Abstract
Despite the harmful effect on health, e-cigarette and hookah smoking in youth in the U.S. has increased. Developing tailored e-cigarette and hookah cessation programs for youth is imperative. The aim of this study was to identify predictor variables such as social, mental, and environmental determinants that cause nicotine addiction in youth e-cigarette or hookah users and build nicotine addiction prediction models using machine learning algorithms. A total of 6511 participants were identified as ever having used e-cigarettes or hookah from the National Youth Tobacco Survey (2019) datasets. Prediction models were built by Random Forest with ReliefF and Least Absolute Shrinkage and Selection Operator (LASSO). ReliefF identified important predictor variables, and the Davies–Bouldin clustering evaluation index selected the optimal number of predictors for Random Forest. A total of 193 predictor variables were included in the final analysis. Performance of prediction models was measured by Root Mean Square Error (RMSE) and Confusion Matrix. The results suggested high performance of prediction. Identified predictor variables were aligned with previous research. The noble predictors found, such as ‘witnessed e-cigarette use in their household’ and ‘perception of their tobacco use’, could be used in public awareness or targeted e-cigarette and hookah youth education and for policymakers.
Highlights
Electronic cigarette (e-cigarette) use in youth in the U.S has increased rapidly in the past ten years
We identified predictor variables and built the nicotine addiction prediction models using machine learning algorithms for youth e-cigarette or hookah users
The models built by Least Absolute Shrinkage and Selection Operator (LASSO) and Random Forest (RF) with ReliefF show high predictive performance
Summary
Electronic cigarette (e-cigarette) use in youth in the U.S has increased rapidly in the past ten years. A survey conducted between 2014 and 2018 showed the rate of e-cigarette use in young adults (18–24 years) to be 7.6%; this is interpreted as approximately one in five adolescents currently using e-cigarettes [3,4]. These numbers are truly alarming and tend to be higher in the state-level surveys. The earlier people start nicotine use, the harder it is to quit later in life This is especially true for e-cigarette users under the age of 25 as their brains and nervous systems are not fully developed and are more vulnerable to nicotine addiction [9]. Recent studies have shown that in addition to highly toxic nicotine, vaping products contain carcinogens, heavy metals, and other harmful substances [10]
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