Summary: | Introduction
Although emotional symptoms and sensation seeking are recognized
as important risk factors for tobacco use among youth and young adults, to date,
their joint influence on tobacco use has not been examined.
Methods
Data used in this study are from the Texas Adolescent Tobacco and
Marketing Surveillance study, a population-based cohort. At baseline, in 2014,
participants were in the 10th grade. Mixed-effects logistic regression models
examined associations between emotional symptoms and sensation seeking in
2014 and odds of past 30-day cigarette and e-cigarette use in 2018. Interactions
between emotional symptoms and sensation seeking were examined to assess
whether one modifies the effect of the other on cigarette and e-cigarette use.
Results
After adjusting for age, sex, race/ethnicity, school type, and ever use of
cigarettes or e-cigarettes at baseline, adolescents with high emotional symptoms
(AOR cig =1.97; 95% CI:1.07–3.60, and AOR e-cig =1.68; 95% CI: 1.06–2.66) and with
high sensation seeking tendencies (AOR cig =2.05; 95% CI: 1.03–4.10, and AOR ecig
=1.68; 95% CI: 1.02–2.76) had significantly higher odds of past 30-day cigarette
and e-cigarette use four years later compared to adolescents with low emotional
symptoms and low sensation seeking tendencies. The interaction was significant
(p=0.01) for e-cigarette use only; among low sensation seekers, adolescents who
reported high levels of emotional symptoms were at increased risk for past 30-
day use (AOR e-cig =3.43; 95% CI: 1.38–8.51), and among adolescents with low
emotional symptoms, high sensation seekers were at increased for risk for past
30-day use (AOR e-cig =3.50; 95% CI: 1.54–7.91).
Conclusions
It is important for tobacco use prevention programs to consider both
behavioral risk factors – sensation seeking and emotional symptoms – in an
integrative way, to target high risk subgroups and thereby increase the efficacy
of existing effective intervention strategies in order to curb tobacco use among
youth and young adults.
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