'It's like if a vape pen and a cigarette had a baby': a mixed methods study of perceptions and use of IQOS among US young adults.

Young adults' perceptions and use of heated tobacco products (HTPs) are understudied. This mixed methods study analyzed (i) Fall 2020 survey data from 2470 US young adults (meanage = 24.67; 19.5% and 25.2% past-month cigarette and e-cigarette use; 4.1% ever HTP use) assessing HTP use intentions and perceptions (1 = not at all to 7 = extremely) and (ii) Spring 2021 interview data regarding IQOS (most widely available HTP) in a subset of 40 e-cigarette users. Among survey participants, HTPs versus cigarettes and e-cigarettes showed lower use intentions (mean = 1.27 vs. mean = 1.73, mean = 2.16) but were perceived as less addictive (mean = 5.11 vs. mean = 6.28, mean = 5.82) and harmful (mean = 5.37 vs. mean = 6.65, mean = 5.62). HTPs were perceived more socially acceptable than cigarettes but less than e-cigarettes (mean = 3.39 vs. mean = 3.13, mean = 4.37). Among interviewees, most reported limited HTP knowledge. A few perceived IQOS as a hybrid of traditional cigarettes and e-cigarettes. Most perceived IQOS as harmful but less harmful than cigarettes and were uncertain in relation to e-cigarettes. Over half reported minimal interest in trying IQOS; common reasons included IQOS containing tobacco, limited flavors and use complexity. The varied perceptions of IQOS versus cigarettes and e-cigarettes underscore the need for continued surveillance of perceptions, use and marketing of IQOS to inform regulatory oversight and potential interventions.

Social distancing and related factors during the COVID-19 pandemic in relation to COVID-19 symptoms and diagnosis and mental health.

Background: Many states, local authorities, organizations, and individuals have taken action to reduce the spread of COVID-19, particularly focused on restricting social interactions. Such actions have raised controversy regarding their implications for the spread of COVID-19 versus mental health. Methods: We examined correlates of: (1) COVID symptoms and test results (i.e., no symptoms/tested negative, symptoms but not tested, tested positive), and (2) mental health symptoms (depressive/anxiety symptoms, COVID-related stress). Data were drawn from Fall 2020 surveys of young adults (n = 2576; M age = 24.67; 55.8% female; 31.0% sexual minority; 5.4% Black; 12.7% Asian; 11.1% Hispanic) in six metropolitan statistical areas (MSAs) with distinct COVID-related state orders. Correlates of interest included MSA, social distancing behaviors, employment status/nature, household composition, and political orientation. Results: Overall, 3.0% tested positive for COVID-19; 7.0% had symptoms but no test; 29.1% reported at least moderate depressive/anxiety symptoms on the PHQ-4 Questionnaire. Correlates of testing positive (vs. having no symptoms) included residing in Oklahoma City vs. Boston, San Diego, or Seattle and less social distancing adherence; there were few differences between those without symptoms/negative test and those with symptoms but not tested. Correlates of greater depressive/anxiety symptoms included greater social distancing adherence, being unemployed/laid off (vs. working outside of the home), living with others (other than partners/children), and being Democrat but not Republican (vs. no lean); findings related to COVID-specific stress were similar. Conclusion: Despite curbing the pandemic, social distancing and individual (e.g., political) and environmental factors that restrict social interaction have negative implications for mental health.