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Vaping Nicotine and Cannabis in Adolescence and Early Adulthood

Institution: University of Southern California
Investigator(s): Jessica Barrington-Trimis, PhD
Award Cycle: 2018 (Cycle 27) Grant #: 27IR-0034 Award: $1,230,250
Subject Area: Tobacco-Use Prevention and Cessation
Award Type: High Impact Research Project Award

Initial Award Abstract

Vaping—the inhalation of substances from e-cigarettes and other devices commonly referred to as “vaporizers”—has increased rapidly in adolescents and young adults over the last several years. Vaping has been traditionally thought of as a method of using nicotine (or simply flavors), but increasingly, many youth are using these devices to vape cannabis (marijuana). Recent reports suggest that 8-29% of youth have vaped cannabis. Nevertheless, the public health community is divided regarding whether vaping poses a threat to the public health of youth. Some argue that youth who vape are those who otherwise would have used other forms of nicotine or cannabis (for example, smoking cigarettes or combustible marijuana). Others are concerned that because youth can vape solutions in different flavors and using popular high-tech devices, low risk youth who would not otherwise have smoked may try vaping, and may then progress on to other types of substance use (the catalyst model of the impact of vaping). Because there still remains relatively limited research regarding vaping among adolescents and young adults – particularly of cannabis – it is unclear whether urgent, targeted efforts are warranted to prevent youth vaping, or what types of messages would be most effective.

In the current proposal, we aim to rigorously test the catalyst model to determine whether vaping is recruiting low-risk youth via appealing characteristics, and whether those who vape are more likely to progress to other types of substance use. We will leverage an existing sample with data on vaping both nicotine and cannabis, and will follow this cohort yearly as they age into early adulthood (ages 18-21). Using digital surveys, we will collect detailed information of vaping or combustible nicotine and cannabis use frequency (days used in past 30) and intensity (vaping episodes per day, puffs per episode, number of joints/cigarettes smoked per day). We will also add images and video clips depicting different vaping products to the online survey to identify which particular product features are predictive of vaping (particularly among low-risk youth) and should be targeted in regulatory policy.

Our first aim of the project is to test hypotheses derived from Step 1 of the catalyst model – to determine whether and how lower risk populations are being drawn into vaping nicotine and cannabis. We hypothesize that low-risk adolescents and young adults will be more likely to vape than to use combustible products. Our second aim is to test hypotheses derived from Step 2 of the catalyst model – to determine whether and how AYAs who vape are more vulnerable to other forms of drug use. Specifically, we hypothesize that vaping nicotine or cannabis may increase the likelihood of: (i) poly-substance vaping, (ii) combustible cannabis and tobacco product use, including poly-substance use, (iii) use of other drugs, (iv) nicotine, cannabis, or other drug dependence. We will further test our hypothesis that these transitions occur because youth who vape experience rewarding effects from vaping, and in turn have greater expectancies that other forms of drug use will similarly engender rewarding effects, thus increasing the likelihood of experimentation with other substances.

Addressing these aims collectively will inform whether and how vaping attracts a broad segment of low-risk youth and young adults into nicotine and/or cannabis use, leads to regular use, and adversely impacts the drug use burden in an era when vaping is rampant entry point into nicotine and cannabis use.