Abstract
ObjectivesEvaluate trends from 2011–2015 in electronic cigarette (e-cigarette) use among U.S. adolescents, grades 6–12, including prevalence and associations with past month use of cigarettes and other tobacco products, cigarette smoking intensity, quit attempts, and quit contemplation.MethodsFive consecutive waves from the National Youth Tobacco Survey (N = 101,011) were used to estimate the grade- and race/ethnicity-standardized prevalence of past month use of e-cigarettes and nine non e-cigarette tobacco products. We assessed linear trends by year and compared outcomes (e.g., tobacco use, smoking intensity) by e-cigarette past month use.ResultsPast month e-cigarette use rose sharply from 2011–2015. In all years and both sexes, e-cigarette past month use and ever use were positively associated with use of cigarettes and other tobacco products, with past month e-cigarette use reaching 52% in 2015 among individuals who used ≥1 non e-cigarette tobacco product in the past month. Meanwhile, from 2011–2015, the population of adolescent past month e-cigarette users increasingly encompassed adolescents who were not past month users of other products (females: 19.0% to 41.7%; males: 11.1% to 36.7%) or had never used other products (females: 7.1% to 13.5%; males: 6.7% to 15.0%). Among male (but not female) past month cigarette users, there was a statistically significant positive association between past month e-cigarette use and daily cigarette smoking but not in all individual years. Past month e-cigarette use among past month cigarette smokers was not associated with cigarette quit attempts or quit contemplation, with no temporal trend.ConclusionAdolescent past month e-cigarette use is associated with past month use of other tobacco but not with cigarette quit attempts or quit contemplation among cigarette users. Over five years, the average characteristics of U.S. adolescents who use e-cigarettes have shifted, increasingly including more adolescents who do not use non e-cigarette tobacco products.
Highlights
In all years and both sexes, e-cigarette past month use and ever use were positively associated with use of cigarettes and other tobacco products, with past month e-cigarette use reaching 52% in 2015 among individuals who used !1 non e-cigarette tobacco product in the past month
Among the unknown public health implications of the expanding popularity of electronic cigarettes (e-cigarettes) are potential influences on adolescents’ use of conventional and emerging tobacco products, with possibilities ranging from displacement to catalysis of tobacco product use [1,2]
We examined secular trends related to e-cigarette ever and past month use over five annual National Youth Tobacco Survey (NYTS) waves from 2011–2015
Summary
Among the unknown public health implications of the expanding popularity of electronic cigarettes (e-cigarettes) are potential influences on adolescents’ use of conventional and emerging tobacco products, with possibilities ranging from displacement to catalysis of tobacco product use [1,2]. That e-cigarettes will reduce population-wide morbidity and mortality as a less harmful alternative to combustible tobacco is plausible but uncertain [3], and at least partly depends on the extent of e-cigarette uptake by adolescents who would not otherwise smoke cigarettes [4]. Concerns regarding adolescent e-cigarette use include exposure to potentially harmful toxins, renormalization of smoking behavior, nicotine dependence, and subsequent initiation and long-term use of cigarettes and other tobacco products [10,11,12]. Effective August 2016, the Food and Drug Administration finalized a rule deeming the agency’s authority to regulate e-cigarettes and other tobacco products in the United States [13]
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