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Grant Details

Grant Number: 5R01CA249883-03 Interpret this number
Primary Investigator: Loukas, Alexandra
Organization: University Of Texas At Austin
Project Title: Depressive Symptoms and Tobacco Use Trajectories and Transitions Across Young Adulthood
Fiscal Year: 2022


PROJECT SUMMARY Young adults have the highest prevalence of past-year depression and current tobacco use in the United States. Co-occurrence of depression and tobacco use is particularly problematic during young adulthood as nicotine addiction is solidified in this developmental period, and elevated levels of depressive symptoms promote sustained tobacco use and undermine quitting. Yet, there is limited research on young adults and evidence for the strength and direction of associations between depressive symptoms and tobacco use is inconclusive. Inconclusive findings indicate there may be heterogeneity in the patterns of associations between depressive symptoms and tobacco use across subgroups of young adults. Yet, few studies examine this heterogeneity. Further, most studies focus on cigarettes, although other products, such as electronic nicotine delivery systems, are increasingly prevalent and the concurrent use of two or more products (i.e., poly tobacco use) is more prevalent than single product use among young adults. Use of newly introduced vape pods, such as JUUL, is increasingly concerning. But, the role of vape pod use in the depressive symptoms-tobacco use association is not known. There is a critical need for longitudinal studies that identify for whom and under what conditions depressive symptoms are associated with use of all types of tobacco, and with transitions in use, such as from current to no tobacco use and vice versa. The primary objectives of this R01 are to determine if: 1) the role of depressive symptoms in tobacco use trajectories and transitions vary for subgroups across young adulthood, ages 18-34 and 2) the strength and direction of associations vary. We will identify moderating factors that capture the heterogeneity, and define for whom and under what conditions depressive symptoms are longitudinally associated with tobacco use outcomes. We will examine sociodemographic, intrapersonal, and contextual moderating factors, and all types of tobacco products and outcomes, including initiation, sustained use, addiction, cessation, poly tobacco use, and transitions in use. To do so, we will use eight waves of existing data collected in 2014-2019 from 5,482 initially 18-29 year old college students. The Specific Aims are to: 1) Identify the role of depressive symptoms in longitudinal tobacco use trajectories and transitions, and elucidate the temporal associations between depressive symptoms and tobacco use; 2) Examine the moderating roles of sociodemographic, intrapersonal, and contextual factors in the longitudinal trajectories, transitions, and temporal associations; and 3) Determine the role of vape pods, like JUUL, in the longitudinal tobacco use trajectories, transitions, and temporal associations. The expected outcome is identification of subgroups most vulnerable to initiating and continuing tobacco use, given elevated depressive symptoms. Results can be used to tailor tobacco interventions and determine to whom they should be targeted.


Depressive symptoms predict trajectories of electronic delivery nicotine systems, cigarette, and cannabis use across 4.5 years among college students.
Authors: Nathan Marti C. , Arora S. , Loukas A. .
Source: Addictive behaviors, 2023 Nov; 146, p. 107809.
EPub date: 2023-07-17.
PMID: 37515895
Related Citations

Longitudinal Examination of ENDS Use Among Young Adult College Students: Associations with Depressive Symptoms and Sensation Seeking.
Authors: Loukas A. , Li X. , Wilkinson A.V. , Marti C.N. .
Source: Prevention science : the official journal of the Society for Prevention Research, 2023 Aug; 24(6), p. 1068-1077.
EPub date: 2023-07-10.
PMID: 37428392
Related Citations

Depressive symptoms and vaping: The mediating effect of outcome expectancies among young adults.
Authors: North C. , Loukas A. .
Source: Drug and alcohol dependence, 2023-06-01; 247, p. 109870.
EPub date: 2023-04-10.
PMID: 37084509
Related Citations

Longitudinal trajectories of marijuana use in tobacco products among young adult Texas college students from 2015 to 2019.
Authors: Hinds J.T. , Marti C.N. , Pasch K.E. , Loukas A. .
Source: Addiction (Abingdon, England), 2023 Feb; 118(2), p. 372-377.
EPub date: 2022-09-14.
PMID: 35971289
Related Citations

Alternative Tobacco Use and Cigarette Smoking Transitions among College Students in Texas.
Authors: Li X. , Holahan C.K. , Loukas A. , Holahan C.J. , Pasch K.E. , Marti C.N. .
Source: Substance use & misuse, 2023; 58(3), p. 389-396.
EPub date: 2023-01-18.
PMID: 36651240
Related Citations

Electronic nicotine delivery systems (ENDS) dependence among Texas Young Adults, 2014-2019: Increasing trajectory after the 2017 surge in vape pod popularity.
Authors: Loukas A. , Marti C.N. , Harrell M.B. , Pasch K.E. , Wilkinson A.V. .
Source: Drug and alcohol dependence, 2022-12-01; 241, p. 109700.
EPub date: 2022-11-12.
PMID: 36434881
Related Citations

Trajectories of depressive symptoms among young adults in Texas 2014-2018: a multilevel growth curve analysis using an intersectional lens.
Authors: Thomas J.E. , Pasch K.E. , Marti C.N. , Hinds J.T. , Wilkinson A.V. , Loukas A. .
Source: Social psychiatry and psychiatric epidemiology, 2022 Apr; 57(4), p. 749-760.
EPub date: 2022-01-20.
PMID: 35059751
Related Citations

Electronic nicotine delivery systems use predicts transitions in cigarette smoking among young adults.
Authors: Loukas A. , Marti C.N. , Harrell M.B. .
Source: Drug and alcohol dependence, 2022-02-01; 231, p. 109251.
EPub date: 2021-12-31.
PMID: 34999270
Related Citations

Rising vape pod popularity disrupted declining use of electronic nicotine delivery systems among young adults in Texas, USA from 2014 to 2019.
Authors: Loukas A. , Marti C.N. , Pasch K.E. , Harrell M.B. , Wilkinson A.V. , Perry C.L. .
Source: Addiction (Abingdon, England), 2022 Jan; 117(1), p. 216-223.
EPub date: 2021-07-05.
PMID: 34159679
Related Citations

A one year prospective examination of risk factors for pod-vape use among young adults.
Authors: North C. , Li X. , Grossberg L.A. , Loukas A. .
Source: Drug and alcohol dependence, 2021-12-01; 229(Pt B), p. 109141.
EPub date: 2021-10-29.
PMID: 34768141
Related Citations

Longitudinal Impact of Depressive Symptoms and Peer Tobacco Use on the Number of Tobacco Products Used by Young Adults.
Authors: North C. , Marti C.N. , Loukas A. .
Source: International journal of environmental research and public health, 2021-10-21; 18(21), .
EPub date: 2021-10-21.
PMID: 34769598
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Tobacco Magazine Advertising Impacts Longitudinal Changes in the Number of Tobacco Products Used by Young Adults.
Authors: Loukas A. , Lewis M.J. , Marti C.N. , Pasch K.E. , Perry C.L. .
Source: The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 2021 Apr; 68(4), p. 773-779.
EPub date: 2021-01-05.
PMID: 33419622
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