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Grant Details

Grant Number: 5R01CA234539-03 Interpret this number
Primary Investigator: Pierce, John
Organization: University Of California, San Diego
Project Title: The Role of Ends Use in Changing Rates of Escalation and Quitting of Cigarette Smoking in Those Under Age 35 Years in Us Population
Fiscal Year: 2020


Abstract Recently, there has been extensive use of Electronic Nicotine Delivery Systems (ENDS) by young people in the United States (US). These products have the potential to significantly reduce the proportion of young adults who are addicted to cigarette smoking, either by influencing the proportion who escalate to daily cigarette smoking or by increasing the proportion who quit under the age of 35 years. Previous research has demonstrated that there are two groups of escalators to daily cigarette smoking: 1) early escalators who are daily smokers before age 20 years, and 2) later escalators (become daily smokers at 21+ years). This proposal will explore the long-term role of ENDS in changing the escalation and quitting of cigarette smoking using the first four waves of the national Population Assessment of Tobacco and Health (PATH) longitudinal study. The study used a four stage stratified area probability design and has enrolled ~26,000 people under the age of 35 years, half of whom were female. The public use data for the first two waves are available and include longitudinal weighting variables. Wave 3 is expected to be publicly available in Spring 2018, and Wave 4 one is expected year later. The weighted response for Wave 2 was 87% for 12-17 year olds, and 83% for adults. With these PATH data, we will explore two scientific premises: 1) that widespread promotion of ENDS has resulted in a new generation of nicotine users who rely on ENDS usage and who did not escalate to daily cigarette smokers when becoming adults; and 2) that the diffusion of ENDS among young tobacco users will result in lower nicotine dependence that, in turn, will be associated with higher rates of successful discontinuance of cigarette smoking before age 35 years. A significant methodological weakness in such complex longitudinal analyses is related to the consideration of a large number of time-varying confounding variables that are prognostic for changes in tobacco use behaviors and are also associated with the outcome of interest. Some epidemiological methods allow the achievement of covariate balance between different exposure groups. With these methods, ongoing differences in outcomes of interest are directly attributable to ENDS usage, for example. In this context, we leverage Propensity Score Matching (PSM), and Marginal Structural Models (MSMs) to adjust for time-varying confounding. We will also explore Targeted Maximum Likelihood Estimation (TMLE) techniques to optimize the performance of PSM. We will conduct separate analyses for early escalators, late escalators, and quitters before age 35 years. This proposal will answer an urgent public health question in regards to the long-term potential benefits associated with ENDS usage, while also providing an example to the tobacco research field of state-of-art epidemiological methods for complex longitudinal analyses.


News coverage of the E-cigarette, or Vaping, product use Associated Lung Injury (EVALI) outbreak and internet searches for vaping cessation.
Authors: Leas E.C. , Nobles A.L. , Caputi T.L. , Dredze M. , Zhu S.H. , Cohen J.E. , Ayers J.W. .
Source: Tobacco control, 2021 09; 30(5), p. 578-582.
EPub date: 2020-10-13.
PMID: 33051278
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Availability and Promotion of Cannabidiol (CBD) Products in Online Vape Shops.
Authors: Leas E.C. , Moy N. , McMenamin S.B. , Shi Y. , Benmarhnia T. , Stone M.D. , Trinidad D.R. , White M. .
Source: International journal of environmental research and public health, 2021-06-22; 18(13), .
EPub date: 2021-06-22.
PMID: 34206501
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Racial/Ethnic Disparities Across Indicators of Cigarette Smoking in the Era of Increased Tobacco Control, 1992-2019.
Authors: Sakuma K.K. , Pierce J.P. , Fagan P. , Nguyen-Grozavu F.T. , Leas E.C. , Messer K. , White M.M. , Tieu A.S. , Trinidad D.R. .
Source: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2021-05-24; 23(6), p. 909-919.
PMID: 33196799
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E-cigarettes and Cessation: The Introduction of Substantial Bias in Analyses of PATH Study.
Authors: Pierce J.P. , Leas E.C. , Benmarhnia T. , McMenamin S.B. , Strong D.R. , Chen R. , Messer K. .
Source: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2021-05-04; 23(5), p. 876-877.
PMID: 33188408
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Google shopping queries for vaping products, JUUL and IQOS during the E-cigarette, or Vaping, product use Associated Lung Injury (EVALI) outbreak.
Authors: Leas E.C. , Moy N.H. , Nobles A.L. , Ayers J. , Zhu S.H. , Purushothaman V. .
Source: Tobacco control, 2021-02-19; , .
EPub date: 2021-02-19.
PMID: 33608466
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Use of E-cigarettes and Other Tobacco Products and Progression to Daily Cigarette Smoking.
Authors: Pierce J.P. , Chen R. , Leas E.C. , White M.M. , Kealey S. , Stone M.D. , Benmarhnia T. , Trinidad D.R. , Strong D.R. , Messer K. .
Source: Pediatrics, 2021 02; 147(2), .
EPub date: 2021-01-11.
PMID: 33431589
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Widening disparities in cigarette smoking by race/ethnicity across education level in the United States.
Authors: Nguyen-Grozavu F.T. , Pierce J.P. , Sakuma K.K. , Leas E.C. , McMenamin S.B. , Kealey S. , Benmarhnia T. , Emery S.L. , White M.M. , Fagan P. , et al. .
Source: Preventive medicine, 2020 10; 139, p. 106220.
EPub date: 2020-07-18.
PMID: 32693179
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A Source of Bias in Studies of E-Cigarettes and Smoking Cessation.
Authors: Pierce J.P. , Messer K. , Leas E.C. , Kealey S. , White M.M. , Benmarhnia T. .
Source: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2020-04-21; 22(5), p. 861-862.
PMID: 31398246
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The effect of college attendance on young adult cigarette, e-cigarette, cigarillo, hookah and smokeless tobacco use and its potential for addressing tobacco-related health disparities.
Authors: Leas E.C. , Trinidad D.R. , Pierce J.P. , Benmarhnia T. .
Source: Preventive medicine, 2020 03; 132, p. 105954.
EPub date: 2020-01-07.
PMID: 31917304
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Responses to addiction help-seeking from Alexa, Siri, Google Assistant, Cortana, and Bixby intelligent virtual assistants.
Authors: Nobles A.L. , Leas E.C. , Caputi T.L. , Zhu S.H. , Strathdee S.A. , Ayers J.W. .
Source: NPJ digital medicine, 2020; 3, p. 11.
EPub date: 2020-01-29.
PMID: 32025572
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Selling tobacco: A comprehensive analysis of the U.S. tobacco advertising landscape.
Authors: Moran M.B. , Heley K. , Baldwin K. , Xiao C. , Lin V. , Pierce J.P. .
Source: Addictive behaviors, 2019 09; 96, p. 100-109.
EPub date: 2019-04-25.
PMID: 31071602
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Ethnic and Socioeconomic Disparities in Recalled Exposure to and Self-Reported Impact of Tobacco Marketing and Promotions.
Authors: Moran M.B. , Heley K. , Pierce J.P. , Niaura R. , Strong D. , Abrams D. .
Source: Health communication, 2019 03; 34(3), p. 280-289.
EPub date: 2017-12-13.
PMID: 29236530
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Trends in Lung Cancer and Cigarette Smoking: California Compared to the Rest of the United States.
Authors: Pierce J.P. , Shi Y. , McMenamin S.B. , Benmarhnia T. , Trinidad D.R. , Strong D.R. , White M.M. , Kealey S. , Hendrickson E.M. , Stone M.D. , et al. .
Source: Cancer prevention research (Philadelphia, Pa.), 2019 01; 12(1), p. 3-12.
EPub date: 2018-10-10.
PMID: 30305281
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Can E-Cigarettes and Pharmaceutical Aids Increase Smoking Cessation and Reduce Cigarette Consumption? Findings From a Nationally Representative Cohort of American Smokers.
Authors: Benmarhnia T. , Pierce J.P. , Leas E. , White M.M. , Strong D.R. , Noble M.L. , Trinidad D.R. .
Source: American journal of epidemiology, 2018-11-01; 187(11), p. 2397-2404.
PMID: 29955810
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Authors: Pierce J.P. , Leas E.C. , Benmarhnia T. , Strong D.R. .
Source: Journal of the National Cancer Institute, 2018-10-01; 110(10), p. 1144.
PMID: 29506059
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Helping smokers to quit.
Authors: Pierce J.P. .
Source: BMJ (Clinical research ed.), 2018-06-27; 361, p. k2806.
EPub date: 2018-06-27.
PMID: 29950493
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