Jill Murphy, Assistant Editor

Results released today from the most recent Monitoring the Future (MTF) survey of substance use behaviors and related attitudes among teens in the United States indicate that levels of nicotine and marijuana vaping did not increase from 2019 to early 2020, although they remain high. The survey was conducted by the University of Michigan’s Institute for Social Research, Ann Arbor, part of the National Institutes of Health.

Since the survey on nicotine and marijuana vaping began 4 years ago, use of these substances among teens have increased to markedly high levels. From 2017 to 2019, the percentage of teenagers who said they vaped nicotine in the past 12 months roughly doubled for 8th graders, from 7.5% to 16.5%, for 10th graders, from 15.8% to 30.7%, and for 12th graders, from 18.8% to 35.3%. In 2020, the rates held steady at a respective 16.6%, 30.7%, and 34.5%, respectively. However, daily or near daily use—defined as 20 occasions in the past 30 days—nicotine vaping declined among 10th and 12th graders from 2019 to 2020, by close to half: from 6.8% to 3.6% in 10th grade, and from 11.6% to 5.3% in 12th grade.

“The rapid rise of teen nicotine vaping in recent years has been unprecedented and deeply concerning since we know that nicotine is highly addictive and can be delivered at high doses by vaping devices, which may also contain other toxic chemicals that may be harmful when inhaled,” said NIDA Director Nora D. Volkow, MD in a prepared statement. “It is encouraging to see a leveling off of this trend though the rates still remain very high.”

The past-year vaping of marijuana also remained steady in 2020, with 8.1% of 8th graders, 19.1%, of 10th graders, and 22.1% of 12th graders reporting past-year use, following a 2-fold increase over the past 2 years. Further, daily marijuana vaping significantly decreased by more than half from 2019, to 1.1% among 10th graders, and 1.5% among 12th graders in 2020.

The MTF survey results also found that reported use of JUUL vaping devices, or e-cigarettes, which contain nicotine and were previously the most popular brand among teens, significantly decreased from 2019 to 2020 among the older 2 grades. In 10th graders, past 12-month use of JUUL vaping devices decreased from 28.7% in 2019 to 20% in 2020, and in 12th graders, it decreased from 28.4% in 2019 to 22.7% in 2020.

The MTF survey is given annually to students in 8th, 10th, and 12th grade who self-report their substance use behaviors over various prevalence periods: daily, past 30 days, past 12 months and lifetime. The survey also details the student’s perception of harm, disapproval of use, and perceived availability of drugs, and the results are released the same year the data are collected.

From February 11, 2020 through March 14, 2020, the MTF survey investigators collected 11,821 surveys in 112 schools before data collection stopped prematurely due to the coronavirus disease 2019 (COVID-19) pandemic. The completed surveys from early 2020 represent about 25% of the sample size of a typical year’s data collection, but the results were gathered from a broad geographic and representative sample, so the data were statistically weighted to provide national numbers.

Estimated data from the MTF study may differ from other government surveys due to differences in study population, questionnaire language, and other factors. Additionally, study investigators are working with schools to deploy the survey in early 2021 to gather data that will reflect substance use during the COVID-19 pandemic and related periods of social distancing.

The MTF researchers also conducted an in-depth analysis of a subset of the 2020 MTF data, combining 10th and 12th graders into a sample of 8660 high schoolers. The percentage of combined 10th and 12th graders who said they vaped nicotine in the past 30 days, past 12 months, or over the course of their lifetime were similar from 2019 to 2020, at 22%, 32%, and 41% respectively.

Similarly, in this group, daily, or near daily, nicotine vaping declined from 9% to 7% from 2019 to 2020. The researchers concluded nicotine vaping for participants in these 2 grades remained steady despite decreases in use of previously popular brands like JUUL due to teens moving to the use of other vaping device brands, such as disposable, single use vaping devices. Other data on trends in vaping brands used, perceived availability of vaping devices, and perceived risk of vaping from this subset of teens were published today in the same study.

Study finds surge of teen vaping levels off, but remains high in early 2020 [press release]. Bethesda, MD; December 15, 2020; NIH. Accessed December 16, 2020. 

https://www.nih.gov/news-events/news-releases/study-finds-surge-teen-vaping-levels-remains-high-early-2020

Articles

Since the survey on nicotine and marijuana vaping began 4 years ago, use of these substances among teens have increased to markedly high levels.

Study: Teen Vaping Levels Remain High Despite Surge Leveling Off

A new study from researchers at the University of California (UC) Davis found that eating Ataulfo mangoes, also known as honey or champagne mangoes, may reduce facial wrinkles in older women with fairer skin.

Postmenopausal women who ate a half cup of Ataulfo mangoes 4 times a week saw a 23% decrease in deep wrinkles after 2 months and a 20% decrease after 4 months, according to the study authors.

“That’s a significant improvement in wrinkles,” said lead study author Vivien Fam, RDN, LDN, a doctoral student in the UC Davis Department of Nutrition, in a press release. “Women who ate a cup and a half of mangoes for the same periods of time saw an increase in wrinkles. This shows that while some mango may be good for skin health, too much of it may not be.”

The pilot study involved 28 postmenopausal women with Fitzpatrick skin types 2 or 3, or skin that burns more easily than it tans. The women were divided into 2 groups, with 1 group consuming a half cup of mangoes 4 times a week for 4 months, and the other group consuming a cup and a half of mangoes for the same period of time. Facial wrinkles were evaluated using a high-resolution camera system, according to the study authors.

“The system we used to analyze wrinkles allowed us to not just visualize wrinkles, but to quantify and measure wrinkles,” said study author Robert Hackman, PhD, professor in the Department of Nutrition, in a press release. “This is extremely accurate and allowed us to capture more than just the appearance of wrinkles or what the eye might see.”

Additionally, the study looked at the severity, length, and width of fine, deep, and emerging wrinkles. The study authors noted that the group that consumed a half cup of mangoes saw improvements in all categories.

Further research is needed to learn the mechanisms behind the reduction in wrinkles, considering the beneficial effects of carotenoids and other phytonutrients that could help build collagen, according to the study authors.




Can eating mangoes reduce women’s facial wrinkles? UC Davis. 

https://www.ucdavis.edu/news/can-eating-mangoes-reduce-womens-facial-wrinkles/

. Published November 19, 2020. Accessed November 23, 2020.


Although women who hate half a cup of mangoes 4 times a week saw a reduction in wrinkles, women who ate more mangoes saw an increase, suggesting that too much may have the opposite intended effect. 

Study: Eating Mangoes Can Reduce Women’s Facial Wrinkles

Researchers at Tampere University and LUT University, both in Finland, studied exoskeleton vests worn by nurses to discover how the new technology would suit the special requirements of patient care. These investigators found that exoskeletons can reduce physical strain.1,2

The studies come from the increased use of wearable exoskeletons in physically demanding jobs to support good ergonomics and augment muscular strength, according to results published in the journal 

"This message from the field led us to investigate what conditions exoskeletons would need to meet in order to reform nursing," said Tuuli Turja, postdoctoral research fellow at Tampere University, in a prepared statement. "Currently, exoskeletons are mainly used in manufacturing and logistics. Isn't it high time to introduce exoskeletons in female-dominated sectors, where musculoskeletal disorders are rampant?"2

Exoskeleton-type technology is generally utilized in rehabilitation settings, where patients wear the skeleton of a walking robot, for example. The latest study article focuses on 2 studies involving users of the Laevo Exoskeleton, a wearable back support vest, which alleviates lower back strain by 40 to 50%, according to the manufacturer.1,2

The first study found pairs of nursing students assisted geriatric patients in moving from a hospital bed into a wheelchair with and without the exoskeleton, whereas the second study found 7 nurses tested the exoskeleton vest in a real care environment for a week.1,2

The study results showed that due to the special characteristics of patient care, exoskeletons need to be developed further before being completely suitable for everyday nursing work. In addition, nurses are willing to use exoskeletons to assist their work if the devices are comfortable and effortless to use and product development considers the requirements of nursing, such as interactive features and safety, in hectic work situations, according to the study authors.1,2

Turja T, Saurio R, Katila J, Hennala L, Pekkarinen S, Melkas H. Intention to Use Exoskeletons in Geriatric Care Work: Need for Ergonomic and Social Design. 

. 30, September 2020. doi:10.1177/1064804620961577

Exoskeletons can reduce strain also in health care. Tampere University. 

https://www.tuni.fi/en/news/exoskeletons-can-reduce-strain-also-health-care

. Published November 10, 2020. Accessed November 11, 2020.

The studies come from the increased use of wearable exoskeletons in physically demanding jobs to support good ergonomics and augment muscular strength.

Study Finds Exoskeletons Can Reduce Strain in Health Care

A paper published recently in the journal 

 found that nurses and other health care providers should talk to patients about their cannabis use the same way they discuss other habits, such as smoking and drinking, routinely and without judgment.

The shared decision-making model starts with either the patient or the provider bringing up the topic of cannabis use then moving on to specifics about the patient’s situation, benefits, and risks of cannabis use based on research and evidence, and finally formulating a plan, according to the paper.

“Central to patient-centered conversations is understanding the top priorities of patients,” wrote Marian Wilson, RN, associate professor at the Washington State University College of Nursing, in the paper. “Researchers have suggested that clinicians should ask ‘What matters to you?’ as well as ‘What is the matter?’”

Certain studies have suggested cannabis use is beneficial to patients with chronic pain who are using opioids, since so many in the patient population are using cannabis or considering it. This reason is why the study authors found it important for providers working in pain management to discuss the subject, even though patients may be reluctant to disclose cannabis use because they might have been penalized in the past.

Wilson noted that providers face real challenges in obtaining current, evidence-based information on benefits and risks of cannabis use. The paper calls for the creation of a centralized, noncommercial, scientific repository of information, research, and best practices on cannabis use.

“We want providers to ask people about their cannabis use and we want patients to feel comfortable talking about it, but right now many don’t,” Wilson said in the paper.

Paper urges healthcare providers to routinely ask patients about cannabis use. Washington State University. 

https://news.wsu.edu/2020/11/05/paper-urges-healthcare-providers-routinely-ask-patients-cannabis-use/

. Published November 5, 2020. Accessed November 6, 2020.

Certain studies have suggested cannabis use is beneficial to patients with chronic pain who are using opioids, since so many in the patient population are using cannabis or considering it.

Research Paper Urges Health Care Providers to Routinely Ask Patients About Cannabis Use

A University of California, Los Angeles-led review of 9 years of social media posts with the hashtag #BCSM suggests that Twitter can be a useful resource not only for patients, but also for physicians and researchers, according to a press release.

The hashtag, an acronym for “breast cancer social media,” first appeared on Twitter in 2011 and was used to curate a weekly informational chat for people with breast cancer.

The research found that between January 1, 2011, and January 1, 2020, #BCSM was used more than 830,000 times by more than 75,000 unique Twitter accounts, generating 4 billion impressions. Further, the hashtag was used 145,600 times in 2019 alone, an increase of 424% from 2011 when it appeared 27,700 times.

The study was intended to help researchers understand the impact of the community that grew around the Twitter chat. The results revealed that the rise of social media in everyday life paralleled with the growing popularity of #BCSM demonstrated that an increasing number of people with breast cancer are turning to online communities for support and education, according to the study.

“The #BCSM online community has experienced tremendous growth since its inception because it has helped fulfill a need among patients who were searching for information and support on the platform,” said lead study author Deanna Attai, MD, assistant clinical professor of surgery at the David Geffen School of Medicine at UCLA, in a press release.

Attai added that it has helped physicians gain insight into the patient perspective and has given them a better understanding of their many issues.

“We often see patients in a much different setting. Compared to our exam room interactions, online is a more raw, unvarnished look into what patients are really going through,” Attai said.

The #BCSM platform has given health care professionals the opportunity to correct misconceptions, provide guidance to people with breast cancer, and steer them toward credible resources, according to the study. Using Symplur, a health care-focused analytics program commonly used to study trends on Twitter, data were compiled on the use of the hashtag.

The study noted that the inclusive nature of the #BCSM hashtag has contributed to its popularity, since it is not restricted by gender or people’s stage of diagnosis. However, its extent may limit how sustainable the online community will be. As cancer therapy becomes more personalized, people may increasingly seek out support groups that are more closely aligned with their own clinical situations.

How a Twitter hashtag provides insights for doctors and support for people with breast cancer. UCLA Newsroom. 

https://newsroom.ucla.edu/releases/bcsm-twitter-breast-cancer-support

. Published October 22, 2020. Accessed October 27, 2020.

A UCLA-led review of 9 years of social media posts with the hashtag #BCSM suggests that Twitter can be a useful resource for patients, physicians and researchers

Twitter Hashtag Provides Insights for Physicians, Support for People with Breast Cancer

Among women with breast cancer, colorectal cancer, or melanoma, those who were taking cholesterol-lowering medications were less likely to die from cancer, according to an analysis published in the 

The researchers tested the hypothesis that adherence to lipid-lowering medications (LLMs) is associated with reduced cancer-specific mortality in a homogeneous population who had used these drugs before cancer diagnosis. The Australian Cancer Database was linked to the Pharmaceutical Benefits Scheme database and to the National Death Index up to the year 2015, according to the study.

Further, the medication adherence was calculated by proportion of days covered. Cox regression models with time-varying covariates were used to derive multivariable-adjusted cause-specific hazard ratio and 95% confidence interval for the associations between adherence to LLMs, statins, lipophilic, and hydrophilic statins, and cancer-specific mortality.

From 2003 to 2013, 3 separate cohorts of 20,046, 11,719, and 6430 female patients with newly diagnosed breast, colorectal cancer, and melanoma were identified, respectively. The 1-year adherence was similar at 1-year pre-diagnosis in the 3 cohorts, at an average of 82%.

Additionally, each 10% increase in 1-year adherence to LLMs was inversely associated with cancer-specific mortality among women with breast cancer, colorectal cancer, or melanoma. The reductions in cancer-specific mortality were more pronounced for women who adhered to lipophilic rather than hydrophilic statins in all 3 cancers, although it was not statistically significant for melanoma, according to the study.

The researchers found that among LLM users, adherence to the drug is associated with a decrease in cancer-specific mortality. If confirmed, LLMs could be considered as an adjuvant cancer therapy to improve prognosis in cancer survivors, according to the study.

Cholesterol medications linked to lower cancer-related deaths in women. EurekAlert! 

https://www.eurekalert.org/pub_releases/2020-10/w-cml101920.php

. Published October 21, 2020. Accessed October 28, 2020.

Feng JL, Qin X. Does adherence to lipid-lowering medications improve cancer survival? A nationwide study of breast and colorectal cancer, and melanoma. 

Among women with breast cancer, colorectal cancer, or melanoma, those who were taking cholesterol-lowering medications were less likely to die from cancer, according to a recent analysis.