Reach News

31 Jan Surgeon General Reports That Doctors Are Not Advising Patients to Stop Smoking

Surgeon General Dr. Jerome Adams warned in a report released last week that a “shocking” number of smokers are not advised to quit by their doctors, despite the current breadth of knowledge on the dangers of smoking cigarettes. “Forty percent of smokers don’t get advised to quit,” Dr. Adams said in an interview. “That was a shocking statistic to me, and it’s a little embarrassing as a health professional.” Dr. Adams is referencing to statistics from the 2015 National Health Interview Survey, collected through the U.S. Census Bureau to monitor “the health of the nation,” that found that four out of nine adult cigarette smokers were not told by a health professional to quit smoking in the past year. In the same report, the Surgeon General warns doctors and health officials that vulnerable populations, such as “gay and transgender people, Native Americans, and people with mental illness diagnoses,” are not getting the help needed to quit smoking, and that more attention should be devoted to these groups. Dr. Adams urged cigarette smokers to use the wide range of cessation methods that have been proven effective by the FDA…a list which does not include e-cigarettes. He referenced the increasingly popular devices after releasing his report, saying that more research was needed on the effects of e-cigarettes. He did, however, offer anecdotal evidence on the “effectiveness of e-cigarettes as smoking cessation tools”, saying: “We’ve heard powerful accounts from adults out there who tell us that they’ve used e-cigarettes to successfully transition from combustible cigarettes.”

Over 55 years since the release of the first surgeon general report that warned the public that smoking causes cancer, smoking remains the “leading cause of preventable death and disease” in the country. Smoking rates, however, are on the decline, with smoking in the U.S. reaching an all-time low of 14 percent. Still, almost half a million Americans die from smoking-related illnesses every year, and about 16 million people suffer from cancer and heart disease linked to smoking, according to the CDC. 

24 Jan Cornell University Designs Innovative Toolkit to Demonstrate Harms of E-Cigarette Use

The Advancing Secondary Science Education Through Tetrahymena (ASSET) program at Cornell University has developed a new learning module kit where high school students can directly test the effects of e-cigarettes on living cells. The kit contains small quantities of e-cigarette vapor condensate, unsmoked vape juice, and water that has been vaporized and re-condensed in a clean e-cigarette. Using these materials, the students then apply it to a single-celled ciliated protozoan called Tetrahymena. The Tetrahymena is an organism that mimics the functions of a human cell, therefore the students will be able to see the moment when a healthy Tetrahymena cell, which is in constant motion, quickly becomes still and sinks to the bottom once introduced to the substance. 

Dr. Donna Cassidy-Hanley, Senior Research Associate and Program Manager of the ASSET program states that “our module is unique in that… it provides a dramatic and impactful demonstration of the real-life effects of e-cigarette vapor on living cells.” The goal of the module kits is to educate and demonstrate to the youth the impact and risks of smoking e-cigarettes in such a way that the students will not forget.

The kit is free for high school teachers and it is currently being used in 18 schools across seven states.

17 Jan Teen Alcohol and Cigarette Use Decreases, Vaping Nicotine and Marijuana Soars

A New York Times article published last month details new information on youth substance use. The annual Monitoring the Future survey that follows 8th, 10th, and 12th graders showed that adolescents are smoking cigarettes, trying hard drugs, or drinking alcohol at lower levels than the past. However, the use of electronic cigarettes to vape marijuana and nicotine has soared. Rates of e-cigarette use to vape marijuana has essentially doubled over the past two years, with 7% of 8th graders, 19.4% of 10th graders, and 20.8% of 12th graders reporting past year use in 2019. This parallels earlier data released by the U.S. government reporting that about 25% of 10th and 12th graders used e-cigarettes in the past month for vaping nicotine. 

This report comes on the heels of the mysterious vaping epidemic of “e-cigarette, or vaping, product use-associated lung injury (EVALI),” which has resulted in 2,668 hospitalized cases, including 60 deaths. According to the Center for Disease Control (CDC), as of early January, 82% of hospitalization cases have reported using THC in their e-cigarette products. According to the CDC, vitamin E acetate, an additive in many THC e-cigarette products, may be a likely source of the outbreak of these EVALI cases, although officials are hesitant to pinpoint the cases on only one chemical or ingredient. 

Although vaping marijuana is steadily on the rise, overall marijuana use (including smoking or eating edibles) was constant compared to last year’s statistics on use in the past year, although daily use did increase. In sum, the results of the Monitoring the Future survey gives public health officials a hesitant feeling of relief, as rates of alcohol and cigarette use continue to decline. “There has been a whole lot of effort at the community level,” said Dr. Sion Kim Harris, a pediatrician and director for the Center for Adolescent Substance Abuse Research at Boston Children’s Hospital. “There are some encouraging trends.” In contrast, it seems that efforts to minimize vaping have yet to take hold, likely due to the steadfast belief among youth that vaping is not harmful. 

The National Institute on Drug Abuse funds the Monitoring the Future survey in order to closely monitor changes in teenage drug use and experimentation, in the hopes of better understanding the constantly changing rates of adolescent substance use. 

13 Jan ReACH Lab Graduate Student Publishes Master’s Manuscript

A big congratulations is due for ReACH Lab graduate student Julie Cristello after her manuscript based off her Master’s project was recently accepted to be published in the journal “Addictive Behaviors”. Please continue reading below to read her abstract, congratulations on this amazing accomplishment Julie! 

The relationship between adolescent sport involvement and later substance use (SU) has been unclear. Understanding the pathways through which sport involvement influences SU may help identify targets for prevention. Using a sample of 535 adolescents from the Michigan Longitudinal Study (MLS; 67.29% male, 78.13% European American), this study prospectively examined whether aggression during late adolescence mediated the association between sport involvement during early adolescence and alcohol, marijuana, and cigarette use during early adulthood. In addition, perceived peer SU during early adolescence was tested as a potential moderator in the association between sport involvement on SU. High sport involvement was associated with more alcohol use. In contrast, the indirect effect of sport involvement on SU via aggression was significant for cigarette use, and marginally significant for marijuana use. Lastly, peer SU was a significant moderator in the cigarette model, indicating low peer SU was somewhat protective among high sport-involved adolescents. Prevention targeting alcohol use and associated consequences, as well as aggressive behaviors may help address future substance use.

13 Jan ACE Project Wraps Up First Wave of Data Collection, Reflects on Two Years of Accomplishments

02 Jan ReACH Lab to Present at Upcoming SRA Conference

ReACH Lab members received an impressive number of acceptances for the upcoming Society for Research on Adolescence Biennial Conference that will take place in San Diego this March. Acceptances include: 1 preconference, 1 symposium, 5 paper presentations, and 1 poster presentation. See below for more information on the accepted materials and congratulations to ReACH Lab members for this notable accomplishment! 

Dr. Trucco and Julie Cristello’s preconference titled “Adolescent Electronic Cigarette Use: How to Assess a Quickly Evolving Behavior” kicks off the conference by providing an overview of available e-cigarette devices (e.g., open- vs closed-systems), and a review of conceptual and methodological considerations (e.g., measuring quantity, frequency, and duration of use across devices) regarding e-cigarette use among adolescents. Invited speaker, Dr. Joanna Jacobus, will present unique assessment considerations related to vaping cannabis and how to properly code simultaneous (e.g., chasing) vs. concurrent use of cannabis and nicotine. An overview of available measures to assess adolescent vaping, as well as attitudes, expectancies, and reasons for vaping will also be presented. Lastly, continued barriers in the assessment of e-cigarette use among adolescents will be discussed.

Dr. Trucco’s symposium titled “Blowing Smoke: Individual, Social, and Biological Factors Linked to Electronic Cigarette Use Among Teens and Young Adults” is sure to be a hit at the conference. The symposium aims to examine factors related to the increasing popularity of e-cigarettes among adolescent, their role in initiating other substances (e.g., conventional cigarettes, cannabis), and their possible negative health consequences. Paper 1, written by ACE Project PIs Dr. Trucco and Dr. Sutherland, and by ReACH Lab graduate student Julie Cristello, examines the role of parental and peer attitudes on early stages (intentions to initiate, favorable attitudes) of e-cigarette use. Paper 2 investigates sociodemographic and psychosocial vulnerability factors associated with single- versus dual- use of e-cigarettes and conventional cigarettes. Paper 3 demonstrates the deleterious effects of e-cigarette and cannabis co-use on the developing brain using diffusion tensor imaging. Paper 4 identifies specific aspects of e-cigarettes that appeal to youth (e.g., devices, flavorings, use behaviors). Identifying key modifiable targets related to e-cigarette initiation, problematic use, and poly-product use patterns will help inform routine screenings, substance use counseling, preventative interventions, and product regulation.

Benjelene Sutherland’s paper in progress titled “The Synergistic Effect of Low Self-Control and Internalizing Symptoms on Adolescent Electronic Cigarette Use Intentions” was accepted as a paper presentation. This study examined the synergistic association between low self-control and symptoms of depression on intentions to use e-cigarettes among adolescents, as well as the interaction between low self-control and symptoms of GA on intentions to use e-cigarettes among adolescents. Consistent with study hypotheses, those with high levels of depression and low self-control endorsed greater future intentions to use e-cigarettes compared to those with low depression. Unexpectedly, those with high levels of self-control and high depression endorsed the lowest level of future intentions to use e-cigarettes, indicative of potential protective effects. Furthermore as expected, those with low self-control and high levels of GA endorsed greater future intentions to use e-cigarettes. Similar to depression, an interesting pattern emerged among individuals high in both self-control and GA. Namely, these adolescents endorsed the lowest future intentions to use e-cigarettes, suggesting potential protective effects.

Brigitte Madan’s paper in progress titled “Outcome Expectancies Mediate the Impact of Hopelessness and Impulsivity on E-Cigarette use Intentions” was also accepted as a paper presentation. This study examined negative affect and social related outcome expectancies (i.e., negative affect reduction [NAR] and social facilitation [SF]) as mediators of the association between personality characteristics (i.e., hopelessness, impulsivity) and adolescent e-cigarette use intentions. Two of the four mediated pathways were supported. There was evidence for a significant indirect effect of both hopelessness and impulsivity on e-cigarette use intentions via SF. Specifically, higher self-reported hopelessness and impulsivity were both associated with greater SF expectancies. In turn, greater SF expectancies were associated with stronger e-cigarette use intentions. In contrast to prior work on cigarette use, these outcomes indicate that one reason why adolescents may use e-cigarettes is for social reasons rather than self-medicating to relieve negative affect. Adolescents feeling greater levels of hopelessness may view e-cigarette use as a means to more effectively socialize with peers, whereas adolescents high in impulsivity may view e-cigarette use as a means to enhance pleasure from social situations.

Michelle Villar’s paper in progress titled “Internalizing Pathways to Adolescent Substance Use from Adverse Childhood Experiences” was also accepted as a paper presentation. This study examined anxiety, depression, and somatic symptoms as mediators of the association between adverse childhood experiences (ACEs) and adolescent substance use. Using data from the Michigan Longitudinal Study, it was found that self reported depression symptoms mediated the association between ACEs and cigarette and marijuana use. Additionally, parent-reported depressive symptoms also mediated the relationship between ACEs and cigarette use. When controlling for externalizing symptoms, results were consistent for the two significant self-report models. However, the significant association in the parent model was replaced with an association of ACEs on alcohol use via anxiety. This association was negative, indicating that ACEs were associated with greater parent-reported anxiety, but greater anxiety predicted low alcohol use. Findings underscore the importance of assessing facets of internalizing symptoms separately, across multiple reporters, to inform more targeted prevention programming for youth who have experienced ACEs.

19 Dec How Juul Hooked a Generation on Nicotine

At a congressional hearing this July, James Monsees, co-founder of Juul Labs, testified that “we [Juul Labs] never wanted any non-nicotine user and certainly nobody underage to ever use Juul products.” But how truthful is this testimony? According to a recent article in the New York Times, Juul’s past shows that this is entirely dishonest. In the wake of an increasing numbers of investigations and lawsuits, Juul has continued to insist that their marketing was never intended to attract teenagers and non-smokers. However, according to NYT interviews with former investors and employees, as well as NYT reviews of legal documentations and social media archives, it seems the company knew exactly what it was doing.

According to the article, Ari Atkins, an engineer that was part of the team that developed the Juul, told The Verge in 2015: “We don’t think a lot about addiction here because we’re not trying to design a cessation product at all. Anything about health is not on our mind.” This point was proven when the company did not include a nicotine warning label on their products until the summer of 2018 when the FDA forced them to do so. In December 2018, the vaping giant continued to raise eyebrows when a 35 percent stake in their company was bought by Altria, one of the world’s largest producers of cigarettes and other tobacco products, uniting Juul with Big Tobacco in an undeniable way. 

Juul has virtually monopolized the e-cigarette industry over the last few year, taking over 75 percent of e-cigarette sales and making more than $1 billion in sales in 2018. The company’s gargantuan growth from 2016 to 2018 occurred at the same time that the number of adult nonsmokers that began vaping in the United States doubled. Also during this time, one in four high school students and one in 10 middle school students became e-cigarette users. Although Juul has only recently been tied to increased vaping among adolescents and young adults, it seems this was part of their early game plan. In 2015 during a campaign called Vaporized, Juul introduced itself to the public with parties in large cities like Miami and New York, and with ads and posts featuring young models. Three members of the company’s sales team recalled confusion regarding this campaign; if the company is supposedly targeting current smokers, why is the campaign so youthful? Scott Dunlap, the chief marketing officer at the time, noticing a sharp increase in adolescents and young adults engaging with social media posts featuring hashtags like #juul and #vaporized. In 2017, employees also began noticing that orders were being made online with clearly fake IDs. Although these orders were not filled, it was an indication that underage teenagers were trying to buy Juuls. This clearly didn’t seem to phase the company, as the company moved forward with filing a patent for a vaping device with a built in “gaming mode” that was seemingly aimed at young vapers. This device, however, was never made. Also in 2017, Juul and other vaping companies were sued by the Center for Environmental Health in order to lower dangerous levels of carcinogenic formaldehyde in their products. The Center for Environmental Health  decided to include a provision in the settlement that required the companies to agree not to market to youth. Juul did not sign this provision until last month.

Following the intense backlash concerning Juul’s role in the current vaping epidemic among teens, the company has taken steps to keep products away from teenage hands, including stopping the sale of most of its flavors and halting all advertising. Late last year, Joshua Raffel, a spokesman for Juul, said “we [the company] fully understand the need to earn back the trust of regulators, policymakers, key stakeholders and society at large and reset our company and the vapor category.” Regardless of these current changes, Juul’s long-term presence in the American marketplace remains uncertain. In May of next year, the FDA will be reviewing whether the benefit of smokers switching to e-cigarettes is worth the drawback of developing a newly nicotine-dependent generation. For now, all there is to do is wait and hear about the company’s wavering future. 

17 Dec The ACE Project Finishes 2019 Strong with Community Outreach Efforts

The ACE Project is finishing up the year strong by hosting several community outreach events at local Miami-Dade County Public Schools and Student Success Centers (SSC). 

In the past week, Co-Principal Investigator, Dr. Matthew Sutherland, and Senior Research Assistant, Brigitte Madan, have visited and presented at two Student Success Centers. On December 3rd, the duo visited Overtown Youth Center and on December 10th, they visited Homestead Senior High. The SSC’s serve as a space where students ages 11 and over can receive academic and counseling support after exhibiting infractions of the Code of Student Conduct. Dr. Sutherland and Ms. Madan educated over 30 students on the harms associated with e-cigarettes/vaping use in adolescence. 

The ACE Project team then continued their outreach efforts by spending two consecutive days giving a series of educational presentations at Miami Palmetto Senior High. On December 5th, Co-Principal Investigator, Dr. Elisa Trucco, and Ms. Madan gave two presentations on e-cigarettes, resulting in over 1300 students learning more about the negative effects of vaping on the brain and body. On the next day, Program  Coordinator, Nasreen Hidmi, Intake Specialist, Odette Manresa, and Ms. Madan, along with graduate students Patricio Viera Perez and Katharine Crooks, gave 27 classroom presentations at Miami Palmetto. They also set up a lunch-time information table where students were able to ask questions openly and receive more information relating to the negative effects of e-cigarettes/vaping. Over 350 students showed interest in participating in the ACE Project at Miami Palmetto Senior High.

In the past year, The ACE Project team have completed 29 community outreach events and have presented to over 5000 students and school professionals. They continue to partner up with M-DCPS middle and high schools, and their Student Success Centers, to inform the youth on the dangers of developing a dependency on nicotine from e-cigarettes/vaping. The ACE Project focuses on discovering how certain factors can influence a teen’s behavior and beliefs about substances during high school in order to understand and improve prevention efforts.

03 Dec New Publication on Gene x Environment Effects Across Development

ReACH Lab Director, Dr. Trucco, teamed up with scientists from the University of Texas, Penn State, and the University of Michigan to examine how gene x environment effects change from childhood to early adulthood. More specifically, the study used a state-of-the-art methodology, time-varying effect modeling, to test whether individuals carrying different genotypes of the GABRG1 gene were more susceptible to peer externalizing behavior and peer substance use on their own externalizing behavior. Findings indicate that those carrying a specific genetic variant of GABRG1 are more sensitive to peer influence and that this increased susceptibility spans late childhood to early adulthood. Findings are published in the Journal of Youth and Adolescence. 

25 Nov The ACE Project Gains New Partnership and Continues Community Outreach

The ACE Project kicked off activities related to a new partnership with the Miami Dade County Public School’s Student Success Centers (SSC) this month. The M-DCPS Student Success Centers serve as an educational setting and haven for referred students ages 11 and up. The purpose of the centers is to deliver academic and counseling support to students who have exhibited infractions of the Code of Student Conduct, which may have involved the use of vaping products. The partnership involves the ACE Project team visiting all of the SSCs as well as the Secondary Success Centers (S3Cs) to educate and present on the harms of vaping/e-cigarette use among teens. This will involve visiting 14 locations through the end of the school year.

The ACE project’s Co-Principal Investigator, Dr. Matthew Sutherland, and their Program Coordinator, Nasreen Hidmi, began the tour on November 1st at 500 Role Model Academy. They provided their educational presentation of the negative effects of vaping/e-cigarettes to over 20 students. On November 5th, they continued their presentations at the North Region Center, where they presented to over 25 students. Lastly, on November 15th, Dr. Sutherland and Ms. Hidmi visited the Parkway Educational Complex and gave their educational presentation to over 21 students. Later, on November 19th, Dr. Sutherland and Ms. Hidmi returned to Parkway Educational Complex, but this time to present to 18 students at the S3C Program, a program designed to accelerate educational experiences for students through computer-based instruction. The team made some additional rounds out to other schools this month. Dr. Sutherland and Ms. Hidmi returned to Miami Macarthur Educational Center on November 4th to present to 30 school teachers and counselors about the harms of e-cigarette use among adolescents. Later in the month, Ms. Hidmi and Ms. Manresa recruited and presented to over 150 students at Miami Coral Park Senior High School on November 14th and 15th.

Finally, on November 20th, Dr. Elisa Trucco and Dr. Matthew Sutherland hosted a workshop at Florida International University open to the public as part of the FIU-RCMIs Community Engagement Speaker Series. The workshop provided up-to-date information on rates of e-cigarette use/vaping among teens, the impact of vaping on the body and brain, and reasons why teens are likely to start initiating e-cigarette use. They then concluded with exciting initial research findings from the ACE Project. The workshop garnered an excellent turnout with over 60 attendees!

In the past month, The ACE Project has presented to over 230 students and 100 professional personnel to educate on the harms associated with e-cigarette use. The ACE Project continues to expand their outreach efforts to educate the youth and the community on the risks of vaping.