Background: The current e-cigarette market has been rapidly evolving with an increase in the share of high nicotine concentration vaping products. This study examined urinary biomarkers of exposure (BOE) by nicotine concentration level among exclusive e-cigarette users. Methods: Data were drawn from wave 5 (December 2018–November 2019) of the Population Assessment of Tobacco and Health study. Between-subject differences in BOEs of nicotine, metal, tobacco-specific nitrosamine, and volatile organic compounds were examined across e-cigarettes containing nicotine or not [yes (n = 300) vs. no (n = 31) vs. non-tobacco use (n = 3,021)] and different nicotine concentration levels (0.1%–1.7%, 1.8%–4.9%, and 5.0%+). Results: Among 3,353 participants, exclusive e-cigarette users exhibited higher mean concentrations of nicotine metabolites than non-tobacco users. Nicotine e-cigarette users had higher concentrations of total nicotine equivalents-2 [TNE2; mean (95% confidence interval), 21.8 (15.2–31.2) vs. 0.2 (0.1–0.6) nmol/mg creatinine, P < 0.0001] and cotinine [1,418.2 (998.0–2,015.4) vs. 12.2 (0.1–0.6), P < 0.0001) ng/mg creatinine, P < 0.0001] than non-nicotine e-cigarette users. Users of e-cigarette products with nicotine levels of 1.8% to 4.9% had higher TNE2 and cotinine levels than those using 0.1% to 1.7%, though differences were insignificant after adjusting for covariates. As compared to non-tobacco users, nicotine vapers had higher concentrations of lead (adjusted P = 0.01). Conclusions: Nicotine containing e-cigarette users exhibited elevated levels of nicotine metabolites than non-nicotine containing vapers and non-tobacco users. Future research needs to investigate health effects of e-cigarette use across different nicotine levels. Impact: Regulating the nicotine content in e-cigarettes could be crucial in managing nicotine exposure and potentially mitigating associated health risks.

Research with immigrant Latino populations often point to findings that immigrants tend to evidence better health outcomes than nonimmigrants. When exploring differences based on nativity, comparisons often end with just comparing these two groups. Exploring these variables alone may oversimplify the shared and unique paths of risk and resilience between these groups. Experimental research shows that discrimination is often directed toward immigrants, but U.S.-born Latinos report more frequent exposure. We sought to address this by examining two distinct pathways by which discrimination leads to negative health. A sample of 240 Latino migrant farmworkers completed questionnaires regarding immigration-related fears, discrimination, physical and mental health, demographics, and other outcomes. While U.S.-born participants reported similar or worse outcomes across health measures, the pathways to these outcomes appeared to differ between the two groups, with immigration-related fears accounting for substantial portions of these health outcomes, especially in the dual paths with discrimination (p values < .05). Simply comparing Latino groups across U.S. nativity may paper over important differences in how they arrive at those health outcomes, including that immigration-related concerns may exacerbate exposure to and severity of discrimination, which in turn leads to negative health outcomes. On the other hand, discrimination itself may account for numerous negative health outcomes more directly for U.S.-born Latinos. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Despite a general decline in smoking rates among the U.S. population, smoking among low-income populations remains disproportionately high, likely due to the social determinants of health. To inform tailored approaches and responsive public health policies, the aim of this study was to qualitatively explore the sociocultural contexts, attitudes, and behaviors regarding smoking and quitting in a sample of low-income adults who smoke. In-depth, semi-structured qualitative interviews were conducted with 20 adults. Participants were recruited through local safety-net primary care clinics and community sites. A thematic analytic approach was utilized to analyze transcribed interviews. In exploring smoking and quitting within the context of low-income individuals, the following six themes were identified: caught between health and tobacco use; the nuances of context; roadblocks to quitting; motivation without movement; a temporary escape; and one size does not fit all. Insights into sociocultural and environmental contexts that shape smoking and quitting among low-income individuals revealed a complex interplay of factors that perpetuate smoking behavior and make it difficult to achieve sustained cessation. The study findings point to the importance of patient-centered and collaborative approaches that tailor smoking cessation efforts to the unique needs and lived experiences of low-income people who smoke.

Prior work has suggested that discrimination and immigration-related stress may impede mental health care seeking and utilization among Latinx populations. These effects may be more nuanced as both discrimination and immigration-related stress may increase symptomology, particularly post-traumatic stress disorder (PTSD) and depression. Both symptoms may, in turn, prompt attempts to seek care. The current study examined the direct effects of discrimination and immigration-related stress on care access, as well as potentially indirect effects with PTSD and depression symptoms as mediators. Interviews and online surveys were completed with 234 Latinx residents of the Midwest, assessing everyday discrimination, discrimination in healthcare, PTSD symptoms, depression symptoms, current mental health utilization, and previous unsuccessful attempts to seek care. Direct effects of discrimination and immigration-related stress were largely unrelated to care access variables. Discrimination in healthcare settings predicted both unsuccessful attempts to seek care and current use, but this effect was positive. The indirect effect was largely supported, but only for PTSD symptoms and not depression. Results indicate that further investigation is necessary to understand the direct effects of discrimination on care access. Further, discrimination and immigration-related stress may indirectly prompt attempts to seek mental health care.

Supplementary Table S1 describes sample characteristics by “I Don’t Know”, nicotine, and no-nicotine e-cigarette use groups.

Prior work has suggested that discrimination and immigration-related stress may impede mental health care seeking and utilization among Latinx populations. These effects may be more nuanced as both discrimination and immigration-related stress may increase symptomology, particularly posttraumatic stress disorder (PTSD) and depression. Both symptoms may in turn prompt attempts to seek care. The current study examined the direct effects of discrimination and immigration-related stress on care access, as well as potentially indirect effects with PTSD and depression symptoms as mediators. Interviews and online surveys were completed with 234 Latinx residents of the Midwest assessing everyday discrimination, discrimination in healthcare, PTSD symptoms, depression symptoms, current mental health utilization, and previous unsuccessful attempts to seek care. Direct effects of discrimination and immigration-related stress were largely unrelated to care access variables. Discrimination in healthcare settings predicted both unsuccessful attempts to seek care and current use, but this effect was positive. The indirect effect was largely supported, but only for PTSD symptoms and not depression. Results indicate further investigation is necessary to understand the direct effects of discrimination on care access. Further, discrimination and immigration-related stress may indirectly prompt attempts to seek mental health care.