ABSTRACT
Background: E-cigarette (ECIG) use has increased substantially in the past decade. Co-use of alcohol and ECIGS may have serious consequences in adolescents. Objectives: To evaluate the association of e-cigarettes (ECIGs) with alcohol use in adolescents. Methods: Searched databases included PubMed, EMBASE, CINAHL, PsycINFO, Web of Science, and gray literature. Studies were included if they contained a non-E-cigarette group (NON-ECIG), an ECIG group, detailed rates of alcohol use, binge drinking, or drunkenness and included adolescents. Two independent reviewers extracted data using MOOSE guidelines. Evidence quality across studies was assessed using Cochrane GRADE methodology. Summary effects of ECIG vs. NON-ECIG use on any alcohol use and a composite of binge drinking/drunkenness were calculated using a random-effects model. Results: 28 of 3768 initially identified studies were included: 25 cross-sectional, 3 cohort studies, N = 458,357 total subjects (49.6% females). Pooling of data showed that ECIG users had a higher risk for any alcohol use compared to NON-ECIG users (Odds Ratio/OR 6.62, 95% confidence interval/CI 5.67-7.72) and a higher rate of binge drinking/drunkenness compared to NON-ECIG users (OR 6.73, 95% CI 4.5 - 10.07). The subset of high school ECIG users had higher rates of alcohol use (OR 8.17, 95% CI 5.95-11.2) and binge drinking/drunkenness (OR 7.98, 95% CI 5.98-10.63) compared to NON-ECIG users. Conclusion: ECIG users had a higher risk of alcohol use and binge drinking/drunkenness compared to NON-ECIG users. Our findings indicate that interventions to reduce ECIG use should be coupled with measures to reduce alcohol use in adolescents.Abbreviations: ECIG: e-cigarettes; NON-ECIG: non e-cigarettes.
Subject(s)
Alcoholic Intoxication/epidemiology , Binge Drinking/epidemiology , Electronic Nicotine Delivery Systems/statistics & numerical data , Underage Drinking/statistics & numerical data , Vaping/epidemiology , Adolescent , Alcohol Drinking/epidemiology , Female , Humans , Male , Young AdultABSTRACT
BACKGROUND: The Internet is a universal source of information for parents of children with acute complaints. OBJECTIVES: We sought to analyze information directed at parents regarding common acute pediatric complaints. METHODS: Authors searched three search engines for four complaints (child + fever, vomiting, cough, stomach pain), assessing the first 20 results for each query. Readability was evaluated using: Flesch-Kincaid Grade Level, Gunning Fog, Simple Measure of Gobbledygook, and the Coleman-Liau Index. Two reviewers independently evaluated Journal of the American Medical Association (JAMA) Benchmark Criteria and National Library of Medicine (NLM) Trustworthy scores. Two physicians (emergency medicine/EM, pediatric EM) analyzed text accuracy (number correct divided by total number of facts). Disagreements were settled by a third physician. Accuracy was defined as ≥ 95% correct, readability as an 8th-grade reading level, high quality as at least three JAMA criteria, and trustworthiness as an NLM score ≥ 3. Accurate and inaccurate websites were compared using chi-squared analysis and Mann-Whitney U test. RESULTS: Eighty-seven websites (60%) were accurate (k = 0.94). Sixty (42%) of 144 evaluable websites were readable, 38 (26%) had high-quality JAMA criteria (kappa/k = 0.68), and 44 (31%) had reliable NLM trustworthy scores (k = 0.66). Accurate websites were more frequently published by professional medical organizations (hospitals, academic societies, governments) compared with inaccurate websites (63% vs. 33%, p < 0.01). There was no association between accuracy and physician authorship, search rank, quality, trustworthiness, or readability. CONCLUSION: Many studied websites had inadequate accuracy, quality, trustworthiness, and readability. Measures should be taken to improve web-based information related to acute pediatric complaints.
