Deepa R Camenga

Yale University | YU · Department of Emergency Medicine

Objective: To contextually examine facilitators of young driver decisions to ride with an impaired driver (RWI) or drive while impaired (DWI). Methods: Data were from the NIH's NEXT Generation Health Study (NEXT), a 7-year longitudinal nationally representative study with a U.S. probability cohort of 10th graders starting in 2009-2010. Using a m...

Objective: Distracted driving is a primary contributor to for motor vehicle crashes, the leading cause for injuries and fatalities for youth. Although attention and working memory clearly underlie driving abilities, few studies explore these functions on the brain-level under the cognitive load of driving. To understand the load driving has on aud...

This study aimed to determine the prevalence and predictors of oral, ocular, or dermal e-liquid exposure and subsequent outcomes (becoming sick, going to the hospital) in the US. We examined survey data from the Population Assessment of Tobacco and Health Study Wave 5 (2018–2019). The analytic sample included US youth (aged 12–17 years), young adul...

Women with vulvovaginal or genital pain more commonly experience interstitial cystitis/bladder pain syndrome (IC/BPS) and urinary tract infections. However, the relationship between genital pain and bladder health is lacking. Women in the Prevention of Lower Urinary Tract Symptoms Consortium’s RISE FOR HEALTH population-based study answered questio...

Background E-cigarette flavors can create sensations of sweetness and coolness while masking the aversiveness of nicotine. Recently, non-tobacco nicotine (NTN) products were introduced to the market, but little is known about flavors in NTN e-cigarette use. We examined associations between flavors (i.e., sweet, mint/menthol) and susceptibility to a...

Introduction The Electronic Nicotine Delivery Systems (ENDS) industry recently introduced non-tobacco nicotine (NTN), which is not tobacco-derived and is often marketed as “tobacco-free nicotine.” Given its novelty, it is important to understand where young adults learn about NTN ENDS. This study examined sources of exposure to NTN ENDS and relatio...

Background: E-cigarette flavors that produce cooling sensations may reduce nicotine harshness and enhance appeal among youth. While previous research has shown that use of cooling flavors is associated with more frequent vaping among youth, it is unknown whether the same holds true for e-cigarette dependence. This study examines the relationship be...

This survey study explores primary care pediatricians’ preparedness to counsel and treat adolescents with opioid use disorder (OUD) and perceived barriers to prescribing OUD medications.

PURPOSE Although maternal depression is associated with adverse outcomes in women and children, its relationship with lower urinary tract symptoms (LUTS) in offspring is less well-characterized. We examined the association between prenatal and postpartum maternal depression and LUTS in primary school-age daughters. DESIGN Observational cohort stud...

Lower urinary tract symptoms (LUTS) are common among adolescent girls. Physical activity (PA) has been implicated as both a risk (high-impact PA) and protective factor (low-impact, moderate to vigorous intensity PA) for LUTS in adult women, but its role in adolescent girls is unclear. This study investigated the prospective association between phys...

Purpose of Review Stand-alone digital interventions—digital interventions delivered without provider or teacher involvement—hold promise for improving access to substance use prevention services for adolescents. We conducted a systematic review and meta-analysis to determine the efficacy of stand-alone digital interventions to prevent substance use...

In book 1 of this 3-part series, we are pleased to present an extensive collection of adolescent health articles that address the diverse needs of the adolescent and young adult population as it relates to preventative health. Through a wide variety of research, we have come to a greater, more informed understanding of the vast needs of this dynami...

Norms and behaviors about toileting in prison can expand understanding of women's lived experience of incarceration. Knowledge about this subject is significant because access to clean, safe toilets is a human rights issue, and toilet habits can impact social, mental, and physical outcomes. Three focus groups were conducted with 15 incarcerated wom...

Significant strides have been made in reducing rates of cigarette smoking among adolescents in the United States. However, rates of e-cigarette and similar device use among youth are high, and rates of other tobacco product use, such as cigars and hookahs, have not declined. In addition, almost 40% of children 3 to 11 years of age are regularly exp...

Tobacco use remains the leading preventable cause of disease and death for adults in the United States. Significant strides have been made in reducing rates of cigarette smoking among adolescents in the United States. However, rates of e-cigarette and similar device use among youth are high, and rates of other tobacco product use, such as cigars an...

This technical report provides the evidence base for the accompanying tobacco clinical report and policy statement. It builds on, strengthens, and expands AAP recommendations from the previous version in 2015. Tobacco use remains the leading preventable cause of disease and death for adults in the United States. The tobacco epidemic takes a substan...

Purpose: We examined how antecedent sexual health factors affect lower urinary tract symptoms (LUTS) in adolescent women. Methods: We analyzed 1,941 adolescent women from the Avon Longitudinal Study of Parents and Children at age 19. At ages 15 and 17, participants reported use of oral contraceptives (OCs), history of sexual intercourse, number...

This study examines the demographic factors associated with youths' first product tried (i.e., cigarettes, e-cigarettes, cigars, hookah, or smokeless tobacco). This study also evaluates whether the first product tried is associated with future nicotine product use (i.e., no use, single product use, and multiple product use) and nicotine dependence....

Background Oral nicotine pouches (NPs) that contain nicotine but no tobacco leaves are rapidly gaining popularity. However, there is limited research on NPs, including within priority populations. In the current study, we examined awareness of, susceptibility to, and use of NPs in young adults as well as comparative risk perceptions with smokeless...

Objective The objectives of the current study were to (1) characterize predictors of perceived risk of driving within 2 h of cannabis use and driving after cannabis use in a sample of adults who have used cannabis in the past year and (2) determine whether the influence of these predictors vary by state legalizations status. Methods Data for this...

This study determined whether young adults' perceptions of how tobacco free nicotine (TFN) compared to tobacco-derived nicotine (TDN) were associated with curiosity to try or use TFN e-cigarettes. U.S. young adults aged 18–25 years (n = 1176) completed an online survey in October 2021. Survey questions assessed TFN awareness, curiosity, use, and pe...

Background Nicotine pouches containing synthetic nicotine or tobacco-derived nicotine (TDN) are available in the United States. Synthetic nicotine pouches often are marketed as “tobacco-free nicotine” (TFN), which may alter risk perceptions and/or product appeal. This study examined young adults’ perceptions about TFN versus TDN pouches and associa...

Introduction: E-cigarettes are increasingly being marketed as containing tobacco-free nicotine (TFN). There is no data examining use of TFN e-cigarettes by young adults and how use may differ from non-TFN e-cigarettes. The current study aims to characterize young adult TFN e-cigarette use and examine differences between those who report using TFN...

Access to timely prevention and treatment services remains challenging for many children, adolescents, young adults, and families affected by substance use. The American Academy of Pediatrics recognizes the scope and urgency of this problem and has developed this policy statement for consideration by Congress, federal and state policy makers, and p...

Purpose of Review The goal of this manuscript is to review the current literature on bladder health education, summarize Prevention of Lower Urinary Tract Symptoms (PLUS) findings on environmental factors that influence knowledge and beliefs about toileting and bladder function, and describe how PLUS work will contribute to improved understanding o...

Background “Tobacco-free” nicotine (TFN) e-cigarettes and nicotine pouches containing synthetic nicotine are increasingly available. The term TFN may lead to reduced risk perceptions and increased use intentions relative to tobacco-derived nicotine products. Effectively communicating messages about TFN may depend on the public’s ability to differen...

E-cigarette use remains a serious public health threat for adolescents in the United States. Pediatric providers can intervene early to prevent the adverse, and sometimes life-long, health consequences of e-cigarette use. This article reviews the clinical management of e-cigarette use among adolescents using the “Ask-Counsel-Treat” model. This mode...

Introduction For young drivers, independent transportation has been noted to offer them opportunities that can be beneficial as they enter early adulthood. However, those that choose to engage in riding with an impaired driver (RWI) and drive while impaired (DWI) over time can face negative consequences reducing such opportunities. This study exami...

Background The proportion of motor vehicle crash fatalities involving alcohol-impaired drivers declined substantially between 1982 and 1997, but progress stopped after 1997. The systemic complexity of alcohol-impaired driving contributes to the persistence of this problem. This study aims to identify and map key feedback mechanisms that affect alco...

Study Objective Menstrual health in adolescents has been understudied in the U.S. We aimed to assess patient and provider perspectives surrounding menstrual health management and screening. Design Our mixed-methods approach consisted of provider surveys, patient surveys, and patient interviews. Setting Participants were recruited from a pediatric...

Background: Dual use of e-cigarettes and combustible tobacco products is common in young adults. We aimed to explore how ratings of subjective and contextual factors differed between discrete episodes of e-cigarette use vs. combustible tobacco product smoking among a sample of young adults. Methods: Young adults (N = 29, ages 18-30) who used e-c...

Objective: This exploratory study aimed to examine associations between executive function and simulated and self-reported driving behavior among young adults with and without a history of prenatal cocaine exposure (PCE). Methods: Young adult drivers with PCE (n = 38) and with no drug exposure (NDE; n = 25) were recruited from an ongoing longitudin...

Introduction E-liquid flavor is typically presented by flavor category (e.g. menthol, mint, fruit, dessert). Cooling sensations produced by flavor additives such as menthol enhance appeal of e-cigarettes among youth, but not all e-liquids that produce cooling sensations are labeled as menthol. Sensory experiences produced by flavors may allow for a...

Background Vaping is the second most common modality of using cannabis following smoking. We examined differences in demographics and substance use behaviors between adolescent cannabis vapers and those exclusively using other cannabis modalities. Methods In 2019, 4875 students from six Connecticut high schools completed school-wide, online survey...

Healthcare providers play an important role in educating youth about the harmful effects of e-cigarettes and supporting vaping cessation attempts. This chapter reviews recommendations for the prevention and treatment of e-cigarette use among adolescents in the clinical setting. Both the 5As and SBIRT (Screening, Brief Intervention, and Referral to...

Purpose: The purpose of this study was to identify and characterize trajectory classes of adolescents who ride with an impaired driver (RWI) and drive while impaired (DWI). Methods: We analyzed all 7 annual assessments (Waves W1-W7) of the NEXT Generation Health Study, a nationally representative longitudinal study starting with 10th grade (2009...

Background Lower urinary tract symptoms (LUTS) are common in children and adolescents. Non-invasive tests evaluating bladder function are generally preferred over invasive tests, yet few studies have explored the range of normative values for these tests in healthy, asymptomatic children. Objective To define normative reference ranges for non-inva...

Study Objective Input from adolescents and healthcare providers is needed to develop electronic tools that can support patient-centered sexual and reproductive (SRH) care. This study explores facilitators and barriers to patient-centered communication in the context of developing an electronic appointment planning tool to promote SRH communication...

Introduction: The opioid epidemic impacts all ages, yet few published medical education curricula exist to train physicians on how to care for opioid use disorder (OUD) in adolescents, a developmental stage where confidentiality protection is appropriate and contributes to quality health care. We developed a simulation-based educational interventi...

In recent years, the tobacco use landscape among youth has changed greatly, underscoring a need to understand current tobacco product initiation patterns. This study aimed to examine if adolescents’ first tobacco product tried differs by race/ethnicity and socioeconomic status (SES). Cross-sectional survey data were collected from 6 Connecticut hig...

Little is known about social processes shaping adolescent and adult women’s toileting behaviors. The “Study of Habits, Attitudes, Realities, and Experiences” (SHARE) examines adolescent and adult women’s experiences related to bladder health across the life course. Forty-four focus groups with 360 participants organized by six age groups were condu...

Objectives In November 2018, JUUL, Inc. restricted sales of mango, fruit medley, crème brûlée, and cucumber pods to its website. Physical/online sales of tobacco, menthol, and mint pods continued. We examined rates of adolescent JUUL device and flavored pod use before and after restrictions were implemented to examine their potential impact. Metho...

Background Adolescent e-cigarette use has increased recently; however, little is known about trends in use of specific devices by youth. This study aims to 1) compare rates of e-cigarette device use over time, 2) examine changes in frequency of device use, and 3) identify predictors of device use. Methods Cross-sectional surveys were distributed s...

Introduction JUUL, a closed system e-cigarette with disposable pods, is popular among youth, with positive attributes of this product linked to current use by youth. However, many youth try JUUL and do not continue using; understanding differences in the appeal of this device between current users and those who chose not to continue use can inform...

Objective To examine the relationship between patterns of alcohol use, as determined by the Alcohol Use Disorders Identification Test, and vehicle control measures in high fidelity driving simulation among adult sober drivers. Methods Baseline data (BAC = 0.00%; N = 108) from a larger study aimed at using high-fidelity driving simulation (National...

Introduction: Prior research shows that physicians in training are at risk for drowsy driving following their clinical duties, which may put them in danger of experiencing adverse driving events. This study explores the relationship between sleepiness, overall sleep hygiene, level of training, and adverse driving events following an overnight shif...

Electronic cigarettes are the tobacco products most commonly used by youths in the United States. The use of e-cigarettes, also known as vaping or JUULing, is a public health epidemic. This collection offers reviews and research to assist pediatric health care providers in identifying and treating adolescent use and exposure to e-cigarettes. https:...

Background: Little research to date has investigated the spectrum of bladder health in women, including both bladder function and well-being. Therefore, we expanded our previous baseline analysis of bladder health in the Boston Area Community Health (BACH) Survey to incorporate several additional measures of bladder-related well-being collected at...

Objectives To examine whether the school toilet environment at age 13, including bullying at toilets, is associated with female LUTS at ages 13 and 19, as little is known about the association among school toilet environment, voiding behaviors, and lower urinary tract symptoms (LUTS) in adolescent girls. Methods The sample comprised 3962 female pa...

Introduction As of February 18, 2020, states have reported 2,807 cases of e-cigarette, or vaping, product use–associated lung injury to the Centers for Disease Control and Prevention. Most cases involved cannabinoids. This study identifies current risk factors for adult marijuana vaping by analyzing 2017 and 2018 Behavioral Risk Factor Surveillance...

Introduction Preliminary evidence suggests adolescents use e-cigarettes in school. However, little is known about the types of devices that are used in schools, where they are used, and who uses them. Knowledge about these issues is critical to inform school regulations. Methods Cross-sectional surveys were conducted in 6 Connecticut high schools...

Distracted driving remains a leading factor in fatal motor vehicle crashes, particularly in young drivers. Due to ongoing neuromaturation, attention capabilities are changing and improving throughout young adulthood. Here, we sought to bridge neuroscience with driving simulation by evaluating the effects of driving on attention processing through a...

Aims: Although lower urinary tract symptoms (LUTS) may occur at different periods during the life course of women, a little research on LUTS has adopted a life course perspective. The purpose of this conceptual paper is to demonstrate how life course theory and life course epidemiology can be applied to study bladder health and LUTS trajectories....

Background: There are thousands of e-liquid flavors available, and some are named after alcohol beverages (e.g., "pina colada"). It is unclear whether use of e-liquids with alcohol beverage names is associated with adolescent alcohol use. E-cigarettes and alcohol are co-used in adolescents; therefore, it is important to investigate these associati...

This applied paper is intended to serve as a “how to” guide for public health researchers, practitioners, and policy makers who are interested in building conceptual models to convey their ideas to diverse audiences. Conceptual models can provide a visual representation of specific research questions. They also can show key components of programs,...

Purpose of Review The purpose of this review is to examine the impact of the opioid epidemic in adolescents and young adults and recent findings regarding the treatment of opioid use disorder (OUD) in pediatric medical settings. Recent Findings Existing guidelines for the treatment of chronic pain in adults are not intended to be applied to adoles...

Introduction: Most tobacco use is initiated during adolescence and susceptibility is an important predictor of initiation. Research is needed to understand susceptibility across tobacco products among youth to inform prevention efforts. Methods: We surveyed 2,945 students from four Southeastern Connecticut high schools in 2017. We assessed susce...

Objective: The objective of this study was to compare the variability in vehicle control for sober young adult drivers (18–23 years old) who either use cannabis but are not acutely exposed or do not use cannabis. Methods: The data analyzed in the study were from 4 prospective driving simulation studies (completed at the National Advanced Driving Si...

Health researchers are increasingly turning to qualitative research for a nuanced understanding of complex health phenomena. The quality and rigor of qualitative research relies on individual data collector skills, yet few guidelines exist for training multidisciplinary, multi-institution qualitative research teams. Specific guidance is needed on q...

Background and aims: To estimate progression to polytobacco use (PTU) over one year among a sample of US youth. Design: Prospective survey with two waves one year apart: Wave 1 (2013-2014) and Wave 2 (2014-2015). We conducted latent transition analysis (LTA) to identify latent class transitions and examine sociodemographic predictors of transiti...

Aims: This analysis explored and characterized adolescent and adult women's lay language and discourse related to bladder health/function. Methods: Forty-four focus groups were conducted across seven United States research centers with 360 adolescents and adult women, organized by six age categories. Multilevel content analyses classified emerge...

Background: Although weight-related reasons for smoking and vaping have been examined in adults, research in adolescents is lacking. Thus, we examined the prevalence and correlates of using flavored e-liquids for appetite control or weight loss in high school adolescents. Methods: The analytic sample included 529 students who completed a school-...

Introduction: JUUL is a closed-system e-cigarette that uses disposable pods with high concentrations of nicotine. JUUL use among youth arose exponentially since 2015, thus, it is essential to understand youths' reasons for liking/disliking JUUL to inform the regulation of the product. Methods: A cross-sectional survey was conducted in 4 high sch...

The World Health Organization recognizes access to clean and safe toilets as crucial for public health. This study explored U.S. adolescent and adult cisgender women’s lived experiences accessing toilets in schools, workplaces, and public spaces. As part of the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium, we conducted 44 f...

Aim: The study purpose is to explore adolescent and adult women's experiences, perceptions, beliefs, knowledge and behaviors related to bladder health across the life course using a socioecological perspective. Lower urinary tract symptoms affect between 20-40% of young adult to middle-aged women, with symptoms increasing in incidence and severity...

Objective: To test the feasibility of a university health center-delivered smoking cessation intervention that adds a 6-week course of text messaging to brief advice and nicotine patch therapy. Participants: Young adult cigarette smokers (n = 40) from 2 universities from January 2015 to May 2016. Methods: Randomized controlled trial comparing brie...