LGBT+ youth. We used Wave 2 of the Population and Tobacco Health (PATH) study. We analyzed data from 7518 youth, comparing past-year blunt use between LGBT+ and non-LGBT youth, controlling for biological sex, race, and age using weighted logistic regression models. Greater than 1 in 10 youth (10.6%) reported using blunts in the past year. More than one in five (21.6%) LGBT+ youth reported using blunts in the past year. There were no significant differences between boys and girls. Older youth (17 years old) were more likely to use blunts in the past year (aPR: 3.04, 95% CI 2.48, 3.79) than younger youth. Compared with non-LGBT youth, LGBT+ youth were 2.17 times (95% CI 1.86, 2.54) more likely to report using blunts in the past year. Blunt use and its respective impact on health outcomes among developing youth are of concern to public health. These findings demonstrate that certain subgroups of youth are more at risk for use and emphasize the need for tailored interventions to mitigate initiation and current use, given that one of the goals of the Healthy People 2030 initiative is to “Improve the health, safety, and well-being of lesbian, gay, bisexual, and transgender (LGBT) individuals”.

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OBJECTIVE:In the United States, guidelines indicate all pregnant women should be screened for and counseled on alcohol use to prevent adverse perinatal outcomes due to alcohol consumption. The objective of this study was to describe sociodemographic factors associated with receipt of prenatal alcohol counseling and perinatal alcohol use among US women.METHODS:State health departments collected data for the Pregnancy Risk Assessment Monitoring System Phase 7 during 2012-2015, and we restricted the sample to a complete case analysis (N = 135 111). The 3 dichotomous outcomes were preconception alcohol use (3 months before pregnancy), prenatal alcohol use (during last 3 months of pregnancy), and prenatal alcohol counseling. Predictor variables were age, race, Hispanic ethnicity, education, marital status, health insurance status, and previous live births. We estimated survey-weighted logistic regression models for each outcome.RESULTS:Half (56.0%) of pregnant women reported preconception alcohol use, 70.5% received prenatal alcohol counseling, and 7.7% reported prenatal alcohol use during the last 3 months of pregnancy. Black women were significantly less likely than White women (odds ratio [OR] = 0.49; 95% CI, 0.46-0.52) and Hispanic women were significantly less likely than non-Hispanic women (OR = 0.62; 95% CI, 0.58-0.66) to report preconception alcohol use. We found similar patterns for prenatal alcohol use among Black women. Black women were significantly more likely than White women (OR = 1.66; 95% CI, 1.55-1.77) and Hispanic women were significantly more likely than non-Hispanic women (OR = 1.51; 95% CI, 1.40-1.61) to receive prenatal alcohol counseling. We found similar patterns for age, education, and health insurance status.CONCLUSION:Disparities in alcohol counseling occurred despite the national recommendation for universal screening and counseling prenatally. Continued integration of universal screening for alcohol use during pregnancy is needed.

Abstract Objective: This study aims to: (1) examine gender differences for weight conscious drinking among college students accounting for the broader phenomenon (e.g. including the Alcohol Effects dimension); and (2) longitudinally examine the effect of weight conscious drinking behaviors on body mass index (BMI). Participants: United States freshmen students from eight participating universities (N= 1,149). Methods: Structural equation modeling was used to model the effect of gender on weight conscious drinking dimensions at 7-month follow-up. Results: Findings suggest a significant effect of gender on Alcohol Effects (β = −.15, SE = .05, p = .005) at 7-month follow-up among college freshmen. Weight conscious drinking dimensions predicted no significant change in BMI at 7-month follow-up among college freshmen. Conclusion: Findings contribute to weight conscious drinking theory and provide campus weight conscious drinking prevention initiatives with evidence to tailor their programming to address female tendencies to engage in compensatory strategies to enhance the psychoactive effects of alcohol.