Tag: adolescents

How Do You Do, Fellow Kids? Making Anti-vaping Messaging Work

Vaping with an e-cigarette
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Effective anti-vaping advertisements geared to teens have the greatest impact when they emphasise the adverse consequences and harms of vaping e-cigarettes, use negative imagery, and avoid memes, hashtags and other ‘teen-centric’ communication styles, according to a first-of-its-kind study by researchers in the journal Tobacco Control.

The researchers also found that certain messaging content currently being used, especially sweets and flavour-related imagery, increases the appeal of vaping and should be avoided when designing prevention messages.

“E-cigarettes and vaping have become a major public health concern, with nicotine addiction and other harmful outcomes looming large for youth,” said Seth M. Noar, PhD, the paper’s corresponding author and UNC Lineberger professor. “The percentage of teens vaping increased from about 5% in 2011 to over 25% in 2019,” Prof Noar said. “That is an alarming trend, making an understanding of effective vaping prevention messages especially urgent.”

Since the introduction of e-cigarettes, numerous US health departments have created their own anti-vaping messaging geared to teens, as have national health organisations such as the US Food and Drug Administration and Centers for Disease Control and Prevention.

The online study asked 1501 teens to rate seven randomly selected vaping prevention ads from a pool of more than 200 ads. Vaping prevention ads that clearly communicated the health harms of vaping, or compared vaping to cigarette smoking, were comparatively more effective. Neutral or less personally relevant content, such as referencing the environmental impact of vaping or the targeting of youth by the tobacco industry, was less impactful.

“Although we anticipated that vaping prevention ads with neutral or pleasant imagery would not be as effective, we were alarmed to find that flavour-related messages actually heightened the attractiveness of vaping,” said Marcella H. Boynton, PhD, first author

“In retrospect, it stands to reason that by reminding teens about pleasurable aspects of e-cigarettes, even within the context of a prevention ad, we run the risk of doing harm. Notably, we found that flavour-related prevention ad content was associated with vaping appeal among both users and non-users of e-cigarettes, which is a good reminder of how much candy and fruit flavours in e-cigarettes have driven the youth vaping epidemic.”

The researchers hope to next investigate the effects of other types of anti-vaping ads on a wide range of audiences. They also are developing a series of messages and a companion website to test the ability of a text message-driven intervention to reduce youth vaping. In that regard, Prof Noar noted that “We have been developing our own evidence-based messages based on the latest science about the harms of vaping. Our messaging approach has been greatly influenced by the insights generated by this study.”

The study used UNC’s Vaping Prevention Resource, a website designed to provide practitioners, researchers and communities with vaping prevention media content from around the world, as well as strategies and resources for youth vaping prevention. It is the largest repository of free, open-access vaping prevention materials, all available for download at https://vapingprevention.org/.

Source: UNC Lineberger Comprehensive Cancer Center

PFAS and Phthalates Linked to Reduced Bone Density in Teen Boys

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Per- and polyfluoroalkyl substances (PFAS) and phthalates (two types of endocrine-disrupting chemicals) may be associated with lower areal bone mineral density (aBMD) in teenage boys, according to a new study published in the Journal of Clinical Endocrinology and Metabolism.

Endocrine disrupting chemicals (EDCs) and potential EDCs are mostly man-made found in various materials. By interfering with the body’s endocrine system, endocrine disruptors produce adverse developmental, reproductive, neurological, and immune effects in humans, abnormal growth patterns and neurodevelopmental delays in children. These include per- and polyfluoroalkyl substances (PFAS) are used in non-stick pots and pans, clothing and food packaging, and are increasingly being found in US water supplies. Phthalates are used in medical devices, personal care products, food processing and children’s toys.

“Adolescence is an important time when our bodies build up bone. Almost all US children and adolescents are exposed to PFAS and phthalates, but few studies have looked at how these chemicals could be impacting our bone health,” said Abby F. Fleisch, MD, MPH, of the Maine Medical Center Research Institute and Maine Medical Center. “Our research found an association between certain PFAS and phthalates and reduced bone mineral density in adolescent males. Because bone accrual primarily occurs during adolescence, if replicated, this finding may have implications for lifelong bone health.”

The researchers accessed data on urine and blood samples from 453 boys and 395 girls from the National Health and Nutrition Examination Survey (NHANES). Participants were on average 15.1 years old, and found that higher levels of PFAS and phthalates may be associated with lower aBMD in adolescent males. The same effect was not found in girls; rather a slight increase in aBMD was observed for certain PFAS and phthalates.

The researchers noted that bone mineral density tracks across a lifetime, so if the same results are seen in longitudinal cohorts, this finding may have implications for lifelong skeletal health.

Source: The Endocrine Society

Negative Effects of Social Media on Girls and Boys

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Girls and boys might be more vulnerable to the negative effects of social media use at different times during their adolescence, according to a study in Nature Communications. Girls were found to experience a negative link between social media use and life satisfaction when they are 11–13 years old and boys when they are 14–15 years old. Increased social media use again predicts lower life satisfaction at age 19 years. At other times the link was not statistically significant.

Since its rapid emergence over a decade ago, social media has prompted concern over its possible impacts on wellbeing, especially in younger people.

A team of researchers analysed two UK datasets which included longitudinal data on 17 400 young people aged 10–21 years old. The team looked for a connection between estimated social media use and reported life satisfaction and found key periods of adolescence where social media use was associated with a decrease in life satisfaction 12 months later. Working backwards, the researchers also found that teens who have lower than average life satisfaction use more social media one year later.

In girls, social media use between ages 11 and 13 was associated with a drop in life satisfaction one year later, whereas in boys this occurred between 14 and 15. This suggests that sensitivity to social media use could be linked to developmental changes, possibly changes in the structure of the brain, or to puberty, which occurs later in boys than in girls.

In both females and males, social media use at the age of 19 years was again associated with a decrease in life satisfaction a year later. The researchers suggest that that social changes at this age, such as leaving home, may make people particularly vulnerable.

At other times, the link between social media use and life satisfaction one year later was not statistically significant. Decreases in life satisfaction also predicted increases in social media use one year later; however this does not change across age and or differ between the sexes.

Dr. Amy Orben, the study leader, said: “The link between social media use and mental wellbeing is clearly very complex. Changes within our bodies, such as brain development and puberty, and in our social circumstances appear to make us vulnerable at particular times of our lives.”

Professor Sarah-Jayne Blakemore, a co-author of the study, said: “It’s not possible to pinpoint the precise processes that underlie this vulnerability. Adolescence is a time of cognitive, biological and social change, all of which are intertwined, making it difficult to disentangle one factor from another. For example, it is not yet clear what might be due to developmental changes in hormones or the brain and what might be down to how an individual interacts with their peers.”

Dr. Orben added: “With our findings, rather than debating whether or not the link exists, we can now focus on the periods of our adolescence where we now know we might be most at risk and use this as a springboard to explore some of the really interesting questions.”

A further complication is that social media use can negatively impact wellbeing, but also the reverse is true, previously reported and confirmed by this study.

The researchers stress that these population-level findings do not predict which individuals are most vulnerable.

Professor Rogier Kievit said: “Our statistical modeling examines averages. This means not every young person is going to experience a negative impact on their wellbeing from social media use. For some, it will often have a positive impact. Some might use social media to connect with friends, or cope with a certain problem or because they don’t have anyone to talk to about a particular problem or how they feel—for these individuals, social media can provide valuable support.”

Professor Andrew Przybylski said: “To pinpoint which individuals might be influenced by social media, more research is needed that combines objective behavioural data with biological and cognitive measurements of development. We therefore call on social media companies and other online platforms to do more to share their data with independent scientists, and, if they are unwilling, for governments to show they are serious about tackling online harms by introducing legislation to compel these companies to be more open.”

Source: University of Oxford

Many Youths with Substance Use Disorder Also Have Autism Traits

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One in five teens and young adults seeking treatment for substance use may have traits characteristic of a previously unrecognised autism spectrum disorder (ASD), according to a study by researchers at Massachusetts General Hospital (MGH).

The study, published in The American Journal on Addictions, found that among patients with an average age of 18.7 years being treated in an outpatient substance use disorder (SUD) clinic, 20% had elevated scores on the Social Responsiveness Scale-2 (SRS-2), a parent- or teacher-reported measure that has been shown to reliably identify the presence and severity of social impairment among individuals along the autism spectrum, and to distinguish autism from other disorders.

Lead author James McKowen, PhD, said this is the first study examining the prevalence of autistic traits among young people with SUD.

“Usually studies of substance use disorder in autism are done in those with an autism diagnosis already,” he said. “We have looked at this question from the other side, asking how many people with substance use disorder have autism.”

The researchers asked parents of 69 youths reporting for the first time to a specialty outpatient psychiatric SUD clinic to fill out the SRS-2 form. The form is designed to measure an individual’s social awareness, cognition, communication and motivation, and restricted interests and repetitive behaviours.

Though few differences were found between those with elevated autistic trait scores and those with lower, non-autistic scores in terms of demographic or psychiatric factors, adolescents with higher SRS-2 scores had a nearly eightfold higher likelihood of stimulant use disorder, and a fivefold higher risk for opioid use disorder.

According to the researchers, the findings highlight the importance of assessing patients in a SUD treatment setting for autistic traits.

“For clinicians, the big takeaway point from this study is that we need to get better at screening and certainly training in the presence of autism spectrum disorder,” said Dr McKown. Clinicians treat the SUD “but don’t have specialty developmental training, particularly for issues around autism.”

The researchers are developing a free clinical therapy protocol that can help clinicians better address the issues of autistic traits in patients with SUD.

Source: Massachusetts General Hospital

Suicidal Ideation in Adolescents Linked to Risky Driving

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Suicide and motor vehicle traffic accidents are two of the most common forms of death among adolescents. A new study published in JAMA Pediatrics found that adolescents who reported at least one suicide attempt within the last year, compared to those reporting no attempts, were also more likely to report infrequent seat belt use and driving with a drunk driver. There were also over twice as likely to report driving drunk.

The researchers analysed data from over 13 500 U.S. high school students who participated in the 2019 Youth Risk Behavior Survey, and found that 19% of the sample reported suicidal ideation. Texting or e-mailing while driving was the most commonly reported form of risky driving behaviours.

Study lead author Kyle T. Ganson, PhD, assistant professor at the University of Toronto, said: “The findings from this study emphasise the need for mental health support for adolescents experiencing suicidality as a means of increasing safety for themselves and their communities, as accidental injury deaths via car accidents were the leading cause of death among adolescents in 2019.”

“The more severe the suicidality, the stronger the association with risky driving behaviours,” Dr Ganson continued. “Adolescents who reported a suicide injury, such as a poisoning or overdose needing to be treated by a medical professional, had the highest likelihood to report all four risky driving behaviors we examined.”

The researchers stress the importance of the implications their findings have to protect the health and well-being of adolescents. “Health care professionals should consider discussing risky driving behaviours with teens who report suicidality,” said co-author Jason M. Nagata, MD, MSc, assistant professor at the University of California, San Francisco.

Source: News-Medical.Net

A Case of Three Teens with COVID and Psychiatric Symptoms

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A case study details three teenagers with mild or asymptomatic COVID presented with suicidal thoughts, “paranoia-like fears,” delusions and “foggy brain”, which could be explained by anti-neural antibodies – ‘turncoat’ antibodies that may attack brain tissue.

Mounting evidence points to neurological and psychiatric effects of COVID, with a UK study finding a 13% risk of a first-time diagnosis after COVID. The study, published in JAMA Neurology, is the first to look at anti-neural antibodies in paediatric patients previously infected with SARS-CoV-2.

Over five months in 2020, 18 children and teens were hospitalised with confirmed COVID at UCSF Benioff Children’s Hospital San Francisco, three of whom were the patients in the study who underwent neurological evaluations.

The researchers examined the patients’ cerebrospinal fluid (CSF) and found that two of the patients, both of whom had histories of unspecified depression and/or anxiety, had antibodies indicating that SARS-CoV-2 may have invaded the central nervous system. They also had anti-neural antibodies in their CSF, suggesting a rampant immune system accidentally targeting the brain.

The research follows a previous UCSF study that also found a high level of autoantibodies in the cerebrospinal fluid of adult patients with acute COVID, who experienced neurological symptoms, including intractable headaches, seizures and loss of smell.

“It is way too soon to know whether COVID is a common trigger for neuropsychiatric illnesses, but it does seem to be a potent trigger for the development of autoantibodies,” said co-corresponding author Samuel Pleasure, MD, PhD. “It is currently totally unknown whether patients predisposed to neuropsychiatric illnesses are more likely to develop worsened symptoms after COVID, or whether COVID infection can act as an independent trigger.”

Unlike most psychiatric presentations, the three patients in the UCSF study had symptoms with sudden onset and rapid progression, representing a marked change from their baselines, said co-first author Claire Johns, MD. “The patients had significant neuropsychiatric manifestations despite mild respiratory symptoms, suggesting potential short and long-term effects of COVID.”

After hospitalisations lasting weeks and ongoing psychiatric medications, the two UCSF patients, whose cerebrospinal fluid tested positive for SARS-CoV-2 antibodies and anti-neural antibodies, were treated with intravenous immunoglobulin, an immunomodulatory therapy that curbs inflammation in autoimmune disorders. After five days, the first patient had “more organised thoughts, decreased paranoia and improved insight.”

Autoantibodies targeting the protein TCF4 were also found, which has genetic links in some schizophrenia cases. However, “we don’t know that the antibodies are actually interfering with the protein’s function,” said co-corresponding author, Michael R. Wilson, MD, noting that the diagnosis of schizophrenia is based on a constellation of symptoms, not a biomarker.
The second patient partially responded to immunotherapy with improved cognition and working memory, but continued to have “impaired mood and cognitive symptoms” six months later. The third patient, with no psychiatric history and without SARS-CoV-2 antibodies or anti-neural antibodies in their cerebrospinal fluid, recovered with psychiatric medications. Their symptoms were attributed to recreational drug use.

In another case study, a 30-year-old patient with mildly symptomatic COVID who presented at a hospital emergency department with delusions, violent outbursts, hyper-anxiety and paranoia was unresponsive to antipsychotic medication but after being diagnosed with possible “autoimmune-mediated psychosis”, responded to intravenous immunoglobulin.

Nonetheless, the researchers agree it’s unlikely that there were pre-existing autoantibodies, and they point to other disorders with psychiatric symptoms, like anti-NMDAR encephalitis syndrome, that are caused by anti-neural antibodies and respond to treatment directed at these rogue antibodies.

The researchers agree that more study is warranted, although Dr Pleasure noted that the rarity of cerebrospinal fluid samples from paediatric patients is a challenge, as they rarely have severe enough COVID to warrant a lumbar puncture.

Source: University of California San Francisco

Paediatricians Can Help Adolescents Quit Vaping

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Even though e-cigarette- or vaping-associated lung injury (EVALI) were “a drop in the bucket” compared with COVID, vaping remains a significant health risk for teens, reported Anne Griffiths, MD, of the Children’s Hospital of Minnesota, during her presentation entitled “Updates on Youth Vaping” at the American Academy of Pediatrics virtual meeting

According to the 2021 National Youth Tobacco Survey, 11.3% (1.72 million) of high school students (ages 16 to 18) and 2.8% (320 000) of middle school students (ages 12 to 15)  reported using e-cigarettes in the past 30 days.
As more than half of youths who tried to stop vaping, there is an opportunity fo paediatricians to intervene, Dr Griffiths said.

Middle school students often start with zero-nicotine, flavour-only products before “they move on to a nicotine-based product and ultimately a THC-based product,” Griffiths noted. Of the middle and high school students who vape, 85% use flavoured products, with sweet and fruity flavours favoured.
Notably, disposable e-cigarettes are now more popular than refillable pods and cartridges this year, with 53.7% of all vaping students reporting use of these products. This comes down to messaging not to reuse vaping products during COVID, Dr Griffiths said.

However, vaping could be a risk factor for COVID, being diagnosed five times more often in vaping adolescents, according to a study in the Journal of Adolescent Health.

E-cigarette flavouring can suppress innate immune function, as demonstrated by studies. Others have shown that e-cigarette vapour may increase ACE2 expression in the lungs, which the receptor that enables entry of SARS-CoV-2 into host cells.

Adolescents presenting with EVALI or COVID (or both) can be differentiated Dr Griffiths said. The patient’s reaction to steroid treatment can be diagnostic: “Unlike SARS-CoV-2 where the [patient’s] improvement might be subtle [with a] gradual response to steroids, in EVALI, one day on high-dose steroids and they feel like a million bucks in comparison.”

In addition, EVALI may present with leukocytosis and high erythrocyte sedimentation rates and C-reactive protein levels, while COVID patients are more likely to have lymphopenia.

Dr Griffiths that in spite of the risks of vaping, “there’s an entire culture surrounding [kids] that can glamorise vaping life.”

Vaping companies reach out to children using methods such as YouTube vape championships, in which competitors perform various smoke tricks. In addition, vaping companies provide scholarships to students, often requiring them to write an essay on the benefits of vaping.

Source: MedPage Today

Spotting Self-harming Risk for Adolescents a Decade in Advance

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Researchers have revealed two subgroups of self-harming adolescents and have shown that those self-harming risk can be identified almost a decade before they begin self-harming.

The team, based at the MRC Cognition and Brain Sciences Unit, University of Cambridge, found that while sleep problems and low self-esteem were common risk factors, there were two distinct profiles of young people who self-harm – one with emotional and behavioural difficulties and a second group with different risk factors.

Between one in five and one in seven adolescents in England self-harms, such as by cutting themselves. Though self-harm is a significant risk factor for later suicide attempts, many do not plan suicide but face other harmful outcomes, including repeatedly self-harming, poor mental health, and risky behaviours like substance abuse. 

Despite its prevalence and lifelong consequences, there has been little progress in the accurate prediction of self-harm, and until recently, little research in the area.

Drawing from a nationally representative UK birth cohort of approximately 11 000 individuals, the Cambridge team picked out adolescents who reported self-harm at age 14. With machine learning analysis, they were able to establish profiles of self-harming young people, with different emotional and behavioural characteristics. This information enabled them to identify risk factors present in early and middle childhood. 

Since the data tracked the participants over time, the researchers could distinguish factors that appear at the same time reported self-harm, such as low self-esteem, from those that came before it, such as bullying.

The analysis showed that there were two distinct subgroups among young people who self-harm, with significant risk factors manifesting as early as age five, almost a decade before self-harming. Both groups were likely to experience sleep difficulties and low self-esteem reported at age 14, but other risk factors differed between the two groups.

The first group tended to have a long history of poor mental health, as well as bullying before self-harming. Their caregivers were also more likely to have their own mental health issues.

With the second group, however, self-harming was harder to predict early in childhood. One of the key signs was a greater willingness to take part in risk-taking behaviour, linked to impulsivity. Research suggests that these tendencies may make the individuals less likely to consider alternatives to self-harm. Relationship factors with their peers were also important for this subgroup, including feeling less secure with friends and family at age 14 and worrying more about the feelings of others as a risk factor at age 11.

First author Stepheni Uh, a Gates Cambridge Scholar, explained: “Self-harm is a significant problem among adolescents, so it’s vital that we understand the nuanced nature of self-harm, especially in terms of the different profiles of young people who self-harm and their potentially different risk factors.

“We found two distinct subgroups of young people who self-harm. The first was much as expected – young people who experience symptoms of depression and low self-esteem, face problems with their families and friends, and are bullied. The second, much larger group was much more surprising as they don’t show the usual traits that are associated with those who self-harm.”

The findings suggest the possibility of predicting who is most at risk of self-harm up to a decade in advance, creating a window of opportunity for intervention.

Principal investigator Dr Duncan Astle said: “The current approach to supporting mental health in young people is to wait until problems escalate. Instead, we need a much better evidence base so we can identify who is at most risk of mental health difficulties in the future, and why. This offers us the opportunity to be proactive, and minimise difficulties before they start.

“Our results suggest that boosting younger children’s self-esteem, making sure that schools implement anti-bullying measures, and providing advice on sleep training, could all help reduce self-harm levels years later.

“Our research gives us potential ways of helping this newly-identified second subgroup. Given that they experience difficulties with their peers and are more willing to engage in risky behaviours, then providing access to self-help and problem-solving or conflict regulation programmes may be effective.”

Source: University of Cambridge

Journal information: Uh, S et al. Two pathways to self-harm in adolescence. Journal of the American Academy of Child and Adolescent Psychiatry; DOI: 10.1016/j.jaac.2021.03.010

Nearly 9% of Alcohol Consumed by Underage Drinkers

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Underage youth consumed $17.5 billion worth, or 8.6 percent, of the alcoholic drinks sold in 2016 in the US. Nearly half of youth consumption was made up of products from three alcohol companies: AB Inbev, MillerCoors and Diageo. The study findings were published in the Journal of Studies on Alcohol and Drugs.

In a landmark study of youth alcohol consumption by brand, the authors collected large amounts of data to estimate, for the first time in two decades, the monetary value of youth alcohol consumption. And for the first time, they were able to attribute those revenues to specific companies.

“The alcohol industry has said they don’t want minors to drink, but when we counted up the drinks, it was clear that they were making billions of dollars from these sales,” said co-lead author Pamela J. Trangenstein, PhD, assistant professor of health behaviour at the University of North Carolina Gillings School of Global Public Health. “There is a clear disconnect when an industry advocates prevention but then makes billions of dollars from prevention’s failure.”

Alcohol is the number one substance used among people ages 12 to 20. Although underage drinking has fallen in recent years, alcohol is still responsible for approximately 3500 deaths annually for under 21s, according to the Centers for Disease Control and Prevention.

In the US, the minimum drinking age is 21, although before 1984 states set their own drinking age. According to the CDC, raising the drinking age to 21 saw a 16% reduction in motor vehicle accident deaths, and there is evidence that this limit protects drinkers from alcohol and other drug dependence, adverse birth outcomes, and suicide and homicide.

“Our prior studies have repeatedly shown that youth are exposed to and influenced by alcohol marketing,” commented co-author David H Jernigan, PhD, professor at Boston University. “If alcohol companies are truly committed to preventing youth drinking, they should be willing to put these revenues into an independent agency able to address underage drinking without a conflict of interest.”

The Institute of Medicine and National Research Council, the science advisory body for the US Congress, made that recommendation in their 2003 report on underage drinking. In 2006, the legislation was passed entirely devoted to curbing underage drinking. While that legislation authorised $18 million in spending, the full amount has never been used. 

“Community coalitions in North Carolina and across the country are constantly begging for dollars to support their work on underage drinking,” said Prof Trangenstein. “Our study identifies a clear source for that badly needed funding. Families and communities are paying the price, while big alcohol companies are reaping all the benefits.”

Source: Journal of Studies on Alcohol and Drugs

More information: Eck, R. H., Trangenstein, P. J., Siegel, M., & Jernigan, D. H. (2021). Company-specific revenues from underage drinking. Journal of Studies on Alcohol and Drugs, 82, 368–376. DOI: 10.15288/jsad.2021.82.368

Cannabis Vaping Soared in High School Students Before COVID

Man vaping. Photo by Nery Zarate on Unsplash

With reports of severe lung illnesses related to vaping making headlines in 2019, cannabis use skyrocketed among high school students were soaring.

Cannabis vaping involves inhaling evaporated oils, or vapours from heated concentrates known as dabs. Joseph J Palamar, PhD, of New York University reported on his study in the Journal of Adolescent Health.

The long-running Monitoring the Future study results showed that 4.9% (95% CI 4.3%-5.5%) of high school students reported “frequent” vaping of cannabis products — 10 times or more in the previous month — up from 2.1% in 2018 (95% CI 1.7%-2.6%). Rates of any cannabis vaping in the previous month also rose significantly, from 7.5% in 2018 (95% CI 6.7%-8.4%) to 14.0% in 2019 (95% CI 13.1%-14.9%).

These increases accompanied an unsettling outbreak of respiratory illnesses, until it was eclipsed by the COVID pandemic. Nearly 3000 Americans, mostly young adults, fell ill with EVALI — e-cigarette or vaping-associated lung injury — and 68 died, noted Dr Palamar. Epidemiological and lab research eventually identified vitamin E acetate as the likely cause. The substance is a common component of illicit cannabis vaping products, even though a substantial minority of victims denied use of such products.

Dr Palamar’s study drew on Monitoring the Future data on 4072 students in 10th and 12th grades in 2018 and 8314 in 2019. The study also highlighted other trends.

Cannabis vaping in the past month nearly tripled among female students from 2018 to 2019, while rates for students in general age 18 and older rose 2.5-fold. Social activity, as indicated by reports of “going out” four to seven times a week, was linked to increased rates of cannabis vaping. There were also small increases in cannabis vaping among students reporting other psychoactive drug use including opioids, cocaine, “tranquilisers”, and non-LSD hallucinogens.

The study did not address the extent to which school closures and social restrictions resulting from the COVID pandemic affected these trends, and it will be some before data from Monitoring the Future can answer this as the survey was stopped in March 2020 when the pandemic closed schools.

Nevertheless, the available 2020 data showed that the number of 10th graders saying cannabis was “fairly easy” or “very easy” to obtain had dropped sharply, accelerating a trend underway for more than 20 years. This was despite the spread of legal marijuana.

Dr Palamar noted several limitations to his study and to Monitoring the Future in general. Data on drug use was self-reported, and the survey took place at schools, meaning that students “chronically absent or who dropped out are underrepresented,” he wrote. There were also some subgroups such as those vaping cannabis daily, that were too small for analysis.

Source: MedPage Today

Journal information: Palamar J “Increases in frequent vaping of cannabis among high school seniors in the United States, 2018-2019” J Adolesc Health 2021; DOI: 10.1016/j.jadohealth.2021.03.034.