Internalizing problems are associated with initiation and past 30-Day use of flavored tobacco products. (February 2022)

• Record Type: Journal Article
• Authors: Ganz, Ollie; Cohn, Amy M.; Goodwin, Renee D.; Giovenco, Daniel P.; Wackowski, Olivia A.; Talbot, Eugene M.; Delnevo, Cristine D.
• Is Part Of: Addictive behaviors. Volume 125(2022)
• Publication Date: 2022-02
• Subjects: Flavored tobacco -- Internalizing problems -- Mental health -- Tobacco use initiation -- Current tobacco use -- Menthol; Substance abuse -- Periodicals; Alcoholism -- Periodicals; Drug addiction -- Periodicals; Nicotine addiction -- Periodicals; Smoking -- Periodicals; Gambling -- Psychological aspects -- Periodicals; Electronic journals; 362.29
• DOI: 10.1016/j.addbeh.2021.107162
• Languages: English
• ISSNs: 0306-4603

Abstract

Highlights: Severe internalizing problems associated with flavored tobacco product initiation. Severe internalizing problems more likely with current use of flavored products. Combusted tobacco users with severe internalizing problems at elevated risk of harm. Abstract: Objective: Tobacco use remains disproportionately common among adults with internalizing problems. The rising prevalence of flavored tobacco use among this population may be a contributing factor. Using data from Wave 4 of the Population Assessment of Tobacco and Health Study, this study examined differences across adult ever tobacco users by severity of internalizing problems, in initiation of tobacco use with a flavored product and past 30-day (current) flavored tobacco use (n = 27, 425). Severity of internalizing problems was measured using the Global Appraisal of Individual Needs–Short Screener Internalizing Disorder Screener. Tobacco use variables included initiation with or current use of a flavored product, assessed separately for each product. Weighted chi-square tests and multivariable modified Poisson regression models were used to examine the associations between severity of internalizing problems and each outcome. Results: Controlling for covariates, ever users with severe internalizing problems were more likely to have initiated with flavors for cigarettes (adjusted prevalence ratio [aPR]: 1.16, 95% confidence interval [CI]: 1.09, 1.24), cigarillos (aPR: 1.09, 95% CI: 1.03, 1.16), electronic nicotine products (aPR: 1.08, 95% CI: 1.03, 1.13) and smokeless tobacco (aPR: 1.15, 95% CI: 1.04, 1.27), relative to those with low internalizing problems. Ever users with severe internalizing problems were more likely to currently use a flavored tobacco product for cigarettes (aPR: 1.15, 95% CI: 1.07, 1.24) and cigarillos (aPR: 1.15, 95% CI: 1.04, 1.28). Conclusions: Flavored tobacco use seems disproportionately common among tobacco users with severe internalizing problems, across a variety of measures.