Associations of Combustible Cigarette, Electronic Cigarette, and Dual Use With COVID Infection and Severity in the U.S.: A Cross-sectional Analysis of the 2021 National Health Information Survey.

Given the potential respiratory health risks, the association of COVID infection and the use of combustible cigarettes, electronic nicotine delivery systems (ENDS), and concurrent dual use is a priority for public health. Many published reports have not accounted for known covarying factors. This study sought to calculate adjusted odds ratios for self-reported COVID infection and disease severity as a function of smoking and ENDS use, while accounting for factors known to influence COVID infection and disease severity (i.e., age, sex, race and ethnicity, socioeconomic status and educational attainment, rural or urban environment, self-reported diabetes, COPD, coronary heart disease, and obesity status). Data from the 2021 U.S. National Health Interview Survey, a cross-sectional questionnaire design, were used to calculate both unadjusted and adjusted odds ratios for self-reported COVID infection and severity of symptoms. Results indicate that combustible cigarette use is associated with a lower likelihood of self-reported COVID infection relative to non-use of tobacco products (AOR = .64; 95% CI [.55, .74]), whereas ENDS use is associated with a higher likelihood of self-reported COVID infection (AOR = 1.30; 95% CI [1.04, 1.63]). There was no significant difference in COVID infection among dual users (ENDS and combustible use) when compared with non-users. Adjusting for covarying factors did not substantially change the results. There were no significant differences in COVID disease severity between those of varying smoking status. Future research should examine the relationship between smoking status and COVID infection and disease severity utilizing longitudinal study designs and non-self-report measures of smoking status (e.g., the biomarker cotinine), COVID infection (e.g., positive tests), and disease severity (e.g., hospitalizations, ventilator assistance, mortality, and ongoing symptoms of long COVID).

Validation of hair ethyl glucuronide using transdermal monitoring and self-reported alcohol use in women of childbearing potential.

AIM: The present study aimed to evaluate the validity of hair ethyl glucuronide concentrations compared with transdermal alcohol concentration and self-reported alcohol use. METHODS: This trial included 25 adolescent and young adult females, aged 16-24, who reported at least one heavy drinking episode (≥4 drinks) in the two weeks prior to baseline. All participants were asked to wear an alcohol biosensor over a one-month prospective study. Detailed self-report of drinking behaviors was assessed weekly. Estimates of blood alcohol concentration were computed from self-report data using the National Highway and Transportation Safety Administration equation. Transdermal alcohol concentration and estimated blood alcohol concentration data were categorized into at-risk (>0.05 g/dL alcohol) and high-risk (>0.08 g/dL alcohol) drinking events. Hair ethyl glucuronide concentration, total number of drinking events, moderate (>0.05 g/dL) and high level (>0.08 g/dL) of transdermal alcohol concentration, and estimated blood alcohol concentration drinking events were analyzed with Spearman's rank correlation test for validity comparisons. RESULTS: No significant correlations were found between hair ethyl glucuronide values and total number, and moderate or high levels of detected drinking events by estimated blood alcohol concentration or transdermal alcohol concentration. Total number of drinking events detected and number of drinking events >0.08 g/dL using estimated blood alcohol concentration and transdermal alcohol concentration methods were significantly correlated with each other (respectively, R = .33, P < .05; R = .42, P < .05). CONCLUSION: Our findings indicate that, due to the number of false negatives, hair ethyl glucuronide concentrations should be used with caution for monitoring abstinence from alcohol use.

Feasibility and reliability of continuously monitoring alcohol use among female adolescents and young adults.

INTRODUCTION AND AIMS: Transdermal alcohol sensors allow objective, continuous monitoring and have potential to expand current research on adolescent and young adult alcohol use. The purpose of this manuscript is to evaluate the feasibility and reliability of transdermal alcohol sensor use among female adolescents as compared to female young adults. DESIGN AND METHODS: This trial included 59 female adolescents and young adults aged 14-24 years who reported drinking during the previous month. All participants were asked to wear a Giner Wrist Transdermal Alcohol Sensor (WrisTAS)-7 over a 1 month prospective study. Participants came to the research lab weekly to complete a detailed self-report of behaviours, including day of drinking events, amounts and types of alcohol use and length of drinking events. Estimates of blood alcohol concentration (eBAC) were computed from self-report data using the Matthew and Miller, NHTSA and Zhang equations. Daily transdermal alcohol concentration (TAC) peaks and calculated eBAC peak data were analysed with paired-samples t-tests and repeated measures correlations for validity comparisons. RESULTS: All participants (100%, n = 59) completed the trial, however, two participants were removed due to greater than 50% of missing transdermal alcohol sensor data. Of the 57 participants, the data included 1,722 days of continuous alcohol monitoring. Missing data was recorded more frequently among female adolescents at about (11.78%) as compared to female young adults (8.59%; χ2  = -18.40, P < 0.001). Participant self-report of drinking occurred with greater frequency (374 events) than detected by the WrisTAS transdermal alcohol sensors (243 events). On days when self-report and sensor data indicated a drinking event, participants' eBAC was moderately correlated with TAC, after accounting for repeated measures. DISCUSSION AND CONCLUSIONS: This study finds that transdermal alcohol sensors are moderately reliable when sensor data is paired with self-report. This objective data collection method may improve the ability to collect alcohol curves among adolescents.

Best Practices for Engaging Pregnant and Postpartum Women at Risk of Substance Use in Longitudinal Research Studies: a Qualitative Examination of Participant Preferences.

There are significant barriers in engaging pregnant and postpartum women that are considered high-risk (e.g., those experiencing substance use and/or substance use disorders (SUD)) into longitudinal research studies. To improve recruitment and retention of this population in studies spanning from the prenatal period to middle childhood, it is imperative to determine ways to improve key research engagement factors. The current manuscript uses a qualitative approach to determine important factors related to recruiting, enrolling, and retaining high-risk pregnant and postpartum women. The current sample included 41 high-risk women who participated in focus groups or individual interviews. All interviews were analyzed to identify broad themes related to engaging high-risk pregnant and parenting women in a 10-year longitudinal research project. Themes were organized into key engagement factors related to the following: (1) recruitment strategies, (2) enrollment, and (3) retention of high-risk pregnant and parenting women in longitudinal research studies. Results indicated recruitment strategies related to ideal recruitment locations, material, and who should share research study information with high-risk participants. Related to enrollment, key areas disclosed focused on enrollment decision-making, factors that create interest in joining a research project, and barriers to joining a longitudinal research study. With regard to retention, themes focused on supports needed to stay in research, barriers to staying in research, and best ways to stay in contact with high-risk participants. Overall, the current qualitative data provide preliminary data that enhance the understanding of a continuum of factors that impact engagement of high-risk pregnant and postpartum women in longitudinal research with current results indicating the need to prioritize recruitment, enrollment, and retention strategies in order to effectively engage vulnerable populations in research.

Electronic Nicotine Delivery Systems and Serum Folate: A Case Study.

INTRODUCTION: In 2018, the US Surgeon General declared youth electronic nicotine delivery systems (ENDS) use as an epidemic. Combustible cigarettes have been shown to adversely affect folate status; however, no study to date has explored how ENDS impact folate status. METHODS: In this case study, a white 18-year-old woman was followed for a 1-month period as part of a larger study. During her participation in the study, a self-report of dietary folate consumption and use of alcohol, tobacco, and other drugs (ATOD) was collected. Each week, dried blood spots were collected to assess red blood cell (RBC) and serum folate. RESULTS: During the first 2 weeks of the study, she used ENDS and her serum folate values were depleted in the ranges of 1.91 to 4.39 µg/L. During the third week, when no ENDS were used, her serum folate value was measured at 29.44 µg/L. When ENDS use resumed during the fourth week, her serum folate value fell to 7.50 µg/L. CONCLUSIONS: This relationship suggests the need for additional studies on ENDS use and serum folate status, particularly among adolescent women who already have the lowest folate status nationally.