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Description

Decreasing tobacco use among adolescents is a challenge in rural areas where evidence-based tobacco control regulatory interventions are weaker than in urban areas. Rural areas also may have fewer resources and personnel dedicated to tobacco control and implement fewer anti-tobacco efforts. Youth e-cigarette use has increased at a higher rate in rural than urban areas. This project aims to understand  the patterns of use of e-cigarettes in youth and young adults with intent to develop interventions to prevent or control health consequences of use.

Adolescents and young adults (AYA) co-use multiple forms of tobacco and substances. Yet, public health researchers and practitioners mostly focus on studying and developing interventions for one substance at a time. The research and practice team decided to implement an approach that mimics AYA lives, and we have expanded the project to understanding the larger landscape of substance use, with the possibility of developing a multi-substance use prevention intervention for this age group. To do so, we are engaged in several sub projects:

1. State of the scholarship about e-cigarette intervention for youth Abigail Lee, in collaboration with Iowa Cancer Consortium and with support of the PRC-RH, developed an infographic for mentors and caregivers with updated information about e-cigarette interventions for youth.
2. A scoping review of qualitative studies exploring factors influencing youth e-cigarette use synthesizes the lived experience of AYA e-cigarette use.
3. A Systematic review (SR) of systematic reviews synthesizes the science on substance use prevention and control interventions for youth. See the protocol here.
4. A concept mapping study about protective factors engages young people (age 13-18) with the following prompt, “Something that makes people my age NOT want to vape is…”. Recruitment for this project was difficult and has resulted in a presentation about the challenges of engaging youth in e-cigarette research. A paper is forthcoming. 
5. A Delphi survey project engages expert interventionalists in concept mapping to share and synthesize expertise about effective interventions for young adult substance use. This study aims at identifying strategies that effectively reduce substance use among young adults (18-24 years) and enrolls researchers or practitioners that have implemented and evaluated interventions. We are interested in strategies that help prevent initiation and/or reduce or stop use of commercial tobacco (including e-cigarettes), alcohol, and marijuana. Although we often intervene with one substance at a time, evidence indicates that young adults who use any substance almost always use others. Therefore, identifying strategies that might address co-use is critical to promoting wellbeing of young adults. The concept mapping prompt is: “A specific intervention strategy, component, or feature that you have found effective for reducing substance use among young adults is...”

Resources, Media, & Publications 

Resources:

• Infographic: State of scholarship about e-cigarette interventions for youth
• Iowa Youth and Vaping: Facts & Support for Mentors and Caregivers

Research protocol:

• Rima Afifi, Priyanka Dubey, Trisha Welter, Abigail Lee, Mark Vander Weg, Shannon Lea Watkins. Evidence-based interventions for substance use prevention and control among youth and young adults: A systematic review of systematic reviews. PROSPERO 2020 CRD42020202864

Presentations: 

• Bomar H, Lee AA, Watkins SL, Welter T, Vander Weg M, Afifi R. Challenges of recruiting rural adolescents to participate in e-cigarette research. Society for Research on Nicotine and Tobacco annual conference. 2022
• Lee A, Haines H, Henry S, Afifi R. Perspectives of national interventionalists on the effectiveness and captivating features of adolescent e-cigarette prevention and cessation programs. Society for Research on Nicotine and Tobacco annual conference. February, 2021
• Dubey P, El Boukhari N, Vander Weg M, Afifi R. Determinants of e-cigarettes among adolescents and young adults: A scoping review of qualitative studies. American Public Health Association annual conference. November, 2020