Factors Associated With E-Cigarette Quitting Behavior Among Adolescents in the United States: A Prospective Observational Study

Abstract

PurposeThis prospective observational study examined the association of socioecological factors with quitting behavior among US adolescents who exclusively use electronic cigarettes (e-cigarettes). MethodsWe used data from past 30-day adolescent exclusive e-cigarette users (n = 243) participating in Wave 3 of the Population Assessment of Tobacco and Health study, who were then followed-up with approximately 12 months later for Wave 4. Weighted unadjusted and adjusted multivariate logistic regression models and structural equation modeling were performed to analyze the data. ResultsAdolescents were significantly less likely to quit e-cigarettes if they perceived that nicotine in e-cigarettes was “slightly/somewhat harmful” to health (adjusted odds ratio [aOR] = 0.38; 95% confidence interval [CI]: 0.16–0.90, p = .02). Similarly, adolescents who reported that someone else in their home owned an e-cigarette (aOR = 0.43 [95% CI: 0.19–0.94], p = .03) or important people in their life used e-cigarettes (aOR = 0.45 [95% CI: 0.21–0.95], p = .03) were significantly less likely to quit e-cigarettes. The structural equation modeling showed a direct significant relationship of individual-level (b = 0.206, p = .02) and interpersonal-level factors (b = 0.170, p = .04) with e-cigarette quitting behavior. DiscussionOur findings suggest that individual-level (harm perception) and interpersonal-level (e-cigarette use at home and by important people) factors may play a significant role in e-cigarette quitting behavior among US adolescents.