Abstract
IntroductionAlthough adolescent cigarette use continues to decline in the United States, electronic cigarette (e‑cigarette) use among adolescents has escalated rapidly. This study assessed trends and patterns of e‑cigarette use and concurrent cigarette smoking and the relationships between e-cigarette use and smoking cessation intentions and behaviors among high school students in North Carolina.MethodsData came from high school students who completed the school-based, cross-sectional North Carolina Youth Tobacco Survey in 2011 (n = 4,791) and 2013 (n = 4,092). This study assessed changes in prevalence of e-cigarette and cigarette use from 2011 through 2013, and cessation-related factors associated with those students’ current and past use of e‑cigarettes in 2013.ResultsThe prevalence of current e-cigarette use (use in the past 30 days) significantly increased from 1.7% (95% CI, 1.3%–2.2%) in 2011 to 7.7% (95% CI, 5.9%–10.0%) in 2013. Among dual users, current e-cigarette use was negatively associated with intention to quit cigarette smoking for good (relative risk ratio [RRR] = 0.51; 95% CI, 0.29–0.87) and with attempts to quit cigarette smoking in the past 12 months (RRR = 0.69; 95% CI, 0.49–0.97). Current e-cigarette smokers were less likely than those who only smoked cigarettes to have ever abstained from cigarette smoking for 6 months (RRR = 0.42; 95% CI, 0.21–0.82) or 1 year (RRR = 0.21; 95% CI, 0.09–0.51) and to have used any kind of aids for smoking cessation (RRR = 0.46; 95% CI, 0.29–0.74).ConclusionPublic health practitioners and cessation clinic service providers should educate adolescents about the risks of using any nicotine-containing products, including e-cigarettes, and provide adequate tobacco cessation resources and counseling to adolescent tobacco users.
Highlights
Adolescent cigarette use continues to decline in the United States, electronic cigarette (e-cigarette) use among adolescents has escalated rapidly
Our study consisted of public high school students only because adolescents of high school age are more vulnerable than younger adolescents to experimenting with risky behaviors, including dual use of cigarette and e-cigarettes, The Centers for Disease Control and Prevention funded and approved the North Carolina Youth Tobacco Survey (NCYTS), which is conducted to evaluate state tobacco control efforts
Participants in the current study were 4,791 students from 90 high schools who participated in the 2011 NCYTS and 4,092 students from 83 high schools who participated in the 2013 NCYTS
Summary
Adolescent cigarette use continues to decline in the United States, electronic cigarette (e-cigarette) use among adolescents has escalated rapidly. Electronic cigarettes (e-cigarettes) are devices that aerosolize liquid that contains nicotine, humectants, and flavoring agents and mimic the experience of cigarette smoking. These devices are being aggressively marketed as smoking cessation aids and as healthy alternatives to cigarette smoking [1,2]. Unlike adults’ reasons for using e-cigarettes, adolescents’ top reason is not a desire to reduce cigarette smoking [6,7,8,9,10]; for adolescents, curiosity, appealing flavors, and peer influences rank as higher reasons [3].
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