Odds Of E-cigarette Use Research Articles

Minority stress mediates associations of sexual minority state policies and tobacco use among US sexual minority young adults

IntroductionState policies surrounding sexual minority (SM) rights are associated with tobacco use among SM individuals. Research is scant regarding the role of distinct SM policy categories on SM young adults’ (SMYAs) tobacco use and mechanisms explaining these associations. MethodsWe analyzed 2023 survey data from 1100 SMYAs (ages 18–34; 14.2 % gender minority; 66.1 % bisexual+, 29.1 % monosexual; 53.2 % racial/ethnic minority) with representation across 45 US states and DC. Regression-based models examined: 1) direct associations of residing in states with negative and limited (vs. comprehensive) SM state policies with respect to 7 policy categories (relationship/parent recognition, nondiscrimination, religious exemptions, LGBTQ youth, healthcare, criminal justice, gender identity documents) with minority stress (mental health, internalized stigma, community connectedness); 2) direct associations of policy categories and minority stress with tobacco use (past-month cigarette, e-cigarette, any tobacco use, number of products used); and 3) indirect associations of policy categories with tobacco use through minority stress. ResultsRelative to residing in states with comprehensive policies, residing in states with limited relationship/parent recognition policies indirectly predicted higher odds of e-cigarette use through mental health; weaker nondiscrimination policies indirectly predicted using more tobacco products through internalized stigma; and negative healthcare policies indirectly predicted higher odds of cigarette and any tobacco use through community connectedness. ConclusionsThese novel findings regarding associations among distinct SM policy categories, minority stress mediators, and tobacco use outcomes warrant further examination to better understand these distinct mechanisms, ultimately to inform SM-related policy and advocacy efforts, as well as tobacco prevention and cessation efforts.

Prevalence, demographic, socio-economic, and lifestyle factors associated with cigarette, e-cigarette, and dual use: evidence from the 2017-2021 Scottish Health Survey.

Understanding the correlation between demographic, socio-economic, and lifestyle factors with e-cigarette use, cigarette smoking, and dual use is essential for targeted public health interventions. This study examines the prevalence of these behaviors in Scotland and identifies the associated factors. We conducted a repeated cross-sectional analysis of the Scottish Health Survey data from 2017 to 2021, leveraging data from 12,644 participants aged 16 and older: 2271 cigarette smokers, 687 e-cigarette users, 428 dual users, and 9258 never users. Weighted prevalences were calculated by age group, sex, and survey year, followed by weighted multinomial logistic regression to explore associated factors. The overall prevalences were 72.0% (95% CI 70.9-73.1) for never users, 18.9% (95% CI 17.9-19.9) for cigarette smokers, 5.5% (95% CI 5.0-6.1) for e-cigarette users, and 3.6% (95% CI 3.2-4.0) for dual users. From 2017 to 2021, cigarette smoking declined from 21.7% (95% CI 19.6-23.9) to 13.1% (95% CI 11.5-15.0), e-cigarette use from 6.5% (95% CI 5.4-7.8) to 4.8% (95% CI 3.6-6.4), and dual use from 3.7% (95% CI 2.9-4.6) to 2.7% (95% CI 1.9-3.7). Age was a critical factor, with the 25-34 age group more likely to use e-cigarettes (p = 0.007) and the 35-44 age group more likely to engage in dual use (p = 0.006) compared to the 16-24 age group. Males had higher odds of e-cigarette use than females (p = 0.031). White individuals had higher odds of using e-cigarettes (p = 0.023) and being dual users (p = 0.017) compared to non-whites. Previously married individuals had higher odds of dual use than singles (p = 0.031). Larger household sizes were linked to reduced odds of all three behaviors (p = 0.001). Rural residents were less likely to use e-cigarettes compared to urban residents (p = 0.025). Higher education correlated with lower odds of all three behaviors (p = 0.001). Manual occupation increased the likelihood of dual use (p = 0.042). Lower income and higher deprivation significantly increased the odds of all three behaviors (p < 0.001). Excessive alcohol consumption was associated with increased odds of the three behaviors (p < 0.001). Poor sleep quality correlated with increased odds of dual use (p = 0.002) and cigarette smoking (p < 0.001). Adherence to physical activity guidelines was associated with reduced odds of all three behaviors (cigarette smoking p < 0.001, e-cigarette use p = 0.031, dual use p = 0.016). In conclusion, this study showed a decline in the prevalence of cigarette smoking, e-cigarette use, and dual usage from 2017 to 2021 in Scotland. Significant associations with demographic, socio-economic, and lifestyle factors highlight the need for targeted public health interventions.

Individual, parent, and school factors associated with e-cigarette use among Asian adolescents

ABSTRACT Objective E-cigarette use has become the predominant method of nicotine consumption among U.S. youth, posing significant public health implications. The current study addresses the scarce research on e-cigarette use among Asian American adolescents, a demographic group that has remained comparatively understudied. Methods Leveraging data from the 2019–2020 Student Drug Use survey, the cross-sectional study investigates the interplay between e-cigarette use and psychosocial determinants among Asian American adolescents in the metropolitan area. Results Results indicate an 8.0% prevalence of e-cigarette use in the past year, with notable variations based on grade level and risk behaviors. Psychosocial factors such as low parental influence [OR = 1.88, 95% CI (1.35,2.61)], engagement in low prosocial activities [OR = 1.78, 95% CI (1.30, 2.44)], and high-risk behaviors [OR = 25.34, 95% CI (15.39,41.71)] correlate significantly with increased odds of e-cigarette use. Logistic regression analysis reinforces these associations, emphasizing the impact of risky behavior and ease of access on e-cigarette usage. Conclusion The study informs targeted interventions at various levels, including schools, policy, community engagement, and cultural competency training, to address the escalating prevalence of e-cigarette use among Asian American adolescents.

Examining the correlates of cigarette smoking, e-cigarette use and dual use among Canadian post-secondary students.

Many Canadians use nicotine products such as cigarettes and e-cigarettes. A particular subpopulation of concern is post-secondary students given they have a higher prevalence of use. Many correlates of cigarette smoking and e-cigarette use have been identified. However, less focus has been on examining the correlates of cigarette smoking, e-cigarette use and dual use. This study explores the correlates of different nicotine modality use in post-secondary students. Using data from the Canadian Campus Wellbeing Survey (CCWS; n = 27,164), a multi-level nominal regression assessed the correlates of nicotine modality use. In comparison to individuals who were <20, individuals 20-24 (OR = .448, 95% CI .321, .625), 25-29 (OR = .140, 95% CI .093, .212), 30-34 (OR = .076, 95% CI .046, .125) and over 35 (OR = .041, 95% CI .024, .071) had lower odds of e-cigarette use compared to cigarette smoking. Identifying as a woman (OR = 1.553, 95% CI 1.202, 2.006), non-heterosexual (OR = .642, 95% CI = .485,0.851), current cannabis user (OR = 1.651, 95% CI 1.296, 2.104), and being an international student (OR = .350, 95% CI .251, .487) also impacted the odds of e-cigarette use vs only cigarette smoking. When considering dual use vs cigarette smoking, individuals aged 20-24 (OR = .491, 95% CI .337, .717), 25-29 (OR = .221, 95% CI .137, .357), 30-34 (OR = .163, 95% CI .091, .292) and over 35 (OR = .122, 95% CI .065, .230) had lower odds than individuals <20. Current cannabis use (OR = 1.680, 95% CI = 1.209, 2.138), binge drinking (OR = 1.885, 95% CI 1.384, 2.568), and international student status (OR = .689, 95% CI .476, .996) also impacted cigarette smoking vs dual-use. Overall, a minority of young adults (11.5%) at post-secondary institutions in our sample use nicotine products, and the higher prevalence of e-cigarette use warrants continued monitoring. Health promotion campaigns addressing e-cigarette use are required. Additionally, tailored intervention efforts could prioritize the treatment needs of international students studying in Canada.

Cross-sectional study of the associations between the implementation of the WHO FCTC tobacco advertising, promotion and sponsorship bans and current e-cigarette use among youth from countries with different income levels

BackgroundThe WHO Framework Convention on Tobacco Control (WHO FCTC) Article 13 requires countries to ban tobacco advertising, promotion and sponsorship (TAPS), and bans are recommended to cover electronic cigarettes (e-cigarettes)....

Social media and e-cigarette use: The mediating role of mental health conditions

BackgroundIn recent years, youth social media use, youth e-cigarette use, and youth mental health conditions have become major public health concerns. We examined the role of mental health condition indicators in the link between youth social media use and e-cigarette use. MethodsWe used data from the 2022 National Youth Tobacco Survey (N = 23,445) to measure social media use by time spent, anxiety and depression symptoms by the Patient Health Questionnaire-4, and past-30-day e-cigarette use. We applied the potential outcomes framework to examine the relationship between social media use and e-cigarette use mediated by mental health condition indicators. ResultsMental health condition indicators mediated the relationship between social media use and e-cigarette use in a dose-response manner, with higher levels of social media use associated with higher odds of e-cigarette use. With mental health condition indicators as a mediator, those who used social media for 4+ hours/day or 3–4 h/day had significantly higher odds of e-cigarette use than those who used social media sometimes or never. In the sex-stratified analysis, we found that very often social media use was associated with higher odds of e-cigarette use for both males and females, compared to sometimes users (OR = 1.53, 95 % CI [1.18,1.96] for males; OR = 2.27, 95 % CI [1.76,2.92] for females). LimitationsAnxiety and depression symptoms were self-reported. ConclusionsThis study shows that anxiety and depression symptoms mediate the relationship between social media and e-cigarette use among youth and support the growing concern that frequent social media use may negatively affect youth health.

Association between e-cigarette use and asthma among US adolescents: Youth Risk Behavior Surveillance System 2015–2019

BackgroundPrevious studies have suggested that e-cigarette use, which has increased rapidly among US adolescents, may cause respiratory distress. This cross-sectional study aimed to investigate the factors associated with e-cigarette use and the relationship between e-cigarette use and asthma among US adolescents. MethodsData from the Youth Risk Behavior Surveillance System between 2015 and 2019 were analyzed, and multivariable logistic regression was used to identify demographic and behavioral factors associated with e-cigarette use. Stratified analyses were conducted to assess the relationship between e-cigarette use and asthma among adolescents by previous combustible product use. ResultsThis study found that Hispanic adolescents had lower odds of e-cigarette use than White adolescents in Texas, with factors such as age, substance use, and depression being associated with use. In the US, male gender, previous combustible and substance use, and depression were associated with higher odds of ever using e-cigarettes, while current use was associated with several factors including age and White race. E-cigarette use was significantly associated with asthma among adolescents who have never used combustible products in both Texas and the entire US after adjusting for covariates (OR 1.32, 95% CI 1.06–1.66 and OR 1.18, 95% CI 1.02–1.37, respectively). ConclusionThe findings from this study can be used to inform public health strategies and policies aimed at reducing e-cigarette use and its associated health risks among adolescents.

Association between socioecological factors and electronic cigarette use among Thai youth: an institution-based cross-sectional study

ObjectivesThis study aimed to examine cigarette use distribution, pattern of e-cigarette use and to determine socioecological model (SEM) factors associated with e-cigarette use among Thai youth (aged 15–24).DesignAn institution-based cross-sectional...

Asian American adolescent e-cigarette use and associated protective factors: Heterogeneity in a statewide sample

ObjectivesThis study characterized variation in e-cigarette use patterns and related protective factors by ethnicity among Asian American adolescents. MethodsMultivariable logistic regressions modelled associations between ethnic group, 6 protective factors (college aspirations, internal developmental assets, positive teacher engagement, family caring, and peer and parent anti-smoking norms), and past 30-day e-cigarette use, adjusting for covariates among 10,482 8th, 9th, and 11th grade Asian American respondents to the 2019 Minnesota Student Survey. Interaction terms (protective factor × ethnic group) were used in 6 subsequent regression models to examine whether the association between each protective factor and e-cigarette use differed as a function of ethnic group. ResultsRespondents included 9.0% Indian, 0.3% Burmese, 7.9% Chinese, 2.5% Filipino, 25.0% Hmong, 3.2% Karen, 4.6% Korean, 2.7% Laotian, 8.2% Vietnamese, 7.5% other, 7.5% multi-ethnic, and 21.6% multi-racial adolescents. E-cigarettes were the predominant form of tobacco use. Laotian and multi-racial groups reported the highest e-cigarette use (16.6% and 16.3%), whereas Chinese and Asian Indians reported the lowest (4.7% and 5.0%). Strong peer anti-smoking norms, higher internal developmental assets scores, and positive teacher engagement were associated with lower odds of e-cigarette use across groups, with significant interactions for internal developmental assets by ethnicity. ConclusionsE-cigarettes are the most prevalent tobacco product used by Asian adolescents in Minnesota, with notable heterogeneity by ethnicity. While most established protective factors appeared to function similarly for Asian adolescents, others differed, underscoring the importance of disaggregating data by ethnicity to inform the tailoring of prevention and control strategies for these ethnic groups.

Association of cancer information seeking behavior with cigarette smoking and E-cigarette use among U.S. adults by education attainment level: A multi-year cross-sectional analysis from a nationally representative sample in 2017–2020

Little is known about the association of cancer information seeking behavior with cigarette smoking and e-cigarette use. A multi-year cross-sectional analysis using a pooled data of the Health Information National Trends Survey 5, Cycles 1–4 (2017–2020) was conducted. To examine the association of cancer information seeking behavior with current cigarette smoking (currently smoke every day/some days among individuals who smoked 100+ cigarettes in lifetime) and e-cigarette use (currently use every day/some days among lifetime users) in nationally representative U.S. adults, we conducted weighted multiple logistic regression analysis, adjusting for sex, race/ethnicity, age, obese status, depressed mood, cancer diagnosis history, metropolitan status, and survey year. The regression models were stratified by education level (<college and ≥ college). Individuals in 18–25 years old were excluded as they have not likely completed their education. A final analytic sample included 12,430 adults. Cancer information seekers had lower odds of cigarette smoking than non-seekers, but this was observed in only ≥college group (Adjusted odds ratio [AOR] = 0.78, 95% confidence interval [CI] = 0.61, 0.99). Conversely, cancer information seekers had higher odds of e-cigarette use than non-seekers, but this was significant in only <college group (AOR = 2.12, 95% CI = 1.18, 3.83). Cancer information seeking behavior might help to reduce cigarette smoking when seekers had ≥college education. However, cancer information seeking behavior might positively influence e-cigarette use in <college group. A proper/easy-to-understand dissemination of proven cancer information regarding cigarette smoking and e-cigarette use considering the unproven cancer risk of e-cigarette use is recommended for less educated individuals.

A resurgence of e-cigarette use among adolescents and young adults late in the COVID-19 pandemic.

Early in the COVID-19 pandemic, e-cigarette use significantly declined among young people due, in part, to losing access through social sources. As the pandemic progressed, adolescents and young adults gained opportunities to resume contact with peers. This study sought to determine whether e-cigarette use has returned to pre-pandemic levels among adolescents and young adults. Data were drawn from a cross-sectional weekly survey of adolescents (aged 15-17) and young adults (aged 18-24) (N = 37,331). Logistic regression analyses measured odds of past 30-day e-cigarette use among respondents surveyed (a) late in the pandemic (April 2021-April 2022) compared to early in the pandemic (March-July 2020) and (b) late in the pandemic (August-December 2021) compared to prior to the pandemic (August-December 2019). The odds of current e-cigarette use were significantly higher later in the COVID-19 pandemic (April 2021-April 2022), compared to its initial months (March-July 2020) (OR:1.27, 95% CI: 1.17-1.38; p = 0.001). There was no significant difference in the odds of e-cigarette use for youth and younger adults late in the pandemic (August-December 2021) compared to the same time period prior to the pandemic (August-December 2019), but odds were greater for young adults aged 21 years or older (OR:1.16; 95% CI: 1.01-1.32; p = 0.030). E-cigarette use has returned to pre-pandemic levels among adolescents and young adults. Young adults over age 21 are more likely to use e-cigarettes than young adults of the same age surveyed prior to the pandemic. Findings have implications for targeted e-cigarette prevention and cessation efforts.

Physical activity and substance use among Canadian adolescents: Examining the moderating role of school connectedness.

Physical activity may play a role in promoting or preventing substance use among youth. The purpose of this study was to examine the association between different types of physical activity [i.e., non-competitive school sport, competitive school sport, outside of school sport and minutes of moderate to vigorous physical activity (MVPA) per day] and substance use (i.e., current smoking, e-cigarette, cannabis, binge drinking) among Canadian youth. Interaction effects between physical activity and school connectedness were also examined. Using data from the COMPASS study (2018-19; n = 73,672), four multi-level logistic regression models were developed to investigate whether physical activity lessened or worsened the odds of (1) smoking; (2) e-cigarette use; (3) cannabis use; and (4) binge drinking. Models were stratified by gender to reflect the inherent differences between genders. Models were adjusted for demographic factors and other covariates. Sport participation was consistently associated with substance use, whereas less evidence was found for meeting MVPA guidelines. Non-competitive school sport lessened the odds of cannabis use for males and females. However, non-competitive school sport only lessened the odds of e-cigarette use for females but increased the odds of binge drinking for males. Participation in competitive school sport lessened the odds of cigarette smoking but increased the odds of e-cigarette use and binge drinking for males and females. Outside of school sport lessened the odds of cigarette smoking and cannabis use but increased the odds of e-cigarette use and binge drinking for males and females. A significant moderation effect was found for males participating in sport outside of school and meeting MVPA guidelines who were at a lower risk of e-cigarette use in the presence of high levels of school connectedness. Our study provides evidence for further consideration and provision of extracurricular activities, specifically non-competitive sport, in protecting against substance use. Caution is required in claiming that sport participation or physical activity, in general, is negatively associated with substance use among youth.

Association of Smoking and E-Cigarette in Chronic Liver Disease: An NHANES Study.

BackgroundThere is an increased trend of e-cigarette but the toxic effects of e-cigarette metabolites are not widely studied especially in liver disease. Hence, we aimed to evaluate the prevalence and patterns of recent e-cigarette use in a nationally representative sample of US adults and adolescents and its association amongst respondents with liver disease.MethodsWe conducted a retrospective cross-sectional study using National Health and Nutrition Examination Survey (NHANES) database from 2015 to 2018. The self-reported NHANES questionnaire was used to assess liver disease (MCQ160L, MCQ170L and MCQ 510 (a-e)), e-cigarette use (SMQ900) and traditional smoking status (SMQ020 or SMQ040). We conducted univariate analysis and multivariable logistic regression models to predict the association of e-cigarette use, traditional smoking and dual smoking amongst the population with liver disease.ResultsOut of total 178,300 respondents, 7,756 (4.35%) were e-cigarette users, 48,625 (27.27%) traditional smoking, 23,444 (13.15%) dual smoking and 98,475 (55.23%) non-smokers. Females had a higher frequency of e-cigarette use (49.3%) compared to dual (43%) and traditional smoking (40.8%) (P < 0.0001). Respondents with a past history of any liver disease have lower frequency of e-cigarette use compared to dual and traditional smoking, respectively (2.4% vs. 6.4% vs. 7.2%; P < 0.0001). In multivariate logistic regression models, we found that e-cigarette users (odds ratio (OR): 1.06; 95% confidence interval (CI): 1.05 - 1.06; P < 0.0001) and dual smoking (OR: 1.50; 95% CI: 1.50 - 1.51; P < 0.0001) were associated with higher odds of having history of liver disease compared to non-smokers.ConclusionOur study found that despite the low frequency of e-cigarette use in respondents with liver disease, there was higher odds of e-cigarette use amongst patients with liver disease. This warrants the need for more future prospective studies to evaluate the long-term effects and precise mechanisms of e-cigarette toxicants on the liver.

Examining the Survey Setting Effect on Current E-Cigarette Use Estimates among High School Students in the 2021 National Youth Tobacco Survey.

The 2021 National Youth Tobacco Survey (NYTS) was completed by youth online during class time, either in school or at home due to the COVID-19 pandemic. Given the role of NYTS data in tobacco regulatory science, it is vital to understand the effect of survey settings (home, school) on tobacco-use estimates. We used a series of multivariable logistic regressions to examine whether survey settings (home vs. school) predicted current e-cigarette use among high school students, controlling for other known predictors of e-cigarette use as well as the pandemic learning model that was dominant in students’ counties (e.g., nearly all at-home, majority in school). We observed a significant survey setting effect. Those who completed the survey in school had higher odds of current e-cigarette use than those who completed the same survey at home (AOR = 1.74); this effect was attenuated when we controlled for the pandemic learning model (AOR = 1.38). Moreover, e-cigarette use was independently associated with students’ learning model; students whose schools were nearly entirely in-person had the highest odds of e-cigarette use compared to students whose learning model was nearly all at-home (AOR = 1.65). Survey setting is a methodological artifact in the 2021 NYTS. Perceived privacy and peer effects can potentially explain this artifact.

Examining the potential role of e-cigarettes to reduce health disparities associated with menthol cigarette use: Characterizing e-cigarette use, flavors, and reasons for use among US adults smoking menthol cigarettes

IntroductionMenthol cigarette use contributes to disproportionate tobacco-related health disparities amongst minoritized race/ethnic groups. E-cigarettes are available in flavors such as menthol and may be a less harmful substitute among adults who smoke. Yet little is known about e-cigarette flavor preference and reasons for use by race/ethnicity among adults who smoke menthol cigarettes. MethodsNationally representative PATH wave 4 adult data (Dec. 2016-Jan. 2018) were used to examine how menthol cigarette status and race/ethnicity were associated with past 30-day e-cigarette use, flavors used, and reasons for use with adjusted logistic regression models. ResultsMenthol (vs. non-menthol) cigarette use was associated with higher odds of e-cigarette use (AOR=1.33, 95%CI=1.16–1.52). However, non-Hispanic (NH) Black and Hispanic individuals (vs. NH White) had lower odds of e-cigarette use (p’s ≤ 0.004). In terms of flavor used, adults smoking menthol cigarettes and NH Black and Hispanic individuals had greater odds of using menthol/mint-flavored e-cigarettes (p’s ≤ 0.02), and older adults (vs. 18–24-year-olds) had lower odds of using sweet-flavored e-cigarettes (p’s < 0.0001). Regarding reasons for use, adults smoking menthol cigarettes had higher odds of reporting using e-cigarettes due to liking flavors (AOR=1.63, 95%CI=1.30–2.04), while NH Black adults had lower odds of liking flavors (AOR=0.64, 95%CI=0.43–0.96), and Hispanic adults had lower odds of using e-cigarettes to cut down on cigarette smoking (AOR=0.59, 95%CI=0.42–0.83). ConclusionsFindings suggest menthol flavored e-cigarettes may be important for adults who smoke menthol cigarettes, although racial disparities in current e-cigarette use and reasons for use may exacerbate tobacco-related health disparities.

Risk factors for early use of e-cigarettes and alcohol: Dimensions and profiles of temperament.

Adolescent e-cigarette use has been labeled an epidemic and alcohol use during this developmental period is associated with deleterious outcomes. Though specific temperamental dimensions have been shown to predict substance use, profiles of temperament have rarely been examined as predictors. This study examines dimensions and profiles of adolescent temperament as predictors of early use of e-cigarettes and alcohol. The sample was comprised of adolescent (62.07% female, 87.59% White, 82.76% Hispanic/Latinx)/caregiver dyads (N = 146) who completed the first two timepoints (M age at second timepoint = 16.16, SD = 0.68) of a longitudinal adolescent substance use study. Models showed parent-reported effortful control predicted protection against adolescent use of e-cigarettes, whereas adolescent report of effortful control predicted protection against alcohol use. Though dissimilar in temperamental pattern, three profiles emerged from both parent- and adolescent-report-based latent profile analysis models. Adolescents characterized by parents as displaying a Resilient profile had greater odds of e-cigarette use than those characterized by a Reserved profile, whereas adolescents who self-characterized as Mixed-type had markedly greater odds of alcohol use than those who self-characterized as Resilient. Utilization of temperamental profiles may aid in identification of particularly vulnerable subgroups of adolescents who may benefit from relevant preventative programing.

Electronic cigarette use among adolescents and young adults in Nigeria: Prevalence, associated factors and patterns of use.

BackgroundElectronic cigarettes (e-cigarettes) have emerged in the Nigerian market, and if used without supervision, may have damaging effects on the physical and mental health of users. Therefore, there is a need to determine the patterns of use, especially among adolescents and young adults. This study aims to assess the prevalence and factors associated with electronic cigarette use, as well as the relationship between their use and anxiety among adolescents and young adults in Lagos, Nigeria.MethodAn online cross-sectional study among participants aged between 15–35 years. The survey had three sections: sociodemographic information, the pattern of e-cigarette use, and a 7-item Generalized Anxiety Disorder (GAD-7) scale. Bivariate and multivariable logistic regression analysis was used to identify factors associated with e-cigarette use. P-values <0.05 were considered significant. Statistical analysis was done using STATA-15.0 software.ResultsData from a total of 949 respondents was analysed. Participants had a mean age of 23.36 years (±3.97) and were predominantly female (55.64%). The prevalence of e-cigarette ever-use was 7.9% (95% CI: 5.8,10.0). Older age and being male were independently associated with higher odds of e-cigarette use. After adjusting for age and sex, alcohol use (p<0.001), friend’s use (p<0.001), and other tobacco product or substance use (p:0.05) remained significantly associated with higher odds of e-cigarette use. There was no association between anxiety levels and e-cigarette use.ConclusionThese findings suggest a higher likelihood of e-cigarette use among alcohol consumers, poly-tobacco or substance users and individuals with friends who use e-cigarettes. Health providers and policy makers in Nigeria might consider preventive measures aimed at young adults with the identified risk factors, as well as close monitoring of trends in e-cigarette use in the coming years.

E-Cigarette Use in Young Adult Never Cigarette Smokers with Disabilities: Results from the Behavioral Risk Factor Surveillance System Survey.

Young adult never cigarette smokers with disabilities may be at particular risk for adopting e-cigarettes, but little attention has been paid to these people. This study examines the associations between different types of disability and e-cigarette use in this population. Young adult never-smokers from the 2016–2017 Behavioral Risk Factor Surveillance System (BRFSS) survey who were either never or current e-cigarette users (n = 79,177) were selected for the analysis. The Least Absolute Shrinkage and Selection Operator (LASSO) algorithm was used to select confounders for multivariable logistic regression models. Multivariable logistic regression models were used to determine the associations between current e-cigarette use and different types of disability after incorporating BRFSS survey design and adjusting for confounders. Young adult never-smokers who reported any disability had increased odds (OR 1.44, 95% CI 1.18–1.76) of e-cigarette use compared to those who reported no disability. Young adult never-smokers who reported self-care, cognitive, vision, and independent living disabilities had higher odds of e-cigarette use compared to those who reported no disability. There was no statistically significant difference in the odds of e-cigarette use for those reporting hearing and mobility disabilities compared to those who reported no disability. This study highlights the need for increased public education and cessation programs for this population.

Association between observing peers vaping on campus and E-cigarette use and susceptibility in middle and high school students

BackgroundThis study examines the association between exposure to e-cigarette use on school campus and e-cigarette use behaviors among adolescents in the United States. MethodsData were obtained from the 2019 National Youth Tobacco Survey. First, two multivariate logistic regression models examined the association between in-school exposure to e-cigarette use and ever and past 30-day (i.e., current) e-cigarette use. Next, a multivariate logistic regression model to examine the relationship between in-school exposure to e-cigarette use and susceptibility to use was conducted among a subsample (n = 11,958) of never e-cigarette users. Covariates included grade, race/ethnicity, marketing exposure, and ever use of other tobacco products. ResultsApproximately 64.3 % of adolescents reported seeing someone use an e-cigarette on school campus; the most common locations being in the bathroom/locker room (34.4 %) and parking lot (34.0 %). In-school exposure to e-cigarette use was associated with greater odds of ever (Adj OR: 2.06; 95 % CI: 1.82–2.33) and current (Adj OR: 1.70; 95 % CI: 1.46–1.98) e-cigarette use among adolescents as well as greater odds of susceptibility to use (Adj OR: 2.00; 95 % CI: 1.82–2.20) among never e-cigarette users. ConclusionsObserving e-cigarette use on school campus was associated with greater odds of e-cigarette use and susceptibility. It is plausible that observing e-cigarette use on campus reinforces the social acceptability of adolescent e-cigarette use. Findings inform on the prevalence of e-cigarettes use on-campus as well as how this phenomenon may influence e-cigarette use/susceptibility among youth. The observed relationship highlights the role of schools in the efforts to reduce adolescent e-cigarette use.

E-cigarette use among adults in China: findings from repeated cross-sectional surveys in 2015–16 and 2018–19

The use of e-cigarettes among adults is increasing globally. Since 2018, policies in China have restricted e-cigarette use; however, little information is available on the national trend in e-cigarette use before regulations were implemented. Therefore, we sought to estimate the trend in e-cigarette use in China before policy implementation and explored associated factors. We assessed two nationally representative cross-sectional datasets from the China Chronic Disease and Nutrition Surveillance (CCDNS) surveys initiated in 2015 (June, 2015, to May, 2016) and 2018 (August, 2018, to June, 2019). The surveys were done at 298 national disease surveillance points in 31 provinces in mainland China, and used a multistage, stratified, cluster-randomised sampling design, recruiting community-based Chinese adults aged 18 years and older. Within the standard CCDNS survey, face-to-face questionnaire interviews were used to collect self-report data on e-cigarette use in the preceding 30 days. E-cigarette users were those who self-reported e-cigarette use on 1 day or more in the past 30 days. Prevalence estimates of past 30-day e-cigarette use were weighted to represent the Chinese adult population accounting for the complex sampling design. Populations for the years 2015-16 and 2018-19 were standardised with the 2010 population census to gain comparable estimates. Multivariable logistic regression models adjusted for age, sex, urban or rural residence, household income, occupation, and education level were applied to identify factors associated with the likelihood of e-cigarette use among the total population, ever smokers (current and former), and never smokers across both surveys. Our study included 189 306 Chinese adults from the 2015 survey (100 405 [53·0%] women; mean age 43·6 years [SD 14·6]) and 184 475 Chinese adults from the 2018 survey (102 373 [55·5%] women; mean age 43·4 years [13·9]). The weighted prevalence of past 30-day e-cigarette use among Chinese adults increased from 1·3% (95% CI 1·1-1·5%) in 2015-16 to 1·6% (95% CI 1·4-1·8%) in 2018-19 (an increase of 0·3% [95% CI 0·1-0·6]; Rao-Scott χ2 p=0·0086). Based on weighted proportion data, e-cigarette users were predominantly men (97·4% [95% CI 96·7-98·1] in 2015-16 and 97·0% [95·4-98·6] in 2018-19) and current conventional smokers (93·0% [90·7-95·2] in 2015-16 and 96·2% [95·1-97·3] in 2018-19). Across both surveys, the odds of e-cigarette use were significantly associated with obesity (odds ratio 1·6 [95% CI 1·3-2·1]; p=0·0007), awareness of smoking hazards (1·2 [1·0-1·4]; p=0·022), and smoking status (in current smokers, 135·2 [87·7-208·6]; and in former smokers, 33·5 [21·3-52·7]; p<0·0001). Among current smokers, the odds were increased with daily cigarette consumption (2·1 [1·5-2·8]; p<0·0001), smoking more than 20 cigarettes per day (1·8 [1·5-2·3]; p<0·0001), and an attempt to quit smoking (within the past 12 months, 1·9 [1·5-2·4]; and before the past 12 months, 1·5 [1·3-1·9]; p<0·0001). In never smokers, the odds were increased in those aware of the hazards of smoking (2·4 [1·2-4·7]; p=0·011). E-cigarette use in China remains low but has increased substantially between 2015 and 2019. Our study identified increased e-cigarette use among subpopulations, and use patterns, that warrant further attention from public health policy makers in China. Chinese Central Government, National Key Research and Development Program of China.