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Purpose: Indicators of poor mental health increased during the COVID-19 pandemic among emerging adults aged 18-24 years, a group already at elevated risk. This study explores associations between contextual and personal stressors with symptoms of emerging adults' anxiety and depression, assessing both multidimensional and distinct measures of stress., Methods: Using Census Household Pulse Surveys from emerging adults aged 18 to 24 years (N = 71,885) and administrative data from April 23, 2020 to March 29, 2021, we estimated logistic regression models adjusted for state and wave fixed effects., Results: Rates of elevated anxiety and depressive symptoms rose dramatically among emerging adults during the first year of the COVID-19 pandemic. Results indicate that potential contextual stressors-state COVID-19 rates and state COVID-19 mitigation policies limiting social interactions (stay-at-home orders, restaurant closures, large gathering restrictions, and mask mandates)-were not significantly associated with symptoms. In contrast, personal economic stressors (nonemployment, household income loss, food insecurity, housing insecurity, lacking health insurance) and disruptions to education were associated significantly with elevated anxiety and depressive symptoms, with greater numbers of stressors associated with worse well-being., Discussion: Emerging adults reported persistently high levels of elevated anxiety and depressive symptoms during the first year of the pandemic, outcomes associated not with COVID-19 rates or mitigation policies, but with economic inequities, and other personal stressors heightened by the pandemic. Providing targeted support for young adults, including ensuring access to mental health supports, health care, and economic relief, is critical., (Copyright © 2024 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Purpose: Given the rapid expansion of recreational marijuana legalization (RML) polices, it is essential to assess whether such policies are associated with shifts in the use of marijuana and other substances, particularly for adolescents, who are uniquely susceptible to negative repercussions of marijuana use. This analysis seeks to provide greater generalizability, specificity, and methodological rigor than limited prior evidence., Methods: Youth Risk Behavior Survey data from 47 states from 1999 to 2017 assessed marijuana, alcohol, cigarette, and e-cigarette use among adolescents (14-18+ years; N = 1,077,938). Associations between RML and adolescent past-month substance use were analyzed using quasi-experimental difference-in-differences zero-inflated negative binomial models., Results: Controlling for other state substance policies, year and state fixed effects, and adolescent demographic characteristics, models found that RML was not associated with a significant shift in the likelihood of marijuana use but predicted a small significant decline in the level of marijuana use among users (incidence rate ratio = .844, 95% confidence interval [.720-.989]) and a small increase in the likelihood of any e-cigarette use (odds ratio of zero use = .647, 95% confidence interval [.515-.812]). Patterns did not vary over adolescent age or sex, with minimal differences across racial/ethnic groups., Conclusions: Results suggest minimal short-term effects of RML on adolescent substance use, with small declines in marijuana use and increase in the likelihood of any e-cigarette use. Given the delayed rollout of commercial marijuana sales in RML states and rapid expansion of RML policies, ongoing assessment of the consequences for adolescent substance use and related health and behavioral repercussions is essential., (Copyright © 2020 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Purpose: Our aims were to examine the impact of cigarette taxes and smoke-free legislation on current adolescent smoking and smoking frequency overall as well as test whether there were differential policy effects by age., Methods: Using data on 717,543 adolescents from 43 states in the 1999-2013 Youth Risk Behavior Surveys, we used difference-in-differences regression models to evaluate the impact of tobacco control policies on current adolescent smoking (yes/no) and, separately, smoking frequency (defined as 0, 1-5, 6-29, 30+ days per month). We tested an interaction between age and cigarette taxes and, separately, smoke-free legislation., Results: From 1999 to 2013, adolescent smoking decreased from 35.3% to 13.9% and 41 of 43 states increased their cigarette tax in real terms by an average of 257%. By the end of the study period, 29 of 43 states had 100% smoke-free restaurant legislation. Although we found no overall effect of cigarette taxes on current smoking, there was a significant interaction by age. Among 14- and 15-year olds, every $1.00 cigarette tax increase was associated with a 2.2 and 1.6 percentage point reduction in smoking, respectively. The enactment of 100% smoke-free restaurant legislation was associated with an overall reduction in adolescent smoking by 1.1 percentage points and there were no differences by age. Cigarette taxes and smoke-free legislation were also associated with decreased smoking frequency., Conclusions: The youngest adolescents are the most price sensitive, and cigarette taxes continue to be a successful approach to reduce adolescent smoking. Smoke-free legislation may also be an effective strategy to reduce smoking among all adolescents., (Copyright © 2016 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Purpose: To examine selected social determinants of children's exposure to household tobacco use and smoking inside the home and to assess the effect of second-hand smoke exposure on asthma and ear infections across children's age groups., Methods: A total of 90,961 parents of children aged 0-17 years from the 2007 National Survey of Children's Health were included in the study., Results: In all, 26.2% of parents reported that anyone in the household used tobacco products. Parents of children aged 6-11 and 12-17 years were 1.97 (adjusted OR; 95% CI, 1.65-2.36) and 2.93 (2.46-3.49) times more likely, respectively, to report that someone smoked inside the house than parents of younger children. Second-hand smoke exposure varied by children's race/ethnicity, and children from more disadvantaged circumstances were more likely to be exposed. For all children, they were more likely to ever have asthma if someone in their household used tobacco. Although young children's likelihood of recurrent ear infections did not increase with household tobacco use, children aged 12-17 were 1.67 (1.02-2.72) times more likely to have recurrent ear infections if someone smoked inside their home., Conclusion: Family members are increasingly likely to smoke indoors as children age, which may increase adolescents' vulnerability to ear infections. Parents and health professionals should monitor second-hand smoke exposure at home and encourage a smoke-free environment., (Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)