Causal effect estimates of online e-cigarette marketing exposure on future e-cigarette harm perception and use.

Electronic cigarette use among sexual minority and heterosexual young adults in a U.S. national sample: Exploring the modifying effects of advertisement exposure

Social media has a large amount of e-cigarette content. Little is known about the associations between social media use and a wide range of e-cigarette use behaviors, including susceptibility, initiation, and continued use. We analyzed national data on US adolescents to assess these associations. We used data on adolescents participating in the Population Assessment of Tobacco and Health (PATH) Study Wave 4 (2016-2018) and Wave 5 (2018-2019). We conducted 2 models: 1) a multinomial logistic regression on e-cigarette use susceptibility and use behaviors at Wave 5 by social media use at Wave 4 among adolescents who never used e-cigarettes at Wave 4 and 2) a binomial logistic regression on current e-cigarette use at Wave 5 by social media use at Wave 4 among adolescents who ever used e-cigarettes at Wave 4. Among adolescents who never used e-cigarettes at Wave 4 (n = 7,872), daily social media use (vs never) was associated with a higher likelihood of being susceptible to e-cigarette use (adjusted odds ratio [aOR] =1.46; 95% CI, 1.20-1.78), past e-cigarette use (aOR = 3.55; 95% CI, 2.49-5.06), and current e-cigarette use (aOR = 3.45; 95% CI, 2.38-5.02) at Wave 5. Among adolescents who ever used e-cigarettes at Wave 4 (n = 794), we found no significant association between social media use at Wave 4 and continued e-cigarette use at Wave 5. Our study found that social media use is associated with subsequent susceptibility to e-cigarette use and initiation but not with continued use of e-cigarettes among US adolescents. These findings suggest that understanding and addressing the association between social media and e-cigarette use is critical.

Research has demonstrated associations between e-cigarette use and tobacco use among youth. However, few studies have examined whether reciprocal relationships exist between e-cigarette and tobacco use. The objective of this study was to examine whether bi-directional associations exist between e-cigarette and tobacco use in a large longitudinal sample of Canadian youth. A longitudinal sample of secondary students (n = 6729) attending 87 schools in Ontario and Alberta, Canada, who completed the COMPASS student questionnaire across three waves (from 2014–2015 to 2016–2017) was identified. Using cross-lagged models, we explored bi-directional associations between current tobacco and e-cigarette use, adjusting for relevant covariates. Our findings showed that current e-cigarette use predicted subsequent tobacco use between Wave 1 (W1) and Wave 2 (W2) of the study (W1–2: OR = 1.54, 95% CI = 1.37–1.74). Similarly, current tobacco use predicted e-cigarette use during earlier waves of the study (W1–2: OR = 1.43, 95% CI = 1.30–1.58). However, these relationships dissipated in later waves, when tobacco use no longer predicted e-cigarette use (W2–3: OR = 1.07, 95% CI = 0.99–1.16). This study extends prior work that focused mainly on the association between e-cigarette and subsequent tobacco use. Specifically, our findings portray a more complex relationship, where e-cigarette use may influence and be influenced by tobacco use.

High International Electronic Cigarette Use Among Never Smoker Adolescents

Rationale: Electronic cigarette (e-cigarette) use is highly prevalent among young adults. However, longitudinal data assessing the association between e-cigarette use and respiratory symptoms are lacking. Objectives: To determine whether e-cigarette use is associated with the development of respiratory symptoms in young adults. Methods: Data are derived from the PATH (Population Assessment of Tobacco and Health) study waves 2 (2014-2015), 3 (2015-2016), 4 (2016-2018), and 5 (2018-2019). Young adults aged 18-24 years at baseline with no prevalent respiratory disease or symptoms were included in the analyses. Binary logistic regression models with a generalized estimating equation were used to estimate time-varying and time-lagged associations of e-cigarette use during waves 2-4, with respiratory symptom development approximately 12 months later at waves 3-5. Measurements and Main Results: The per-wave prevalence of former and current e-cigarette use was 15.2% and 5.6%, respectively. Former e-cigarette use was associated with higher odds of developing any respiratory symptom (adjusted odds ratio [aOR], 1.20; 95% confidence interval [CI], 1.04-1.39) and wheezing in the chest (aOR, 1.41; 95% CI, 1.08-1.83) in multivariable adjusted models. Current e-cigarette use was associated with higher odds for any respiratory symptom (aOR, 1.32; 95% CI, 1.06-1.65) and wheezing in the chest (aOR, 1.51; 95% CI, 1.06-2.14). Associations persisted among participants who never smoked combustible cigarettes. Conclusions: In this nationally representative cohort of young adults, former and current e-cigarette use was associated with higher odds of developing wheezing-related respiratory symptoms, after accounting for cigarette smoking and other combustible tobacco product use.

BackgroundSocial media may influence children and young people’s health behaviour, including cigarette and e-cigarette use.MethodsWe analysed data from participants aged 10–25 years in the UK Household Longitudinal Study 2015–2021. The...

BackgroundLimited information exist on tobacco and e-cigarette use patterns in cancer survivors. The purpose of this study is to report on use patterns in cancer survivors compared with non-cancer participants from the Population Assessment of Tobacco and Health (PATH) Study.MethodsSociodemographic data and tobacco product use were analyzed for 32,244 adult participants from the PATH Study in 2013–2014 by cancer status and age. Logistic regression examined the patterns of and factors associated with tobacco use by cancer status.ResultsOverall, cancer survivors represented 7.1% (n = 1,527) of participants, were older, and had a higher proportion of females and non-Hispanic whites than non-cancer participants. In cancer survivors, current and former cigarette smoking was reported in 12.7% and 32.9% respectively, compared with 18.5% and 19.0% in non-cancer adults. Current e-cigarette use was reported by 3.8% of survivors compared with 5.7% of non-cancer participants. Dual tobacco use was reported by 25.0% and poly use by 6.9% of cancer survivors who currently smoked. All other forms of current tobacco use were individually reported by <5% of survivors. Young adult cancer survivors (aged 18–44) reported the highest rates of current cigarette smoking (27.9%) and current e-cigarette use (11.8%). The effects of age, sex, race/ethnicity, education, and income on tobacco use status were comparable for cancer survivors and non-cancer participants. Cancer survivors who were younger, male, of lower educational attainment, and those diagnosed with a tobacco-related cancer were more likely to report current tobacco use.ConclusionsAmong cancer survivors, cigarette smoking remains the predominant form of tobacco use, although other tobacco/nicotine use and dual/poly use are common. The PATH Study provides detailed tobacco product use patterns in survivors, including their adoption of emerging alternative tobacco products.

Associations of social media use with smoking and e-cigarettes: a national longitudinal study

Youth Social Media Use and Health Outcomes: #diggingdeeper

Extensive social media use and frequency of current e-cigarette use among US youth

To what extent does time spent on social media influence adolescent use of cigarettes and e-cigarettes: a longitudinal analysis of the UK Millennium Cohort Study

This study aimed to examine the relationship between social media use, e-health literacy, and the risk and benefit perceptions of e-cigarettes among college students in Taiwan. A cross-sectional online survey was conducted with 1,571 Taiwanese college students, which included four questionnaires to assess participants' perceptions, social media use behavior, e-health literacy, and sociodemographic factors. The data were presented in terms of means, standard deviations, and percentages. Stepwise regression was used to identify factors associated with the participants' perceptions. The study found that 75.01% of the participants were exposed to e-cigarette information on social media, with 31.26% actively searching for it and 15.95% sharing it. Participants had a high e-cigarette risk perception, indicating low benefit perception, but acceptable e-health literacy. Factors such as current e-cigarette and tobacco use, e-health literacy, academic achievement, and sex significantly predicted e-cigarette risk perception, while sharing e-cigarette related information, sex, age, academic achievement, and current e-cigarette use significantly predicted its benefit perception. Thus, implementing effective e-health literacy programs to enhance college students' e-cigarette risk perception is recommended along with a proactive approach to tackle e-cigarette advertising messages on social media, minimizing their sharing behavior to decrease their perception of associated benefits.

Marijuana use modifies the association between heavy alcohol consumption and tobacco use patterns among US adults: Findings from Behavioral Risk Factor Surveillance System, 2020

Social media use and cannabis vaping initiation among US youth

FigureElectronic cigarettes, or e-cigarettes, are battery-powered devices that provide doses of nicotine and other additives to the user in an aerosol. Depending on the brand, e-cigarette cartridges typically contain nicotine, a component to produce the aerosol (e.g., propylene glycol or glycerol), and flavorings (e.g., fruit, mint, or chocolate).1 Potentially harmful constituents also have been documented in some e-cigarette cartridges, including irritants, genotoxins, and animal carcinogens.1 E-cigarettes that are not marketed for therapeutic purposes are currently unregulated by the Food and Drug Administration, and in most states there are no restrictions on the sale of e-cigarettes to minors. Use of e-cigarettes has increased among U.S. adult current and former smokers in recent years,2 but the extent of use among youths is uncertain. Data from the 2011 and 2012 National Youth Tobacco Survey (NYTS), a school-based, pencil-and-paper questionnaire given to U.S. middle school (grades 6–8) and high school (grades 9–12) students, were used to estimate the prevalence of ever and current (one or more per day in the past 30 days) use of e-cigarettes, ever and current (one or more per day in the past 30 days) use of conventional cigarettes, and use of both. The survey consists of a cross-sectional, nationally representative sample of students in grades 6–12 from all 50 states and the District of Columbia.3 During 2011–2012, among all students in grades 6–12, “ever” e-cigarette use increased from 3.3 to 6.8 percent (p<0.05); current e-cigarette use increased from 1.1 to 2.1 percent (p<0.05); and current use of both e-cigarettes and conventional cigarettes increased from 0.8 to 1.6 percent (p<0.05). In 2012, among ever e-cigarette users, 9.3 percent reported never smoking conventional cigarettes; among current e-cigarette users, 76.3 percent reported current conventional cigarette smoking.Figure: Ever electronic cigarette (e-cigarette) use among middle and high school students, by year, in the United States during 2011–2012. During that time, among all students in grades 6–12, ever e-cigarette use increased from 3.3% to 6.8%; current e-cigarette use increased from 1.1% to 2.1%, and current use of both e-cigarettes and conventional cigarettes increased from 0.8% to 1.6%.Among middle school students, ever e-cigarette use increased from 1.4 to 2.7 percent during 2011–2012 (p<0.05); current e-cigarette use increased from 0.6 to 1.1 percent (p<0.05); and current use of both e-cigarettes and conventional cigarettes increased from 0.3 to 0.7 percent (p<0.05). In 2012, among middle school ever e-cigarette users, 20.3 percent reported never smoking conventional cigarettes; among middle school current e-cigarette users, 61.1 percent reported current conventional cigarette smoking. Among high school students, ever e-cigarette use increased from 4.7 to 10.0 percent during 2011–2012 (p<0.05); current e-cigarette use increased from 1.5 to 2.8 percent (p<0.05); and current use of both e-cigarettes and conventional cigarettes increased from 1.2 to 2.2 percent (p<0.05). In 2012, among high school ever e-cigarette users, 7.2 percent reported never smoking conventional cigarettes; among high school current e-cigarette users, 80.5 percent reported current conventional cigarette smoking. Use Doubled E-cigarette experimentation and recent use doubled among U.S. middle and high school students during 2011–2012, resulting in an estimated 1.78 million students having ever used e-cigarettes as of 2012. Moreover, in 2012, an estimated 160,000 students who reported ever using e-cigarettes had never used conventional cigarettes. This is a serious concern because the overall impact of e-cigarette use on public health remains uncertain. In youths, concerns include the potential negative impact of nicotine on adolescent brain development,4 as well as the risk for nicotine addiction and initiation of the use of conventional cigarettes or other tobacco products. CDC and the Food and Drug Administration will continue to explore ways to increase surveillance and research on e-cigarettes. Given the rapid increase in use and youths' susceptibility to social and environmental influences to use tobacco, developing strategies to prevent marketing, sales, and use of e-cigarettes among youths is critical. Reprinted (slightly edited) from Morbidity and Mortality Weekly Report 2013; 62:729–730