Nora Satybaldiyeva

All Publications

• College Students' Reported Sources of Nicotine Vapes and Cigarettes Following California's Restriction on Flavored Tobacco Sales. American journal of preventive medicine Satybaldiyeva, N., Schleicher, N. C., Johnson, T. O., Alam, A., Prochaska, J. J., Henriksen, L. 2026: 108291

  Abstract

  California prohibited sales of flavored tobacco products in brick-and-mortar stores effective December 21, 2022. California college students were surveyed about their use and source of nicotine vapes and/or cigarettes in 2024.A cross-sectional, online survey of California students (n=3,921, ages 18-24) clustered in community colleges (n=112) and four-year universities (n=54) was conducted April-August 2024 using Qualtrics. Data were analyzed January-May 2025. Students who reported past 30-day (i.e., current) nicotine vaping and/or cigarette smoking also reported their product flavor and source (i.e., brick-and-mortar store, online, other). Among those who reported current use of nicotine vapes (n=1,255) and cigarettes (n=935), six separate generalized linear mixed models estimated product source as a function of product flavor, adjusting for students' sociodemographics and tobacco product use characteristics.Most students reported visiting a brick-and-mortar store to get their nicotine vapes or cigarettes (75.0% and 74.0%, respectively). Compared to students who used only unflavored vapes, students who used only flavored vapes were less likely to get them from a store (63.4% vs. 81.3%, aOR=0.39, 95% CI=0.25, 0.61) and, separately, online (12.1% vs. 39.2%, aOR=0.29, 95% CI=0.20, 0.44). However, students who smoked only menthol cigarettes were more likely to get cigarettes from a store than students who smoked only non-menthol (74.8% vs. 61.3%, aOR=1.96, 95% CI=1.30, 2.94).More than 15 months after California prohibited sales of flavored tobacco, brick-and-mortar stores were still the most common source for menthol cigarettes and flavored nicotine vapes among college students who used these products. Better enforcement is needed to eliminate sales of flavored tobacco.

  View details for DOI 10.1016/j.amepre.2026.108291

  View details for PubMedID 41617164

• Associations between loneliness severity and depression and suicidal ideation among older adults during the COVID-19 pandemic. Aging & mental health Yang, K. H., Kepner, W., Satybaldiyeva, N., Bergstrom, J., Moore, A. A., Lee, E. E. 2026: 1-10

  Abstract

  The COVID-19 pandemic has exacerbated loneliness among older adults. This study evaluates the relationship between loneliness, depression, and suicidal ideation in this population during the early pandemic by utilizing data from the All of Us (AoU) Research Program.We analyzed cross-sectional data from 17,084 individuals aged ≥65 enrolled in the AoU Research Program who completed a COVID-19 related survey in May 2020. Participants were categorized into loneliness quartiles based on their UCLA Loneliness Scale Short Form-8 scores. Descriptive statistics and chi-square tests assessed demographic differences. Poisson regression models with robust standard errors tested associations between loneliness quartiles and both depression and suicidal ideation, adjusting for age, gender, race, ethnicity, education, marital status, employment status, housing status, health insurance status, and social support.Among 17,084 participants (mean age 72.0 years [SD 5.3], 55% female, 89% White), we found a clear stepwise pattern: as loneliness increased, so did the risk of depression and suicidal ideation. Compared to the lowest loneliness quartile, those in the highest loneliness quartile were approximately 25 times more likely to experience moderate-to-severe depression (adjusted relative risk [aRR] = 25.09, 95% CI: 16.63-37.84) and 44 times more likely to report suicidal ideation (aRR = 44.31, 95% CI: 19.69-99.71). Intermediate loneliness levels (quartiles 2-3) also showed elevated risks (depression aRRs: 2.45, 7.33; suicidal ideation aRRs: 4.03, 11.87).Increasing levels of loneliness were associated with greater risk of depression and suicidal ideation among older adults during the early pandemic, underscoring the need for targeted loneliness interventions for this vulnerable population.

  View details for DOI 10.1080/13607863.2026.2612734

  View details for PubMedID 41574431

• Supporting Patients in Becoming Tobacco Free-Going Beyond Quitting. JAMA internal medicine Prochaska, J. J., Satybaldiyeva, N. 2026

  View details for DOI 10.1001/jamainternmed.2025.7449

  View details for PubMedID 41557342

• Prevalence and reasons for using cannabidiol, delta-8 tetrahydrocannabinol, cannabinol, cannabigerol, and hexahydrocannabinol among US adults. Journal of cannabis research Satybaldiyeva, N., Yang, K. H., Kepner, W., Ferran, K., Leas, E. C. 2025; 7 (1): 100

  Abstract

  Since the passage of the 2018 US Farm Bill there has been a market for cannabinoid products derived from Cannabis sativa L. that contain < 0.3% delta-9 tetrahydrocannabinol (THC). Understanding the characteristics and motivations of cannabinoid product users is crucial for appropriate regulation of these products.We conducted a cross-sectional survey of 1,523 adults 18 years or older using the probability-based Ipsos KnowledgePanel, representative of 97% of US households. We assessed lifetime use of cannabidiol (CBD), delta-8 THC, cannabinol (CBN), cannabigerol (CBG), and hexahydrocannabinol (HHC), as well as self-reported reasons for using these products (i.e., medical vs. recreational). Using multivariable logistic regression models, we investigated associations of demographic and health behavior characteristics with product use. Lastly, we used the Medical Dictionary for Regulatory Activities to code medical reasons for cannabinoid product use into system organ class and preferred term categories.Lifetime use of CBD was 35.2% (95% CI 32.7-37.9), compared with 7.7% (95% CI 6.5-9.1) for delta-8 THC, 4.5% (95% CI 3.7-5.6) for CBN, 1.3% (95% CI 0.9-1.9) for CBG, and 1.5% (95% CI 1.0-2.1) for HHC. More adults used CBD for medical purposes (71.9%, 95% CI 68.9-74.7) than recreation (47.1%, 95% CI 43.9-50.3), which was also the case for CBN, CBG and HHC. Conversely, more adults used delta-8 THC for recreation (76.1% 95% CI 67.0-83.3) than for medical reasons (50.9; 95% CI 42.6-59.2). The most cited preferred terms for CBD use were anxiety (14.7%, 95% CI 13.0-16.6), pain (13.1%, 95% CI 11.5-15.0) and arthralgia (11.2%, 95% CI 9.5-13.2), for delta-8 THC use they were anxiety (18.6%, 95% CI 13.3-25.3), pain (15.2%, 95% CI 11.1-20.5) and insomnia (10.7%, 95% CI 7.4-15.3), and for CBN use they were insomnia (15.4%, 95% CI 9.6-23.9), pain (11.1%, 95% CI 6.4-18.7) and anxiety (10.9%, 95% CI 6.0-19.0).Use of cannabinoid products is appreciable, particularly CBD and delta-8 THC. Most adults use CBD, CBN, CBG, and HHC for medical reasons, but delta-8 THC for recreation. Pain, anxiety, insomnia and arthralgia were common medical reasons for use across the different cannabinoids assessed.

  View details for DOI 10.1186/s42238-025-00359-8

  View details for PubMedID 41366718

  View details for PubMedCentralID PMC12690965

• Internet Searches for Lorazepam Following the Release of The White Lotus. JAMA health forum Yang, K. H., Satybaldiyeva, N., Kepner, W., Friedman, J., Leas, E. C. 2025; 6 (11): e254931

  Abstract

  This cross-sectional study examines whether there was an uptick in online searches about lorazepam after the release of the third season of The White Lotus.

  View details for DOI 10.1001/jamahealthforum.2025.4931

  View details for PubMedID 41236765

• U.S. State Marijuana and Delta-8-Tetrahydrocannabinol Laws and Delta-8-Tetrahydrocannabinol Use. American journal of preventive medicine Satybaldiyeva, N., Yang, K. H., Kepner, W. E., Leas, E. C. 2025: 108026

  Abstract

  Delta-8-tetrahydrocannabinol has gained popularity since the passage of the 2018 U.S. Farm Bill. The absence of federal laws and varying state regulations governing delta-8-tetrahydrocannabinol have allowed manufacturers to evade restrictions placed on marijuana products. This study examined delta-8-tetrahydrocannabinol use across different state marijuana and delta-8-tetrahydrocannabinol policies.A cross-sectional, web-based survey of 1,523 U.S. adults was conducted in October-November 2023. Responses were weighted to represent the national adult population. Inverse-probability-of-treatment weights balanced covariates across policy groups; adjusted risk ratios and 95% CIs were estimated in 2025 for state (1) marijuana policy (prohibited, medical only, recreational) and (2) delta-8-tetrahydrocannabinol policy (prohibited, regulated, unregulated).Approximately 7.7% (95% CI=6.5, 9.1) of U.S. adults reported using delta-8-tetrahydrocannabinol in their lifetime. The prevalence of delta-8-tetrahydrocannabinol use was lower among adults in states permitting recreational marijuana use (5.5%; adjusted risk ratio=0.48, 95% CI=0.33, 0.70) and lower in states permitting medical use only (8.5%; adjusted risk ratio=0.73, 95% CI=0.46, 1.14) than in states prohibiting all marijuana use (10.9%). Adults in states that regulated (3.9%; adjusted risk ratio=0.33, 95% CI=0.20, 0.55) or prohibited (4.5%; adjusted risk ratio=0.47, 95% CI=0.28, 0.78) delta-8-tetrahydrocannabinol sales reported lower rates of delta-8-tetrahydrocannabinol use than adults in states with unregulated markets for delta-8-tetrahydrocannabinol (10.5%).Delta-8-tetrahydrocannabinol use is more common where marijuana remains prohibited and less common where delta-8-tetrahydrocannabinol sales are regulated or prohibited. State-level restrictions targeting delta-8-tetrahydrocannabinol appear to reduce use, suggesting that closing regulatory gaps could limit consumption of these products.

  View details for DOI 10.1016/j.amepre.2025.108026

  View details for PubMedID 40900067

• Cigarette and cigarillo ads promote 'flavour' in a US state that prohibits flavoured tobacco sales. Tobacco control Johnson, T. O., Satybaldiyeva, N., Schleicher, N. C., Hrywna, M., Henriksen, L. 2025

  View details for DOI 10.1136/tc-2025-059515

  View details for PubMedID 40841155

• College Students' Awareness of California's Law Prohibiting Sales of Flavored Tobacco. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco Satybaldiyeva, N., Schleicher, N. C., Johnson, T., Alam, A., Prochaska, J. J., Henriksen, L. 2025

  Abstract

  Laws prohibiting sales of flavored tobacco are increasingly prevalent across the US, with eight states and 402 localities passing such laws between 2010 and 2024. California's statewide law prohibiting sales of flavored tobacco products went into effect on December 21, 2022. It is unknown whether California college students are aware of this law.An online survey of California college students (ages 18-24) was conducted April 4-August 6, 2024 (n=3,919). Mixed models estimated associations between awareness of the state law and any tobacco product use (including nicotine vapes, cigarettes, cigars, hookah, and nicotine pouches), adjusting for sociodemographic characteristics.Overall, only 20.8% of students were aware of the state law. Awareness differed by any tobacco use: 16.1% among never, 23.3% ever (not current), and 24.4% current. Compared to students who never used tobacco, students who reported ever using were more likely to be aware (aOR=1.50, 95% CI: 1.19, 1.90), as were those who reported current use (aOR=1.53, 95% CI: 1.24, 1.87). Among students who reported current use, those who used flavored tobacco were less likely to be aware compared to those who used unflavored tobacco (23.3% vs. 31.6%; aOR=0.59, 95% CI: 0.42, 0.83).More than 15 months after California prohibited flavored tobacco sales, only one in five college students was aware of the law. Surprisingly, awareness was lower among students who used flavored tobacco than those who used unflavored tobacco. Students who use unflavored tobacco may have greater awareness as a result of challenges with purchasing flavored tobacco.This is the first study to examine awareness of California's law prohibiting sales of flavored tobacco among young adults (ages 18-24). Only 20.8% of California college students were aware of the law. Notably, awareness was lower among students who reported current use of flavored tobacco compared to those who reported current use of unflavored tobacco. Some students may have faced difficulties purchasing flavored tobacco, which raised their awareness of the law. These results suggest the need for public health campaigns and retail signage to improve awareness of the law, particularly among young adults.

  View details for DOI 10.1093/ntr/ntaf160

  View details for PubMedID 40728300

• Saliva detection of the cannabinoids tetrahydrocannabinolic acid A (THCA-A) and cannabinol (CBN) among nightclub attendees in New York City, 2024. The American journal of drug and alcohol abuse Satybaldiyeva, N., Yang, K. H., Krotulski, A. J., Walton, S. E., Stang, B., Palamar, J. J. 2025: 1-8

  Abstract

  Background: The 2018 U.S. Farm Bill led to a rapid expansion of derived cannabinoid products. Prior studies examining their use rely on self-reported data, which can be unreliable. Nightclubs offer a unique environment for biological surveillance due to their high prevalence of substance use.Objectives: We used biological measures to better understand the prevalence of specific cannabinoids.Methods: Throughout 2024, adults entering New York City nightclubs (n = 1,024; 45.9% female) were surveyed and had their saliva tested for cannabinoids including tetrahydrocannabinolic acid A (THCA-A) and cannabinol (CBN). We calculated the prevalence and correlates of detection for these two compounds.Results: Tetrahydrocannabinol (THC) was detected in 30.8% of the sample, THCA-A in 11.7% and CBN in 8.9%. Compared to males, females had lower odds of testing positive for THCA-A (aOR = 0.28, 95% CI: 0.16-0.48) and CBN (aOR = 0.47, 95% CI: 0.27-0.83), and compared to white participants, black participants had higher odds of testing positive for THCA-A (aOR = 2.04, 95% CI: 1.12-3.72) and CBN (aOR = 3.74, 95% CI: 1.94-7.23). Compared to those with a college degree or higher, those with a high school diploma or less had higher odds of testing positive for THCA-A (aOR = 4.02, 95% CI: 2.40-6.74) and CBN (aOR = 2.49, 95% CI: 1.34-4.63) and those with some college had higher odds of testing positive for CBN (aOR = 2.02, 95% CI: 1.10-3.72).Conclusions: A sizable proportion of nightclub attendees had detectable levels of THCA-A and CBN, highlighting the need to screen for derived cannabinoids alongside THC. Biological drug testing with self-report may improve public health surveillance.

  View details for DOI 10.1080/00952990.2025.2515360

  View details for PubMedID 40549974

• Correlates of Suicidal Ideation Among Elementary School-Aged Pediatric Patients. Pediatric emergency care Satybaldiyeva, N., Ferran, K., Saleh, F., Kepner, W., Hollenbach, K. 2025

  Abstract

  OBJECTIVES: While suicide is the second leading cause of death among 10- to 14-year-old children, information regarding the factors associated with suicide-related behaviors is scarce-especially for children under the age of 12. We aimed to examine characteristics associated with suicidal ideation, as compared with other behavioral health concerns, in elementary school-aged children seeking emergency medical care.METHODS: We conducted a retrospective analysis of all 5- to 11-year-old children seen in a pediatric emergency department for a behavioral health concern during a 1-year period. Data on patient demographics, medical history, and behavioral health history were abstracted from the electronic medical record. Multivariate logistic regression was used to determine the associations between demographic and behavioral health characteristics and suicidal ideation.RESULTS: Of the 393 children in the study sample, 56.7% were seen for suicidal ideation, and 43.3% were seen for other behavioral health concerns. Both groups had similar demographic characteristics and were mostly male, White, non-Hispanic, and covered by public health insurance. Patients seen for suicidal ideation were more likely to have depression (adjusted odds ratio (aOR)=2.88, 95% CI: 1.54-5.40), a family history of psychiatric disorders (aOR=2.03, 95% CI: 1.27-3.25), experienced bullying (aOR=2.82, 95% CI: 1.48-5.39), been a victim of abuse (aOR=2.01, 95% CI: 1.10-3.64), and be of older age (aOR=1.33, 95% CI: 1.17-1.52) than patients seen for other behavioral health concerns.CONCLUSIONS: Most elementary school-aged children presenting to the emergency department for behavioral health concerns were seen for suicidal ideation. Similar to studies among adolescents, depression, psychiatric family history, bullying, abuse, and age were associated with suicidal ideation among younger children. An important future direction will be to replicate these findings in other geographic locations where children seek emergency medical care for behavioral health conditions and to find ways to address the growing mental health needs of children before they resort to emergency care.

  View details for DOI 10.1097/PEC.0000000000003401

  View details for PubMedID 40304417

• Derived cannabinoid product availability among online vape shops. Preventive medicine reports Satybaldiyeva, N., Harati, R., Mejorado, T., Morales, N., Benitez, G., Ellis, S. E., Ferran, K., Leas, E. C. 2024; 48: 102910

  Abstract

  To determine the proportion of online vape shops that offer derived cannabinoid products in a large metropolitan area (San Diego, California), measure their compliance with state hemp regulations, and estimate whether these shops receive more website traffic compared to those that offered nicotine or tobacco.We obtained vape shops (n = 109) using browser-based (i.e., Google Search) and map-based (i.e., Google Maps and Yelp) searches in San Diego from March to August 2023 and conducted a content analysis of their websites to identify derived cannabinoid products offered for mail-order purchasing. Using website traffic data, we examined the association between derived cannabinoid product availability and monthly website visits.Among the 109 online vape shops in the study sample, 35.8 % offered derived cannabinoid products for mail-order purchase and 26.6 % sold flavored (excluding terpenes) and inhalable cannabinoid products. Compared to vape shops that did not offer derived cannabinoid products (Mean: 23,619; 95 % CI: 23,605-23,634), those offering flavored and inhalable cannabinoid products received 2.5 times more monthly website visits (Mean: 57,950; 95 % CI: 57,913-57,986) and those offering any derived cannabinoid products received 5.5 times more monthly website visits (Mean: 130,694; 95 % CI: 130,607-130,782).The prevalence of flavored and inhalable derived cannabinoid products, despite being prohibited under California's hemp regulations, highlights the need for additional enforcement measures to ensure retailer compliance. The higher website traffic observed among vape shops offering cannabinoid products may be indicative of greater popularity of retailers selling derived cannabinoid products compared to those selling nicotine or tobacco products alone.

  View details for DOI 10.1016/j.pmedr.2024.102910

  View details for PubMedID 39526213

  View details for PubMedCentralID PMC11541839

• Emergency care utilization in persons with substance related diagnoses. Addictive behaviors reports Kepner, W., Courchesne-Krak, N. S., Satybaldiyeva, N., Narasimhan, R., Marienfeld, C. B. 2024; 20: 100573

  Abstract

  Substance use is a significant contributor to emergency department (ED) visits. Little is known about ED utilization patterns of individuals with substance related diagnosis (SRD). We used electronic health records (EHR) from a large healthcare system in California to examine ED healthcare utilization and socio-demographic characteristics of individuals with SRDs.We used EHR data on all adult patients in our health system from April 2012 through September 2019 to conduct adjusted logistic regression models to determine socio-demographic correlates of SRDs (e.g., use, misuse, dependence) and associations between having an SRD and receiving emergency care.Among the sample (n = 342,651), the majority were female (55.08 %), Non-Hispanic White (58.10 %), with mean age of 48.26 (SD = 18.10), and there were 18,015 (5.26 %) individuals with an SRD. Patients with an alcohol-related diagnosis had the highest odds of visiting the ED (aOR = 3.75), followed by those with opioid (aOR = 3.57) and stimulant-related diagnoses (aOR = 3.48). Individuals with an SRD were more likely to identify as male, Black/African American, Hispanic/Latinx, have no health insurance, and have a serious mental illness. In the adjusted model, those with an SRD were significantly more likely to have ever received emergency care (aOR 3.72 [95 % CI 3.62-3.84]) than those without an SRD.Our study found an association between having an SRD and utilizing emergency health services. Demographic characteristics suggest disparities exist for those with SRDs around gender, race/ethnicity, insurance status, and mental health. These data can help with screening and targeted responses to prevent or provide emergency care.

  View details for DOI 10.1016/j.abrep.2024.100573

  View details for PubMedID 39687706

  View details for PubMedCentralID PMC11647655

• Online Retailer Nonadherence to Age Verification, Shipping, and Flavor Restrictions on E-Cigarettes. JAMA Harati, R. M., Ellis, S. E., Satybaldiyeva, N., Mejorado, T., Benitez, G., Henriksen, L., Leas, E. C. 2024

  View details for DOI 10.1001/jama.2024.21597

  View details for PubMedID 39527068

• Switching people who smoke to unfiltered cigarettes: Effects on smoking topography ADDICTIVE BEHAVIORS REPORTS Romero, D. R., Appolon, G., Novotny, T. E., Pulvers, K., Tracy, L., Satybaldiyeva, N., Magraner, J., Oren, E. 2024; 19: 100548

  Abstract

  Smoking topography (ST) describes smoking behavior and patterns. Removal of the cigarette filter and subsequent impact on ST has not been investigated. This is the first clinical trial comparing ST for filtered and unfiltered cigarettes in a naturalistic experiment.We conducted a crossover clinical trial following established people who smoke cigarettes (n = 32) for two weeks under filtered and unfiltered smoking experimental conditions. Participants (50 % female, mean age 38.3 yr.) smoked in each experimental condition followed by a 3-week post-washout period. ST (puff count, volume, duration, peak and average flow) was measured at six time-points. Statistical analysis included a linear repeated mixed-effects model of smoking experimental conditions by visit number and sex.Average flow (ml/sec) was significantly less for filtered smoking (-6.92 lower (95 % CI: -13.44 to -0.39), p < 0.05), thus demonstrating more resistance on inhalation. No significant differences were found between filtered or unfiltered experimental conditions for other ST variables. However, average volume and average peak flow were somewhat higher in unfiltered smoking, and lower mean puff counts/cigarette were observed for unfiltered compared to filtered smoking.Lower average flow rates were associated with filtered cigarette smoking. No significant differences were found for other ST variables between smoking experimental conditions. ST measurements comparing cigarette smoking conditions may determine if product regulatory changes, such as removing the cigarette filter could impact smoking behavioral patterns among people who smoke. This proof-of-principle study measuring ST may be replicated in larger trials to determine potential behavioral changes in smoking unfiltered cigarettes.

  View details for DOI 10.1016/j.abrep.2024.100548

  View details for Web of Science ID 001335796500001

  View details for PubMedID 38706887

  View details for PubMedCentralID PMC11066995