Adult smokers who shift to using to e-cigarettes may have more chances to improve health and well-being, according to new research from the 91探花.

The study monitored changes in health and social functioning among smokers at two stages in adulthood, age 30 and again at 39. Approximately one-third of smokers shifted to vaping some or all the time by age 39. This group reported better physical health, exercised more and had more active social engagement, the study found.

鈥淒espite the obvious risks to nonsmokers, e-cigarettes have the potential to play a health-promoting role in the lives of smokers,鈥� said study co-author Marina Epstein, a research scientist with the in the 91探花School of Social Work.

The , which recently published in Drug and Alcohol Dependence, drew from a larger longitudinal study, the Seattle Social Development Project, which in 1985 began following some 800 children as fifth-graders in Seattle elementary schools. The sample for the current study focused on 156 of those participants who reported smoking at age 30 and smoking or vaping at age 39.

E-cigarettes first appeared in the United States in the mid-2000s, right around the time the participants in the study sample turned 30. By 2018, . Vaping is especially popular among teens and young adults; the Centers for Disease Control and Prevention identifies e-cigarettes as the most popular tobacco product among young people in the U.S., estimating that . Previous research, from and , found that adolescent and young adult vaping can lead to later cigarette use. “In this way, e-cigarettes have been a public health disaster,” said study lead author Rick Kosterman, a research scientist with the Social Development Research Group.

At the same time, while vaping carries certain risks 鈥� the aerosol contains nicotine, small amounts of heavy metals and other ultrafine and cancer-causing particles that can enter the lungs 鈥� the CDC considers them .

Given the common perception of e-cigarettes as a 鈥渉ealthier鈥� alternative, the researchers wanted to examine behavior among smokers who switch to e-cigarettes some or all the time as they approach midlife. The research team collected a series of accepted measures of healthy aging and well-being, such as overall physical and mental health, engaging in healthy behaviors and social activities, and education and income levels. They then surveyed participants, at ages 30 and 39, about this information and how often they engaged in certain activities.

Of the 156 study participants, 64% smoked only combustible cigarettes at age 39; 28% smoked and vaped; and 8% only vaped. Results from the surveys showed that more frequent vaping 鈥� relative to smoking 鈥� was associated with better physical health, more exercise, more active social engagement and higher socioeconomic status.

鈥淎lthough the study cannot show a causal relationship, we think that because e-cigarettes have less stigma, less odor and are less physically harmful, they may increase health-promoting opportunities among smokers. E-cigarette users may be more likely to be in settings that promote physical activity and have more opportunities to interact with nonsmokers,鈥� said Kosterman.

No association was found between switching to vaping and better mental health, less-frequent use of other substances such as alcohol, or whether one’s partner or closest peers smoke (though vapers’ broader social environment may be healthier).

Overall, the researchers stress that e-cigarettes still have substantial public health downsides, but this study shows that smokers who turn to vaping, whether occasionally or instead of cigarettes, may have more opportunities for healthier lifestyle choices. That doesn鈥檛 mean vaping is healthy, they say, but that for people who already smoke 鈥� and are unable to quit 鈥� it can be associated with other healthy routines.

The study was funded by the National Cancer Institute, the National Institute on Aging and the National Institute on Drug Abuse.

Co-authors were Jennifer Bailey and J. David Hawkins of the Social Development Research Group.

For more information, contact Kosterman at rickk@uw.edu or Epstein at marinaep@uw.edu.

The legalization of marijuana for Washington state adults may be thwarting a steady downward trend in teen marijuana use, according to new research from the 91探花.

The longitudinal study of more than 230 teens and young adults finds that teens may be more likely to use marijuana following legalization 鈥� with the proliferation of stores and increasing adult use of the drug 鈥� than they otherwise would have been.

鈥淲hen we think about marijuana legalization, a worry is that underage use may go up,鈥� said , the study鈥檚 lead author and principal investigator with the Social Development Research Group in the 91探花School of Social Work. 鈥淓arly use and heavy use during adolescence can have a lot of negative health consequences, then and later in life, so we don鈥檛 want teen use to be going up.鈥�

Bailey notes that before marijuana legalization, rates of teen marijuana use and other drug use had both been decreasing over the last couple of decades.

The was published July 9 in the American Journal of Preventive Medicine.

Researchers examined whether marijuana legalization led to teen use of the drug, as well as teens鈥� perceptions that the drug is harmful. Controlling for age, sex, race and parent education of the participants, researchers found that kids who entered their teens more recently were less likely to report they’d used marijuana in the past year. For example, 11% of kids born before 2000 reported using marijuana over the past year at age 15, but only 5% of kids born after 2000 said they used marijuana at age 15.

That finding goes along with the general downward trend in teen substance use. But it was after accounting for this trend that the effect of legalization showed up, Bailey said. Controlling for the year when kids were born, teens interviewed after voter approval in 2012 of nonmedical marijuana were several times more likely to report they鈥檇 used marijuana in the past year. Bailey thinks this means that marijuana legalization may be working against the decreases in teen substance use seen in the recent past.

The new findings differ slightly from other showing that rates of underage marijuana use are holding steady or dropping a little after legalization. 91探花researchers say this may reflect methodology. The 91探花study was able to account for long-term trends in teen drug use by following kids born between 1989 and 2002 for 15 years and comparing kids who were teenagers before legalization to those who were teenagers after legalization. Other studies have used school-based or optional surveys to assess a larger population at once, and have not always accounted for long-term trends.

Those methods supply important information too, Bailey said. They just reflect a different angle on the issue. Broader, point-in-time surveys don鈥檛 look at individual change.

鈥淭hey can only see how a whole state changes over time,鈥� Bailey said. 鈥淒ata like ours let you look at individuals and how drug use and behavior change over time, and then we can relate that to changes in policy.鈥�

The participants in the 91探花research are some of the children of participants in a larger and older longitudinal study: the Seattle Social Development Project. That study has followed hundreds of people 鈥� since they were fifth-graders in Seattle elementary schools in the 1980s 鈥攖o evaluate an assortment of conditions, behaviors and life choices. The results from interviews with 233 of their children, pre- and post-marijuana legalization, were included in this new study.

Child participants ranged in age from 1 to 13 years old when the study began in 2002; marijuana use was assessed from ages 10 to 20. Researchers found that children in the sample entering their teens more recently were more likely to perceive the drug as harmful. For example, 69% of 15-year-olds born before 2000 said regular marijuana use is harmful, but 77% of 15-year-olds born after 2000 said using marijuana regularly is harmful. Bailey attributes this to years of drug prevention and education efforts in schools and communities.

The study did not, however, find an overall association between marijuana legalization and teens鈥� perceived harm from the drug. It could be that changing societal attitudes drive changes in marijuana laws, the authors noted, rather than that changing laws drive perceptions.

Researchers study the perception of harm because people are more likely to engage in a behavior they see as relatively risk-free, Bailey said. In the 1960s and 1970s, for instance, there was a generally low perception of harm from many drugs, and usage was higher than it was in subsequent decades, when perceived harm increased.

鈥淧eople generally like to take care of themselves. They don鈥檛 typically do things that carry risk of harm. Throughout the decades that we鈥檝e been tracking marijuana use, this highly correlates with whether someone will use or not,鈥� she said.

The 91探花study also found no connection between marijuana legalization and teen cigarette smoking; the use of one substance often goes with the other, Bailey said. Teen smoking nationwide has , which has been to higher taxes, greater restrictions and widespread public health marketing. Researchers are watching closely to see whether affect declines in teen smoking rates.

Similar studies in other states where marijuana has been legalized 鈥� the participants in this study lived almost exclusively in Washington state 鈥� could provide further evidence of links between laws and behavior, Bailey said. Currently, nearly a dozen states permit the sale of marijuana for nonmedical use; an additional 22 states allow the drug for medical purposes only.

Nonetheless, the 91探花findings can help inform prevention messages targeting teens and marijuana, Bailey said.

鈥淎 teen usage rate that holds steady isn鈥檛 good enough if it would normally be going down. We need to devote more attention to prevention of adolescent use in the context of legalization because we want to keep the decreases we鈥檝e been seeing before legalization was implemented,鈥� Bailey said.

The study was funded by the National Institute on Drug Abuse. Co-authors were and of the 91探花Social Development Research Group; Sabrina Oesterle, formerly of the Social Development Research Group, now at Arizona State University; Joseph Roscoe of the University of California, Berkeley; and Karl Hill of the University of Colorado Boulder.

For more information, contact Bailey at jabailey@uw.edu.

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Youth programs designed to prevent drug use and delinquency and support healthy development can reap lasting benefits not only for participants, but also for their future kids, according to a decades-long study by the University of Colorado and the 91探花.

The research focuses on a program called Raising Healthy Children, which the UW鈥檚 monitored in several Seattle elementary schools in the 1980s. The program was among the first to test the idea that problem behaviors could be prevented with specialized training for teachers, parents and young children.

Lead author , a professor of psychology and neuroscience at CU Boulder and director of the , first got involved with the study while a professor at the UW.

鈥淭his is the first published study to show that a broadly implemented, early childhood prevention program can have positive effects on the next generation,鈥� said Hill. 聽“Previous studies have shown that childhood interventions can demonstrate benefits well into adulthood. These results show that benefits may extend into the next generation as well.”

The , part of a longitudinal study known as the Seattle Social Development Project, is published June 8 in JAMA Pediatrics.

For the study, researchers assessed children whose parents had participated in , created by 91探花social work professors聽听补苍诲听, founders of the Social Development Research Group. 聽聽The lessons, for use by parents and teachers, focused on enhancing children鈥檚 opportunities for forming healthy bonds in grades 1 through 6 and providing them with social skills and reinforcements.聽Set in 18 public elementary schools in Seattle, the program was among the first to test the idea that problem behaviors could be prevented with specialized training for teachers, parents and young children.

鈥淭eachers were taught how to better manage their classrooms, parents were taught to better manage their families, and kids were taught how to better manage their emotions and decision making,鈥� said Hill.

Previous studies have shown that by age 18 those who had gone through the program demonstrated better academic achievement than non-participants and were less likely to engage in violence, substance use or unsafe sex. By their 30s, they had gone further in school, tended to be better off financially, and scored better on mental health assessments.

Beginning in 2002, the researchers started following the first-born children of program participants via questionnaires for their teachers and parents. Beginning when the children were 6 years old, they also conducted annual interviews.

A total of 182 kids were studied for the new paper, including 72 whose parents had gone through the program and 110 whose parents had not.

Those whose parents had participated in Raising Healthy Children had fewer developmental delays in the first five years of life, fewer behavior problems, fewer symptoms of attention deficit hyperactivity disorder 鈥� or ADHD 鈥� and better cognitive, academic and emotional maturity in the classroom. They were also significantly less likely to report using drugs or alcohol as a teenager.

鈥淲e already know that if you can prevent kids from getting involved in the criminal justice system, engaging in underage drinking and drug use, and experiencing depression and anxiety, you can save governments and families a lot of money,鈥� said co-author , assistant director of the Social Development Research Group at the UW. 鈥淥ur results suggest these programs, by delivering cross-generational effects, may be working even better than we thought.鈥�

Children whose parents had gone through the program in the 1980s also showed less 鈥渙ppositional defiance鈥� and 鈥渆xternalizing behaviors鈥� 鈥� two common precursors to serious violence later in life 鈥� said Hill. This suggests such interventions could play a role in stemming the tide of school violence.

The researchers caution that the study was a non-randomized controlled trial conducted in only one region of the country, and needs to be replicated before broad conclusions can be drawn. But amid a pandemic, when youth depression and anxiety are on the rise while budgets are being slashed and lawmakers may have a tendency to place prevention at a lower priority, Hill hopes the findings send a message.

鈥淏y investing in kids now and continuing to invest in them, we could be making generations to come more resilient for when the next national emergency comes around,鈥� said Hill.

The study was funded by the National Institute on Drug Abuse. In addition to Hawkins and Catalano, co-authors from the 91探花Social Development Research Group are principal investigator and project director . Additional authors were , an emeritus professor in the 91探花College of Education, and Christine Steeger of the University of Colorado.

For more information, contact Bailey at jabailey@uw.edu or Hill at karl.hill@colorado.edu.

Adapted from a University of Colorado news release.

Substance use at any age has consequences. Studies frequently cite the negative impacts 鈥� and occasionally tout some benefits of limited consumption 鈥� of alcohol and marijuana.

What is less known is how patterns of alcohol or marijuana use in one phase of life can affect the next generation, even long after an individual has stopped using.

A new study by the 91探花鈥檚 Social Development Research Group shows how a parent鈥檚 use of marijuana, past or present, can influence their child’s substance use and well-being.

鈥淭he really important takeaway is that parent history of marijuana use is an important risk factor for kids,鈥� said , lead author of the study and a project director at the SDRG, which is part of the 91探花School of Social Work.

The, published online Sept. 9 in the journal Psychology of Addictive Behaviors,聽builds off previous work that had grouped participants according to whether, when and how often they used, and examined impacts to their health and behavior. That study found four distinct patterns: 鈥渘onusers鈥�; 鈥渁dolescent-limited鈥� (confined to only that period of life); 鈥渓ate onset鈥� (starting in their late teens, early 20s); and 鈥渃hronic鈥� (ongoing and frequent). This study is based on a subset of the original participants who have become parents, and has linked parents’ past use of marijuana to their children’s use of and attitudes toward alcohol and marijuana, other problem behavior, and school achievement.

The original investigation involving parents began in the 1980s when the now-adults were in fifth grade at several Seattle elementary schools. Researchers have followed the participants ever since. In 2002, when the participants were 27, SDRG recruited those who had become parents and began interviewing their children about alcohol beginning at age 6, and marijuana starting at age 10. To date, 360 children completed interviews between the ages of 10 and 20.

Children and teens of chronic users were most likely to use alcohol and marijuana themselves, as researchers had predicted. But what came as more of a surprise was the behavior of children whose parents had primarily used during adolescence: Compared to the children of nonusers, children of adults in the 鈥渁dolescent-limited鈥� group were more than 2.5 times as likely to use marijuana and 1.8 times as likely to use alcohol. This was true even after parents鈥� current marijuana use was accounted for.

In comparison, children of chronic users were nearly 4.5 times as likely to use marijuana, and 2.75 times as likely to use alcohol, as children of nonusers.

Children in the 鈥渓ate-onset鈥� group, as it turned out, were least likely to use marijuana, as were children of nonusers. They did, however, have lower grades.

鈥淯sing marijuana in adolescence is associated with a host of other problems in the present and later into adulthood,鈥� said Epstein, who was the lead author on the that established the marijuana usage patterns. 鈥淣ow we see that echoing through to their children.鈥�

According to that prior study, people who used marijuana during their teen years tended to have poorer functioning during the period in which they were actively using, and, by their early 30s, to have lower academic and economic outcomes than people who started using as adults, or who never used.

Chronic users had the worst outcomes in terms of health and quality of life, Epstein added: Poor mental health, lower academic outcomes, less financial stability and greater tendency of criminal and/or risky behaviors were associated with frequent, lifetime marijuana use.

The researchers need additional studies to uncover reasons for the relatively high usage patterns among children in the adolescent-limited group. There may be a connection between a parent鈥檚 use during adolescence, for example, and their subsequent attitudes toward substance use among teenagers in general, Epstein said.

Today, 33 states have legalized marijuana in some form, often for medical purposes, and of those, 11 states 鈥� including Washington 鈥� have legalized it for recreational use. Those developments have implications for how parents talk to their children about marijuana and how health care providers talk to patients. Even a routine review of a child鈥檚 health history could include a question about a parent鈥檚 history of marijuana use 鈥� just to consider the potential impact on the child, Epstein said.

鈥淣ow that marijuana is legal, we have to be able to talk to parents about how they鈥檙e using, and to be more specific 鈥� how much, how often, whether this is lifelong pattern,鈥� said Epstein. 鈥淭he landscape of marijuana is changing, and we have to be mindful of it.鈥�

Co-authors were Jennifer Bailey and Madeline Furlong of the UW, and Christine Steeger and Karl Hill of the University of Colorado Boulder. The study was funded by the National Institute on Drug Abuse.

For information, contact Epstein at marinaep@uw.edu.

Grant numbers: R01DA023089, R01DA012138, R01DA033956, R01DA009679

Adults who smoke marijuana often cut back after becoming parents 鈥� but they don鈥檛 necessarily quit.

The influence of a significant other and positive attitudes toward the drug overall, in addition to the onset of parenthood, also are factors in whether someone uses marijuana.

It’s a changing landscape for marijuana use, as laws ease and cultural acceptance grows 鈥� in Washington state and elsewhere around the country. Against that backdrop, the study by the 91探花’s Social Development Research Group (SDRG) aims to present information about marijuana use among parents and nonparents alike.

“When it comes to adults, we don’t know long-term consequences of moderate marijuana use in the legal context, so that we cannot say that we absolutely must intervene,” explained , a 91探花research scientist and lead author of the study. “However, when it comes to parents, their use is strongly related to their children鈥檚 marijuana use, and that is a significant problem, since adolescent marijuana use can be harmful. Our study wanted to prepare us to build effective interventions for all adults if it becomes an issue.”

The , published online May 19 in Prevention Science, surveyed 808 adults (parents and nonparents), a group the SDRG first identified as fifth-graders at Seattle elementary schools in the 1980s as part of a long-term research project. For the marijuana study, participants were interviewed at specific intervals over a 12-year period, ending when most participants were 39 years old. That survey concluded in 2014 鈥� two years after marijuana was legalized in Washington. A parent-only subset of 383 people was surveyed at separate times, ending in 2011, just before the statewide vote that gave rise to pot shops.

Women and people of color made up approximately half the big study pool; of the parent subsample, about 60 percent were women, and an equivalent percentage were people of color.

The increasing availability of marijuana, along with shifting societal opinions about it, lends a timeliness to the findings and provides potential for further study, Epstein said. What factors affect behavior, especially among parents? Past studies have linked parenthood with decreased marijuana use; what makes this one different is the examination of other influences, too, and how those might inform intervention strategies.

More than half of Americans now support legalizing marijuana, according to a 2015 Pew Research Center , and data from 2014 indicate a majority of Americans view alcohol as more damaging to a person’s health than pot.

Meanwhile, concerns about the health effects of marijuana tend to focus on children and teens 鈥� years when the brain is still developing. The and the stress the potential for long-term cognitive impairment, problems with attention and coordination and other risk-taking behaviors due to heavy marijuana use. For those reasons, medical professionals recommend that parents avoid using marijuana 鈥� or drinking heavily 鈥� around kids to prevent modeling the behavior.

The 91探花research found that, in general, a greater percentage of nonparents reported using marijuana in the past year than parents. At age 27, for example, 40 percent of nonparents said they had smoked pot, compared to about 25 percent of parents. By participants’ early 30s, their marijuana use had declined, but a gap between the two groups remained: Slightly more than 16 percent of parents said they smoked pot in the past year, while 31 percent of nonparents reported the same.

But the study also showed that participants who started using marijuana as young adults were much more likely to continue to use into their mid- to late 30s, even after they became parents. Having a partner who used marijuana also increased the likelihood of participants’ continued use. Those trends were true of both parents and nonparents, demonstrating the impact of attitudes and the behavior of others, Epstein said.

“This shows that we need to treat substance use as a family unit. It isn’t enough that one person quits; intervention means working with both partners,” she said. “We also need to tackle people’s positive attitudes toward marijuana if we want to reduce use.”

And while the health risks to adults are being debated, the focus on children can be a driver for prevention campaigns, Epstein said.

The paper’s co-authors were , , and , all from the Social Development Research Group, part of the 91探花School of Social Work. The study was funded by the National Institute on Drug Abuse.

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For more information, contact Epstein at marinaep@uw.edu.

Grant number: R01DA023089