College of Public Health

College publishes on electronic nicotine delivery systems

Dr. Hadii Mamudu, Professor for the Department of Health Services Management and Policy has authored an article in Substance Abuse and Misuse.  The article, Exploring Patterns of the Use of Electronic Nicotine Delivery Systems among Adolescents in High-Risk Appalachian (U.S.A) Communities, increases the limited body of research on Central Appalachia, a region with historically high rates of tobacco and other substance use.

Dr. Manik Ahuja and Dr. Ying Liu, faculty, and Ms. Esther Adeniran, student, in the College of Public Health are co-authors.  Additional faculty and staff co-authors at East Tennessee State University include Dr. Florence Weierbach of the College of Nursing, Dr. Jean Swindle of the College of Education, Ms. Janet Keener of Research Computing Services, Ms. Cynthia Blair of the Center for Cardiovascular Risks Research, and Dr. David Wood of the Quillen College of Medicine.  Additional co-authors include members of George Washington University, Baylor University, Ohio State University, and the Tennessee Department of Health.

Electronic nicotine delivery systems use among adolescents in the United States has surpassed conventional tobacco products, including cigarettes. Evidence from the literature indicates that several factors are associated with their use among youth in the U.S., including perceptions that they are less harmful, parental/peer use behavior, flavoring, advertising and marketing, and academic performance. Additionally, there is increasing evidence that dual use of cannabis and electronic nicotine delivery systems is associated with more severe dependence.

This study was conducted in an Appalachian Regional Commission-designated distressed county in Appalachian Tennessee  through a collaboration among the state’s Department of Substance Use and Mental Health Services Administration, the local and regional health departments, and a private firm. An online survey was conducted in 2018 after first working with school administration to obtain the permission from parents and assent of adolescent participants.  

Overall, lifetime electronic nicotine delivery systems and cannabis prevalence estimates were 31.1% and 18.6%, respectively. Lifetime electronic nicotine delivery systems had increased odds of also being lifetime cannabis users, of reporting use among peers, and lower academic performance. The findings have implications for public health intervention planning to address not only electronic nicotine delivery systems, but also substance use among Appalachian youth.

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