Tag: Jennifer Unger

Young adults who identify as Republicans more often ignore COVID-19 safety precautions

From infrequently social distancing to visiting more indoor venues, a new USC study finds that young Republicans are more likely than their peers to disregard public health recommendations.


Young Californians who identify as Republicans are less likely to follow social distancing guidelines that prevent COVID-19 transmission than those who identify as Democrats or independents, according to a new USC study published today in JAMA Internal Medicine.

The findings among 18- to 25-year-olds mirror what many have observed about America’s politicized response to the coronavirus and are a source of concern for public health experts. The United States is now averaging 207,000 new cases and 2,319 deaths per day, as of Dec. 11.

“You might expect middle-aged or older adults to have established ideologies that affect their health behavior but to see it in young adults who have historically been less politically inclined is unexpected,” said Adam Leventhal, director of the USC Institute for Addiction Science. “Regardless of age, we would never hope to find results like this. Public health practices should not correlate with politics.”

As COVID-19 spreads, young Republicans less likely to social distance

The study was conducted during the summer of 2020 via an online survey that was completed by 2,065 18- to 25-year-olds living predominantly in Los Angeles County. The participants were initially recruited as ninth-grade high school students as part of the USC Happiness & Health Project, which has been surveying this group about their health behaviors every six months since 2013.

Of the young adults contacted, 891 identified as Democrat, 148 as Republican, 320 as “independent or other,” and 706 declined to answer or said they didn’t know what political party they identify with.

Researchers found that 24.3% of Republican young adults said they don’t frequently social distance from others, compared with just 5.2% of Democrats.

Differences in social distancing practices were also found when Republicans were compared to independents and young adults who did not report a political party affiliation. Researchers discovered that Republicans were more likely than members of other groups to visit public indoor venues such as malls, restaurants, bars or clubs, or attend or host parties with 10 people or more.

Throughout most of the COVID-19 pandemic, California has recommended that all residents practice social distancing and wear a mask when outside the home. Current restrictions prohibit private gatherings of any size.

Leventhal noted that when his team statistically adjusted for 21 factors that could explain the difference in social distancing across political party groups, including propensity for risk-taking behaviors, Republicans were 4 times more likely than the others to be infrequent social distancers.

He also said that the “blue county within a blue state” setting for the study underscores that the link between political party affiliation and social distancing cannot simply be reduced to an issue of urban versus rural differences.

To cope with COVID, many young people are stress eating

USC’s Department of Preventive Medicine recently looked at another impact of the pandemic on young adults: stress eating.

The pandemic has resulted in a widely reported uptick in snacking, grazing and purchasing of unhealthy “comfort” food. The new USC study, published Dec. 4 in the Journal of Adolescent Health, surveyed 1,820 19-year-olds about their pandemic coping behaviors.

They found that young adults who reported overeating to cope with social distancing and isolation had gained 5.5 pounds in the first 13 weeks of the pandemic.

“Interventions to promote healthy eating practices in young adults warrant consideration for weight gain prevention during the pandemic,” wrote first author Tyler Mason, an assistant professor of clinical preventive medicine.

— Leigh Hopper

In addition to Leventhal, other authors of the politics and social distancing study include Jessica Barrington-Trimis, Rob McConnell, Jennifer Unger, Steve Sussman and Junhan Cho, all of USC; and Hongying Dai of the University of Nebraska. The stress-eating study includes Leventhal and Barrington-Trimis as co-authors.

The studies were supported by grants from the National Cancer Institute (R01CA229617), the National Institute on Drug Abuse (K24DA048160) and the National Institute of Diabetes and Digestive and Kidney Diseases (K01DK124435).

Do cannabis stores target minorities in California?


California neighborhoods where cannabis retailers are located tend to have higher proportions of Hispanic and Black residents, and lower proportions of whites, while also being poorer than those areas without such retailers. That’s according to a new study co-authored by researchers from the KSOM Department of Preventive Medicine and USC Dornsife’s Spatial Sciences Institute and published in the September issue of Preventive Medicine Reports.

The research shows that “minority populations in California are disproportionately exposed to unlicensed cannabis retailers,” the authors wrote. The study examined areas where both licensed and unlicensed retailers are located. Overall, neighborhoods served by any retailer represented 42% of the state’s population.

Recreational use of cannabis by adults became legal in California in 2016, and state and local licenses were issued starting in 2018. Only 20% of California cities allow retail sales, but according to the study’s findings, a thriving black market exists where unlicensed cannabis retailers operate.

The researchers identified 1,110 cannabis retailers in the state — 448 licensed and 662 unlicensed. Relative to neighborhoods without retailers, neighborhoods with retailers had higher proportions of Hispanics, African Americans, and residents living below the poverty level. Compared with neighborhoods with only licensed retailers, neighborhoods with only unlicensed retailers had higher proportions of Hispanics and African Americans, and lower proportions of non-Hispanic whites. Neighborhoods with both licensed and unlicensed retailers had higher proportions of African Americans, Asian Americans, and people living in poverty, relative to neighborhoods with only licensed retailers.

Unger, Vos and Steinberg

The paper noted that unincorporated areas lack enforcement capabilities to inspect stores for product quality, to ensure minors aren’t being sold the products, and to close down retailers who violate the law, “thereby potentially exacerbating health disparities within these communities.”

The paper was co-written by Jennifer B. Unger, PhD, professor of preventive medicine; Robert O. Vos, PhD, assistant professor of spatial sciences; and Jane Steinberg, PhD, MPH, assistant professor in clinical preventive medicine.

Other researchers were Daniel W. Soto, MPH; Christopher Rogers, MPH; Jasmine SiyuWu, BS (candidate); Kimberly Hardaway, BS; and Ada Y. LiSarain, MS, PhD (candidate).

— By Landon Hall

Researchers take to Twitter to hear vaping concerns amidst COVID-19

vapor cloud

The team at USC Tobacco Center of Regulatory Science (TCORS) has made it their mission to investigate the use, and understand the health effects, of e-cigarettes for the last 7 years. As COVID-19 hits with a vengeance at a time when vaping is as popular as ever, the team naturally wondered if others are as concerned about health implications for vapers as they are. Anuja Majmundar, doctoral candidate, along with mentors Jon-Patrick Allem, Tess Boley Cruz and Jennifer B. Unger, took to Twitter to find out.

They discovered that Twitter users discussed whether vaping increases the risk of contracting COVID-19 , and if the virus could survive in vapor clouds and be transmitted to those nearby. Some even wondered if some early COVID-19 cases among the vaping community were misdiagnosed as a vaping illness formally referred to as EVALI – E-cigarette or Vaping Product Use-Associated Lung Injury.

Majmundar believes the health community should be listening. “The public health community has an opportunity to share emerging scientific findings to address these concerns in a timely fashion.

Major reasons for health communicators to address vaping in conjunction with COVID-19 include the potential consequences of unsubstantiated claims circulating on social media platforms. “ One of the emerging unsubstantiated claims was that vaping can protect or treat individuals during the pandemic” suggests Majmundar, referring to claims that vaping devices could be used to administer medication or holistic substances, or protect the lungs by introducing humidity. “Such claims can mislead individuals and snowball into a bigger public health problem.”

There is ongoing research examining ways in which vaping and inhaling vapor into the lungs may impact COVID-19 outcomes. Organizations such as National Institutes of Health, and other experts in tobacco control, believe it calls for further study. For their part, the team at TCORS plans to continue analysis of conversations on this topic. “Our in-depth investigation will help prioritize specific health-related aspects of COVID-19 and vaping to be addressed in future public health campaigns.”

While more studies are in the pipeline, keeping an ear to the ground in online communities, and analyzing health records of COVID-19 patients can help the health community plan interventions, health education messaging and patient-provider practices.

Read the commentary here…

— by Carolyn Barnes

USC contributes to surgeon general’s first report on e-cigarettes

The United States Surgeon General on Dec. 8 released a new report calling e-cigarettes “a major public health concern.”

“E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General” is the first comprehensive review on this public health challenge from the nation’s highest public-health authority. 

The report provides insights into youth e-cigarette use, which has more than tripled since 2011, and outlines dangers to which young people are uniquely vulnerable.

While recognizing the need for further research, the report finds that the aerosol inhaled by e-cigarette smokers may cause mood disorders, deficits in attention and cognition, and addiction to nicotine—and may also be harmful secondhand to non-users.

USC’s Jonathan Samet, distinguished professor and director of the USC Institute for Global Health, contributed to the development of the chapter on e-cigarette policy. Samet is an expert in tobacco and public health and the Flora L. Thornton Chair of the Department of Preventive Medicine at the Keck School of Medicine of USC. He was the senior scientific editor of the 2014 surgeon general’s report “The Health Consequences of Smoking—50 years of progress.”

The new report on e-cigarettes extensively cites research by USC faculty in the department of preventive medicine. Their most recent study published in JAMA last month found that adolescents who regularly vape have a higher risk of more frequent and heavy smoking six months later.

“The scientific story is still incomplete for e-cigarettes and we are living in an age of misinformation”

Research is well underway at USC and other institutions to better understand health effects of e-cigarettes. However, it will be years before scientists can fully understand the risks because the products and patterns of usage are changing rapidly. Meantime, Samet said he urges people not to assume that e-cigarettes are safe.

“The scientific story is still incomplete for e-cigarettes and we are living in an age of misinformation,” Samet said. “The benefits of e-cigarettes for harm reduction and smoking cessation have been exaggerated by some, and I concur with the surgeon general on the need for protecting adolescents and young adults from using tobacco products.”

The report outlines ways to control young people’s use of e-cigarettes. It calls for increased tobacco-related surveillance; tactical and comprehensive research; strategies to protect youth; and other actions modeled after proven tobacco control methods. These include incorporating e-cigarettes into smoke-free policies, preventing adolescents’ access to e-cigarettes, taxation, regulation and more.

In November the chief executive for Philip Morris International, the world’s largest global tobacco company outside of China, indicated that the company would eventually stop selling cigarettes in favor of alternative products.

But this shift is more concerning than comforting to researchers, given the risks to youth and their high exposure to e-cigarette advertising.

“It’s an entire renormalization of that imagery, of that advertising and marketing that we had worked for decades to take out of the public space,” said Heather Wipfli, associate director of the USC Institute for Global Health, in the The Christian Science Monitor. Ranking e-cigarettes as safer than deadly cigarettes sets a low bar for health standards and is misleading, she said.

Samet and preventive medicine professor Maryann Pentz lead the USC Tobacco Center of Regulatory Science for Vulnerable Populations, one of 14 centers in the U.S conducting research to inform the FDA. The surgeon general’s report referenced findings from three USC TCORS studies.

“Thanks to the multidisciplinary strength of our researchers, USC is emerging as a leader in e-cigarette research,” said Rohit Varma, dean of the Keck School of Medicine of USC. “We’re approaching this from every angle—from the clinical to the behavioral.”

USC Contributions in the News:

CBS News Los Angeles affiliate KCBS-TV featured research by Jonathan Samet, Adam Leventhal, Jennifer Unger, Daniel Soto and other Keck Medicine of USC colleagues who contributed to the report. KCBS quoted Soto about the serious health risks and possible impact on brain development for young e-cigarette users. “It can be addictive. I would tell parents watch out for e-cigs,” Leventhal told ABC News Los Angeles affiliate KABC-TVKPCC-FM’s “Take Two” interviewed Unger about her research contributions to the report. Consumer Affairs also highlighted the research.

Major Findings:

  1. E-cigarettes are a rapidly emerging and diversified product class. These devices typically deliver nicotine, flavorings, and other additives to users via an inhaled aerosol. These devices are referred to by a variety of names, including “e-cigs,” “e-hookahs,” “mods,” “vape pens,” “vapes,” and “tank systems.”
  2. E-cigarette use among youth and young adults has become a public health concern. In 2014, current use of e-cigarettes by young adults 18–24 years of age surpassed that of adults 25 years of age and older.
  3. E-cigarettes are now the most commonly used tobacco product among youth, surpassing conventional cigarettes in 2014. E-cigarette use is strongly associated with the use of other tobacco products among youth and young adults, including combustible tobacco products.
  4. The use of products containing nicotine poses dangers to youth, pregnant women, and fetuses. The use of products containing nicotine in any form among youth, including in e-cigarettes, is unsafe.
  5. E-cigarette aerosol is not harmless. It can contain harmful and potentially harmful constituents, including nicotine. Nicotine exposure during adolescence can cause addiction and can harm the developing adolescent brain.
  6. E-cigarettes are marketed by promoting flavors and using a wide variety of media channels and approaches that have been used in the past for marketing conventional tobacco products to youth and young adults.
  7. Action can be taken at the national, state, local, tribal, and territorial levels to address e-cigarette use among youth and young adults. Actions could include incorporating e-cigarettes into smoke-free policies, preventing access to e-cigarettes by youth, price and tax policies, retail licensure, regulation of e-cigarette marketing likely to attract youth, and educational initiatives targeting youth and young adults.

— By Larissa Puro