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      Trajectories of Nicotine and Cannabis Vaping and Polyuse From Adolescence to Young Adulthood

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          Abstract

          This cohort study assesses the developmental trajectories of nicotine and cannabis vaping from late adolescence to young adulthood in Southern California.

          Key Points

          Question

          Do nicotine vaping and cannabis vaping follow similar developmental trajectories, and is polysubstance vaping common from late adolescence to young adulthood?

          Findings

          In this cohort study of 3322 youths, developmental trajectories of nicotine vaping and cannabis vaping were similar and characterized by frequency and developmental timing of use. Youths in trajectories reflecting more frequent nicotine vaping had a high probability of membership in a cannabis-use trajectory.

          Meaning

          In this study, polysubstance vaping was common from late adolescence to young adulthood particularly among those reporting more frequent vaping use.

          Abstract

          Importance

          Little is known about cannabis vaping trajectories across adolescence and young adulthood or the co-occurrence with nicotine vaping.

          Objective

          To evaluate nicotine vaping and cannabis vaping trajectories from late adolescence to young adulthood (≥18 years of age) and the extent of polysubstance vaping.

          Design, Setting, and Participants

          In this prospective cohort study, 5 surveys (including information on substance vaped) were completed at 10 high schools in the Los Angeles, California, metro area. Students were surveyed at 6-month intervals from fall of 11th grade (October to December 2015; wave 5) through spring of 12th grade (March to June 2017; wave 8) and again approximately 1 to 2 years after high school (October 2018 to October 2019; wave 9).

          Exposures

          Past 30-day nicotine and cannabis vaping frequency across 5 waves.

          Main Outcomes and Measures

          Self-reported frequency of nicotine vaping and cannabis vaping within the past 30 days across 5 time points from late adolescence to young adulthood. Trajectories were measured with these past 30-day use frequencies at each wave. Parallel growth mixture modeling estimated conditional probabilities of polysubstance vaping.

          Results

          The analytic sample included 3322 participants with at least 1 time point of data (mean [SD] age, 16.50 [0.42] years at baseline; 1777 [53.5%] female; 1573 [47.4%] Hispanic or Latino). Growth mixture modeling identified the 5-trajectory model as optimal for both nicotine vaping and cannabis vaping. Trajectories for nicotine and cannabis vaping were similar (nonusers: 2246 [67.6%] nicotine, 2157 [64.9%] cannabis; infrequent users: 566 [17.0%] nicotine, 608 [18.3%] cannabis; moderate users: 167 [5.0%] nicotine, 233 [7.0%] cannabis; young adult–onset frequent users: 213 [6.4%] nicotine, 190 [5.7%] cannabis; adolescent-onset escalating frequent users: 131 [3.9%] nicotine, 134 [4.0%] cannabis). Males had greater odds of belonging to the adolescent-onset escalating frequent users nicotine (adjusted odds ratio, 2.88; 95% CI, 1.58-5.23; P < .01) and cannabis (adjusted odds ratio, 1.95; 95% CI,1.03-3.66; P < .05) vaping trajectories compared with nonusers. Polysubstance vaping was common, with those in trajectories reflecting more frequent nicotine vaping (adolescent-onset escalating frequent users and young adult–onset frequent users) having a high probability of membership (85% and 93%, respectively) in a cannabis-use trajectory.

          Conclusions and Relevance

          In this cohort study, the prevalence and type of nicotine vaping and cannabis vaping developmental trajectories from late adolescence to young adulthood were similar. Polysubstance vaping was common from late adolescence to young adulthood, particularly among those reporting more frequent vaping use. The findings suggest that public health policy and clinical interventions should address polysubstance vaping in both adolescence and young adulthood.

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          Most cited references39

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          Auxiliary Variables in Mixture Modeling: Three-Step Approaches Using Mplus

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            Testing the number of components in a normal mixture

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              Trends in Adolescent Vaping, 2017–2019

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                Author and article information

                Journal
                JAMA Netw Open
                JAMA Netw Open
                JAMA Netw Open
                JAMA Network Open
                American Medical Association
                2574-3805
                6 October 2020
                October 2020
                6 October 2020
                : 3
                : 10
                : e2019181
                Affiliations
                [1 ]Department of Human Development, California State University, Long Beach
                [2 ]Department of Preventive Medicine, University of Southern California, Los Angeles
                [3 ]Department of Psychology, University of Southern California, Los Angeles
                [4 ]University of Southern California Norris Comprehensive Cancer Center, Los Angeles
                Author notes
                Article Information
                Accepted for Publication: July 21, 2020.
                Published: October 6, 2020. doi:10.1001/jamanetworkopen.2020.19181
                Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2020 Lanza HI et al. JAMA Network Open.
                Corresponding Author: H. Isabella Lanza, PhD, Department of Human Development, California State University, Long Beach, 1250 Bellflower Blvd, LA3-202, Long Beach, CA 90840 ( Isabella.Lanza@ 123456csulb.edu ).
                Author Contributions: Dr Lanza had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
                Concept and design: Lanza, Barrington-Trimis, McConnell, Braymiller, Leventhal.
                Acquisition, analysis, or interpretation of data: Lanza, Barrington-Trimis, Cho, Braymiller, Krueger, Leventhal.
                Drafting of the manuscript: Lanza, Cho, Leventhal.
                Critical revision of the manuscript for important intellectual content: Lanza, Barrington-Trimis, McConnell, Braymiller, Krueger, Leventhal.
                Statistical analysis: Lanza, Cho, Krueger.
                Obtained funding: Barrington-Trimis, Leventhal.
                Administrative, technical, or material support: Barrington-Trimis, Cho, Leventhal.
                Supervision: Barrington-Trimis, Leventhal.
                Conflict of Interest Disclosures: Dr McConnell reported receiving grants from the National Institutes of Health during the conduct of the study. Dr Krueger reported receiving grants from the University of Southern California during the conduct of the study. No other disclosures were reported.
                Funding/Support: This project was supported in part by Tobacco Centers of Regulatory Science award U54CA180905 from the National Cancer Institute and the US Food and Drug Administration, award R01CA229617 (Leventhal) from the National Cancer Institute, award 27-IR-0034 (Barrington-Trimis) from the California Tobacco-Related Disease Research Program, and awards K01DA042950 (Barrington-Trimis) and K24DA048160 (Leventhal) from the National Institute on Drug Abuse.
                Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
                Article
                zoi200677
                10.1001/jamanetworkopen.2020.19181
                7539114
                33021651
                02ec4fb6-8955-4db0-bf32-d06621423802
                Copyright 2020 Lanza HI et al. JAMA Network Open.

                This is an open access article distributed under the terms of the CC-BY License.

                History
                : 1 June 2020
                : 21 July 2020
                Categories
                Research
                Original Investigation
                Online Only
                Substance Use and Addiction

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