Tracing the Impact of Evolving Environmental Exposure to Tobacco, Cannabis, and Nicotine Smoke and Vapor Emissions on Children's Mental Health Symptom Trajectories

PROJECT SUMMARY
Background: In recent years, while combustible cigarette smoking has decreased, use and co-use of electronic
nicotine delivery systems (ENDS) and cannabis smoking has increased among adults of reproductive age. This
suggests that some children may be experiencing higher levels of environmental exposure to combustible
cigarettes (ETS), electronic nicotine delivery systems vapor (ENV), and cannabis smoke (ECS). However,
exposure profiles across child development remain poorly characterized, which hinders efforts to quantify
whether exposures are associated with developmental risks among children, particularly poorer mental health.
Aims: This project will use the Environmental Influences on Child Health Outcomes (ECHO) dataset, which is a
large, national sample of longitudinal, observational data, to accomplish the following aims: 1) Characterize ETS,
ENV, and ECS emission exposure subgroups at each of the following timepoints: the prenatal period, infancy,
early childhood, middle childhood, and adolescence, 1a) Identify sociodemographic and primary caregiver
mental health characteristics associated with exposure group membership across each developmental period,
1b) Specify stability and changes in ETS, ENV, and ECS exposure group transitions across the prenatal period,
infancy, early childhood, middle childhood, and adolescence to delineate trajectories, and 2) Examine how
exposure during the prenatal period predicts trajectories of internalizing and externalizing symptoms across early
childhood, middle childhood, and adolescence.
Significance: This project will elucidate how shifting adult smoking and vaping patterns translate into emission
exposures among children. It addresses limitations of previous evidence by accounting for co-occurring smoke
and vapor longitudinally while accounting for possible confounds such as maternal psychological stress.
Identifying high-risk subgroups and associated mental health consequences can inform policy prevention and
public understanding of this emergent hazard.
Training: If funded, this dissertation grant will contribute to the applicant’s goal of an academic research career
and will advance an innovative research program investigating the impact of parent, or family member, substance
use on child development through a multisystemic lens, such as the consequences associated with
environmental health risks like environmental smoke and vapor exposure.

Grant Number: 5R36OD037669-02
NIH Institute/Center: NIH
Principal Investigator: Hannah Appleseth