Odds Of E-cigarette Use Research Articles

Prevalence and Factors Associated with Electronic Cigarette Use Among Young Adult Cancer Survivors Using Behavioral Risk Factor Surveillance System, 2016-2018.

Purpose: This study describes the prevalence trends of electronic cigarette (e-cigarette) use in young adult cancer survivors and compares these to the prevalence among young adults without a cancer history. It also examines the association between conventional cigarette use, binge drinking, depression, and other sociodemographic factors, and e-cigarette use in young adult cancer survivors. Methods: Cross-sectional analyses, using the Behavioral Risk Factor Surveillance System, 2016-2018, were done. Multivariable logistic regression was used to examine the associations between conventional cigarette use, binge drinking, and depression as well as other factors associated with e-cigarette use in young adult cancer survivors. Results: Lifetime e-cigarette use increased from 40.1% in 2016 to 47.4% in 2018. Former smokers were 5.47 times (95% confidence interval [CI]: 3.48-8.61) more likely to be lifetime e-cigarette users and 1.9 times (95% CI: 1.12-3.23) more likely to be current e-cigarette users compared to never smokers. Current smokers were over sixteen folds more likely (adjusted odds ratio: 16.50, 95% CI: 11.59-23.57) to be lifetime e-cigarette users and 2.1 times (95% CI: 1.24-3.57) more likely to be current e-cigarette users relative to never smokers. Furthermore, binge drinking and depression were associated with higher odds of lifetime e-cigarette use, while increasing age was associated with lower odds of e-cigarette use. Compared to females, males were significantly more likely to be current users of e-cigarettes relative to former users. Conclusion: Conventional cigarette use, binge drinking, depression, age, and gender were found to be associated with e-cigarette use among young adult cancer survivors. Policies targeted at e-cigarette control among young adult cancer survivors need to be multipronged, simultaneously addressing other harmful practices such as binge drinking and the use of conventional cigarettes.

Abstract 4659: Association between e-cigarette use and propensity for risk behaviors

Abstract Background: The use of e-cigarettes has been rapidly increasing in the United States however factors contributing to this phenomena have not been studied systematically. This goal of this study was to investigate the association between e-cigarette consumption and risk behaviors. Methods: A cross-sectional analysis of Behavioral Risk Factor Surveillance System (BRFSS) data from 2016 to 2018 was carried out with sampling weights applied in all analyses. Propensity for risk behaviors was defined as a positive self-report to any of the following: heavy drinking; not having flu shot in the past year; not always using seat belt; injecting any drug other than those prescribed; being treated for a sexually transmitted disease or STD; being given or received money or drugs in exchange for sex in the past year; being tested for HIV. Chi-square test was used to compare prevalence between study groups. Multiple logistic regression (MLR) was carried out to estimate the association between e-cigarette use and risk behaviors adjusting for demographic factors and tobacco smoking status. Results: Overall, 3.5% of participants reported to be current e-cigarette users (N=23,803), with 72.1% of them being non-Hispanic white. Among current e-cigarette users, 60.3% were male, younger adults (18-44 years of age, 71.3%), with more than 12 years of education (49.7%) and middle income ($25K-75K, 40.9%), tobacco users (49.8%) and having risk behaviors (92.4%). The current tobacco smokers (14.3%, former smoker: 5.6%, never smoked: 1.6%) were more likely to use e-cigarettes. Younger adults aged 18-44 years (7.3 %, 45-64 years:3.7 %, 65+ years: 1.5%), male (5.8%, female: 3.6%), non-Hispanic Whites (5.2 %, non-Hispanic Black: 3.4%, Hispanic: 3.3 %), as well as people with high school education (6.0 %, <12 years: 4.9%, >12 years: 3.9 %) and income below $25K (5.5 %, $25K-75K: 4.7 %, above $75K: 4.0%) reported higher e-cigarette use. Upward growth trajectory in e-cigarette consumption from 2016 to 2018 was found in males (2016: 5.6%, 2017:5.4%, 2018: 6.9%), people aged 18-44 years (2016:6.7%, 2017:6.9%, 2018:9.4%), people with risk behaviors (2016:5.2%, 2017:5.1%, 2018:6.2%) and those who never smoked tobacco (2016:0.5%, 2017:0.6%, 2018:2.3%). After adjusting for confounders in MLR, people with risk behaviors were 1.39 times more likely to use e-cigarettes compared to those without risk behaviors (OR=1.39, [95%CI, 1.29-1.49]). The odds of e-cigarette use among 18-44 years adults (OR= 4.85 [95% CI, 4.53-5.18]) and 45-64 years adults (OR= 2.26 [95% CI, 2.10-2.43]) were higher than 65+ years adults. Current tobacco smokers (OR=9.50, [95%CI, 8.92-10.11]) and former smokers (OR=5.15, [95%CI, 4.83-5.48]) demonstrated higher probability of e-cigarette use than those who never smoked. Conclusions: There is a significant association between e-cigarette consumption and risk-taking behavior. Former or current tobacco users are more likely to use e-cigarettes. Citation Format: Xingyue Huo, Joseph Finkelstein. Association between e-cigarette use and propensity for risk behaviors [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 4659.

A cross-sectional analysis of electronic cigarette use in US adults by asthma status.

Electronic cigarette (e-cigarette) use has been shown to worsen the asthma symptoms, but there is little information on current e-cigarette use patterns in the general US adult asthma population. We examined the unadjusted and adjusted estimates of current e-cigarette use in a nationally representative sample of US adults by asthma status and what factors influence this use. We determined the prevalence of current e-cigarette use in adults with and without asthma using the 2016-2018 Behavioural Risk Factor Surveillance System datasets. A multinomial logistic regression model was used to obtain adjusted estimates of e-cigarette use by asthma status while also identifying which sociodemographic and clinical factors are associated with e-cigarette use in adults with asthma. Of the 23,071 adults with asthma in the study, 22.5% were currently using e-cigarettes. After adjusting for sociodemographic and clinical factors associated with asthma and current e-cigarette use, adults with asthma had similar odds of every day e-cigarette use (odds ratio (OR): 1.04, 95% confidence interval (CI): 0.93-1.15) but higher odds of e-cigarette use on some days (OR: 1.18, 95% CI: 1.10-1.27) compared to adults without asthma. Younger age, male sex and former or current traditional cigarette use were significantly associated with both e-cigarette use on some days and every day in adults with asthma. Current e-cigarette use estimates among US adults with asthma indicate a need for further e-cigarette education and cessation interventions that are specifically tailored to sociodemographic and clinical groups who are especially prone to e-cigarette use within this population.

High-School Students Rarely Use E-Cigarettes Alone: A Sociodemographic Analysis of Polysubstance Use Among Adolescents in the United States.

Most adolescents reporting e-cigarette use have also used combustible tobacco; however, the extent to which they use other substances is less clear. This study assessed e-cigarette use with tobacco, alcohol, or cannabis and quantified the risk of polysubstance use among adolescents overall and by sociodemographic characteristics. Using 2017 Youth Behavioral Risk Factor Surveillance System data from adolescents (grades 9-12) with complete substance use information (n = 11 244), we examined e-cigarette poly-use status (none [referent], e-cigarettes only, or e-cigarettes + other substances). We estimated the prevalence of substance use and modeled odds of e-cigarette use, alone or with other substances, by several sociodemographic characteristics. Analyses were completed in Stata version 15.1 using survey procedures to account for the complex survey design. Approximately 12% of adolescents reported past 30-day e-cigarette use. Almost all (93%) e-cigarette users also reported other substance use; alcohol appeared most frequently in combinations. Odds of e-cigarette single use and e-cigarette poly-use (vs. no use) were higher for males and adolescents with lower grades (odds ratios [ORs] = 1.44-2.31). Racial/ethnic minorities had lower odds of e-cigarette poly-use than White peers (ORs = 0.18-0.61), and bisexual (vs. straight) adolescents were more likely to be e-cigarette poly-users (OR = 1.62). E-cigarette use increased from 9th grade (7%) to 12th grade (16%). Polysubstance use is highly prevalent among adolescents who use e-cigarettes. Therefore, e-cigarette screening should include the assessment of other substances, especially alcohol. Early and comprehensive prevention efforts to reduce e-cigarette and other substance use could have a substantial beneficial impact on population health over time. This study extends knowledge about e-cigarette use among adolescents by exploring its use with alcohol, cannabis, and other tobacco products. We found that e-cigarettes were very rarely used alone, and our analysis identified several sociodemographic factors associated with greater odds of e-cigarette polysubstance use. In response, we recommend that prevention interventions address multiple substances concurrently, screen repeatedly to detect new initiation as age increases, focus on e-cigarette use as a less stigmatized entry point to discussions of substance use, and target priority population subgroups.

Trends and sociodemographic factors of e-cigarette use among adult daily smokers in South Korea.

Previous studies have identified the sociodemographic factors associated with e-cigarette use among adolescents in South Korea. However, literature regarding e-cigarette use among adult smokers remains limited in South Korea. Applying four waves (2013-2016) of The Korea National Health and Nutrition Examination Survey (n = 3227), sociodemographic factors were included in the multivariable logistic regression model to study their relationships with e-cigarette use among adult daily smokers. E-cigarette use increased from approximately 21.2% to 34.6% from 2013 to 2016, respectively. Females had lower odds of e-cigarette use (adjusted odds ratio [AOR] = 0.76; 95% CI, 0.58-0.99, P < .05) compared with males. Older age was negatively associated with e-cigarette use experience (all Ps < .01). Daily smokers with high school education or above all had higher odds of using e-cigarettes compared those with elementary school education (all Ps < .05). As this study examined the trends of e-cigarette use and factors associated with e-cigarette use among adult daily smokers in South Korea, further research is needed to investigate the long-term effect of e-cigarette use on smoking cessation in South Korea as well as other Asian countries.

Cannabis Concentrate Use Among Adolescents

Research Article| December 01 2019 Cannabis Concentrate Use Among Adolescents AAP Grand Rounds (2019) 42 (6): 65. https://doi.org/10.1542/gr.42-6-65 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Cannabis Concentrate Use Among Adolescents. AAP Grand Rounds December 2019; 42 (6): 65. https://doi.org/10.1542/gr.42-6-65 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: marijuana Source: Meier MH, Docherty M, Leischow SJ, et al. Cannabis concentrate use in adolescents. Pediatrics. 2019; 144(3): e20190338; doi: https://doi.org/10.1542/peds.2019-0338Google Scholar Investigators from Arizona State University conducted a study of adolescents to assess the proportion of cannabis concentrate users and the association of cannabis concentrate with other risky behaviors. Data were obtained from the 2018 Arizona Youth Survey, which is conducted every 2 years and administered to all Arizona schools that serve 8th-, 10th-, and 12th-grade students. Students completed the survey at school on paper or online. On the survey, participants were queried about whether they ever used marijuana or cannabis concentrate and, if so, on how many occasions over their lifetime. Participants were also queried on their lifetime use of tobacco, e-cigarettes, and alcohol, as well as on several risk and protective factors for problem behaviors (such as perceived risk of harm of marijuana, peer substance use, and commitment to school). Investigators used descriptive statistics to determine the proportion of participants who tried cannabis concentrate in their lifetime. Regression analyses were used to assess for differences in other substance use and risk and protective factors among concentrate users, cannabis users who never tried concentrate, and nonusers. There were 47,142 participants included in analysis, of whom 33% reported cannabis use in their lifetime; 24% reported cannabis concentrate use. Among those who reported using cannabis, 72% also reported using cannabis concentrate. Concentrate users had significantly increased odds of other substance use and risk factors compared to cannabis users who never tried concentrate and nonusers. For instance, concentrate users had 3.2-fold increased odds of e-cigarette use and 1.8-fold increased odds of alcohol use compared to non-concentrate cannabis users; when compared to nonusers, these odds ratios were 24.5 and 13.9, respectively. Concentrate users also scored higher on every risk factor and lower on every protective factor, compared to non-concentrate cannabis users and nonusers, such as having significantly reduced odds of perceiving risk of harm of marijuana and significantly increased odds of low commitment to school. Investigators conclude that most adolescents who use cannabis report using cannabis concentrates, and those using concentrate are at increased risk for other substance use. Dr Wong has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. The landscape of adolescent substance use continues to evolve. The use of marijuana and cannabis concentrate products (eg, hash oil, wax, crumble, shatter) that contain higher levels of active ingredient tetrahydrocannabinol (THC) has increased among adolescents.1 The last decade has seen an alarming rise in teen vaping, or use of e-cigarettes.2 Contributing to the rapid rise in e-cigarette and cannabis products is the declining perceived risk of these products, with legal adult use of e-cigarettes broadly and marijuana on a state-by-state basis.3 Adolescents often refer to vaping of cannabis concentrate as “dabbing/penning.” The combination of vaping and marijuana has recently drawn urgent public... You do not currently have access to this content.

E-Cigarette Use Among Adult Primary Care Patients: Results from a Multisite Study.

Primary care settings provide opportunities to identify electronic-cigarette (e-cigarette) use and to implement strategies for changing tobacco use behavior. However, a better understanding of the extent and associated characteristics of e-cigarette use among primary care patients are needed to inform such efforts. To describe patient demographic and substance use characteristics by e-cigarette use status among a large sample of primary care patients. To examine the prevalence and correlates of e-cigarette use among tobacco users in the sample. Cross-sectional analysis from a multisite validation study of a substance use screening instrument. Adult primary care patients aged 18 and older (n = 2000) recruited across 5 primary care clinics in the Eastern USA from 2014 to 2015. Patients reported past 3-month e-cigarette use, sociodemographics, tobacco use, and other substance use. Current nicotine dependence and DSM-5 criteria for past-year substance use disorders were also assessed. Among the total sample, 7.7% (n = 154) adults reported past 3-month e-cigarette use. Adults who reported e-cigarette use (vs. no use) were more likely to be younger, white, or have frequent tobacco use, nicotine dependence, or past-year illicit drug use/disorders. Among past 3-month tobacco users, 16.3% reported e-cigarette use. Adjusted logistic regression indicated that odds of e-cigarette use were greater among tobacco users who had some college education or more (vs. < high school) or were daily/almost daily tobacco users (vs. not); odds were lower among Blacks/African-Americans (vs. whites). E-cigarette use among tobacco users was associated with increased odds of current nicotine dependence or tobacco use disorder as well as more severe dependence/disorder. Enhanced surveillance of e-cigarette use among adult tobacco users in primary care, particularly among those who use tobacco frequently, may have implications for helping patients with tobacco cessation using established approaches including behavioral support, pharmacotherapy, or referral to specialized care.

Race, Educational Attainment, and E-Cigarette Use.

Although higher educational attainment lowers high-risk behaviors such as substance use, according to the Minorities' Diminished Returns theory, the effect of educational attainment may be smaller for Blacks than Whites. To explore the racial differences in the link between educational attainment and electronic cigarettes (e-cigarettes). We used the Health Information National Trends Survey (HINTS) data. This national survey was conducted in 2017 and included 2,277 American adults composed of 1,868 White and 409 Black individuals. Educational attainment was the independent variable. E-cigarette use (lifetime) was the dependent variables. Age and gender were the covariates. Race was the effect modifier. In the overall sample, a higher level of education attainment was linked to lower odds of e-cigarette use (OR = 0.76, 95% CI =0.61-0.95). Race showed a significant interaction with educational attainment on the outcome (OR = 1.63, 95% CI =1.04-2.56), suggesting a weaker negative association between high educational attainment and e-cigarette use for Blacks than Whites. In race-stratified logistic regression models, high educational attainment was inversely associated with risk of e-cigarette use for Whites but not Blacks. Educational attainment shows a stronger effect on e-cigarette use in White than Black Americans.

Perceptions and use of e-cigarettes among young adults in Hong Kong

BackgroundLittle is known about the risk and addiction perceptions of e-cigarettes among Asian populations. We examined e-cigarette perceptions among young adults in Hong Kong and the association between the perceptions and e-cigarette use patterns.MethodsAn online survey was administered to a convenience sample of Hong Kong residents aged 18–35 (N = 1186). Measures of e-cigarette perceptions included perceived harm and addictiveness of e-cigarettes, perceived harm of secondhand e-cigarette aerosol, and perceived popularity of e-cigarette use among peers. Separate multinomial logistic regression models were conducted to examine the associations between the four perceptions and former and current use of e-cigarettes relative to never use, controlling for demographics and current cigarette smoking status. Interactions of e-cigarette perceptions and current cigarette smoking were assessed in all models. Among current e-cigarette users, bivariate exact logistic regression models were used to examine the relationships between each of the perceptions and frequent e-cigarette use (≥3 days in past 30-day vs. 1–2 days). Among participants who had never used e-cigarettes, separate multivariable logistic regression models were conducted to examine the associations between e-cigarette perceptions and susceptibility to e-cigarette use.ResultsOverall, 97.2% of participants were aware of e-cigarettes, and 16.1% had tried e-cigarettes (11.3% former users; 4.8% current users). Young adults perceived e-cigarettes (and aerosol) as less harmful, less addictive, and less popular than cigarettes. Current cigarette smokers reported significantly lower perceived harmfulness and addictiveness of e-cigarettes, lower perceived harmfulness of e-cigarette aerosol, and higher perceived popularity than nonsmokers. The lower degree of harm and addiction perceptions, and higher levels of popularity perceptions were associated with greater odds of e-cigarette use, and these relationships were generally stronger among nonsmokers compared to current cigarette smokers. E-cigarette perceptions were not associated with frequent e-cigarette use. Perceiving e-cigarettes (and aerosol) as less harmful and less addictive were associated with greater susceptibility to e-cigarette use. Compared to nonsmokers, current smokers were more likely to report e-cigarette use and susceptibility.ConclusionsContinued monitoring of e-cigarette use and perceptions is needed. Educational programs should emphasize the potential harmful and addictive properties of e-cigarettes and the risks of secondhand exposure to e-cigarette aerosol.

Ever Use of E-Cigarettes Among Adults in the United States: A Cross-Sectional Study of Sociodemographic Factors.

E-cigarette use among adolescents is well-documented, but less is known about adult users of e-cigarettes. The purpose of this study was to examine associations between sociodemographic factors and e-cigarette use in a nationally representative sample of adults in the United States. Cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) for years 2015-2016 were analyzed to assess e-cigarette use among 5989 adults aged ≥18 years. Multivariable logistic regression was conducted to examine associations between the sociodemographic exposures of age, sex, race, marital status, education level, employment status, and poverty-income ratio and the outcome of e-cigarette use. The weighted prevalence of ever use of e-cigarettes was 20%. Compared with adults aged ≥55 years, odds of e-cigarette use were 4.77 times (95% confidence interval [CI] = 3.63-6.27) higher among ages 18 to 34 years and 2.16 times (95% CI = 1.49-3.14) higher among ages 35 to 54 years. Higher odds of e-cigarette use were observed among widowed/divorced/separated participants compared with those who were married/living with a partner, among participants with less than high school (odds ratio [OR] = 1.47; 95% CI = 1.08-2.00) or high school/general educational development (GED) education (OR=1.41; 95% CI = 1.12-1.77) compared with those with college degrees/some college, and among those with incomes below the poverty level (OR=1.31; 95% CI = 1.01-1.69) compared with above the poverty level. For non-smokers of conventional cigarettes, higher odds of e-cigarette use were observed among males compared with females, Mexican Americans/Other Hispanics compared with non-Hispanic whites, and non-working participants compared with those who were working. Overall findings indicate that individuals who are widowed/divorced/separated, individuals with lower education, and with incomes below the poverty level are likely to report ever use of e-cigarettes. As increasing evidence demonstrates negative health consequences, e-cigarette initiation may ultimately contribute to additional smoking-related health inequalities even among non-smokers of conventional cigarettes.

E-cigarette use in England 2014-17 as a function of socio-economic profile.

E-cigarettes have the potential either to decrease or increase health inequalities, depending on socio-economic differences in their use and effectiveness. This paper estimated the associations between socio-economic status (SES) and e-cigarette use and examined whether these associations changed between 2014 and 2017. A monthly repeat cross-sectional household survey of adults (16+) between January 2014 and December 2017. This time-period was chosen given that the prevalence of e-cigarette use stabilized in England in late 2013. England. Participants in the Smoking Toolkit Study, a monthly household survey of smoking and smoking cessation among adults (n=81 063; mean age=48.4years, 49% were women) in England. Subsets included past year smokers (n=16 232; mean age=42.8, 46% women), smokers during a quit attempt (n=5305, mean age=40.6, 49% women) and long-term ex-smokers (n=13 562, mean age=59.3, 44% women). The outcome measure for the analyses was current e-cigarette use. We also included smokers during a quit attempt where use of an e-cigarette during the most recent quit attempt was the outcome measure. Social grade based on occupation was the SES explanatory variable, using the National Readership Survey classification system of AB (higher and intermediate managerial, administrative and professional), C1 (supervisory, clerical and junior managerial, administrative and professional), C2 (skilled manual workers), D (semi-skilled and unskilled manual workers) and E (state pensioners, casual and lowest-grade workers, unemployed with state benefits only). The analyses were stratified by year to assess the changes in these associations over time. Among past-year smokers, lower SES groups had lower overall odds of e-cigarette use compared with the highest SES group AB (D: odds ratio=0.53, 95% confidence interval=0.40-0.71; E: 0.67, 0.50-0.89). These differences in e-cigarette use reduced over time. The use of e-cigarettes during a quit attempt showed no clear temporal or socio-economic patterns. Among long-term ex-smokers, use of e-cigarettes increased from 2014 to 2017 among all groups and use was more likely in SES groups C2 (2.03, 1.08-3.96) and D (2.29, 1.13-4.70) compared with AB. From 2014 to 2017 in England, e-cigarette use was greater among smokers from higher compared with lower socio-economic status (SES) groups, but this difference attenuated over time. Use during a quit attempt was similar throughout SES groups. Use by long-term ex-smokers increased over time among all groups and was consistently more common in lower SES groups.

Use of social networking sites, electronic cigarettes, and waterpipes among adolescents.

Electronic cigarettes (e-cigarettes) and waterpipes are gaining in popularity among adolescents in tandem with the increasing popularity of social networking sites (SNSs). The objective of this study was to examine the associations between the use of SNSs and e-cigarette and waterpipe use among adolescents, and to test whether these associations are independent of tobacco cigarette smoking. A province-wide school-based cross-sectional study. Data were derived from the 2013 Ontario Student Drug Use and Health Survey. Our analyses included representative data from 2841 high school students across Ontario, Canada, who completed the questionnaire that included measures of lifetime use of e-cigarette and past-year use of waterpipe. Nearly 14.6% of students reported having smoked an e-cigarette in their lifetime and 12.2% reported having smoked a waterpipe in the past year. After adjusting for various covariates, daily use of SNSs of at least 1h/day was associated with greater odds of e-cigarette use (odds ratios ranged from 3.31 for SNS use of 1h/day to 3.43 for ≥3h/day), while daily use of SNSs of at least 2h was associated with waterpipe use (odds ratios of 3.28 for SNS use of 2h/day and 2.83 for use of ≥3h/day). The observed associations remained significant after further adjusting for tobacco cigarette smoking. The use of SNSs was positively associated with e-cigarette and waterpipe use, independent of tobacco cigarette smoking. These findings highlight the need for including SNSs in ongoing prevention and intervention efforts.

E-cigarette advertising exposure in e-cigarette naïve adolescents and subsequent e-cigarette use: A longitudinal cohort study

ObjectiveElectronic (E-) cigarettes are one of the most popular tobacco products used by adolescents today. This study examined whether exposure to advertisements in (1) social networking sites (Facebook, Twitter, YouTube, Pinterest/Google Plus), (2) traditional media (television/radio, magazines, billboards), or (3) retail stores (convenience stores, mall kiosks, tobacco shops) was associated with subsequent e-cigarette use in a longitudinal cohort of adolescents. MethodsData were drawn from longitudinal surveys conducted in fall 2013 (wave 1) and spring 2014 (wave 2) of a school-based cohort attending 3 high schools and 2 middle schools in Connecticut. Adolescents were asked about tobacco use behaviors and where they had recently seen e-cigarette advertising at wave 1. We used logistic regression to determine whether advertising exposure at wave 1 increased the odds of e-cigarette use by wave 2, controlling for demographics and cigarette smoking status at wave 1. ResultsAmong those who have never used e-cigarettes in wave 1 (n = 1742), 9.6% reported e-cigarette use at wave 2. Multivariate logistic regression demonstrated that exposure to e-cigarette advertising on Facebook (OR 2.12 = p < 0.02) at wave 1, but not other venues, significantly increased the odds of subsequent e-cigarette use wave 2. Age, white race, and cigarette smoking at wave 1 also was associated with e-cigarette use at wave 2. ConclusionThis study provides one of the first longitudinal examinations demonstrating that exposure to e-cigarette advertising on social networking sites among youth who had never used e-cigarettes increases the likelihood of subsequent e-cigarette use.

Utilizing Social Norms Marketing to Address E-Cigarette Use on College Campuses

E-cigarette use is a serious health concern among adolescents and young adults. This study identifies factors associated with e-cigarette use in an effort to better understand what impacts college students’ decisions to use this tobacco product. This study utilizes data from a survey conducted at a research institution and two community colleges located in Hawaii. A multivariate logistic regression analysis identified key risk factors associated with college student e-cigarette use. Independent factors associated with e-cigarette use included use of traditional cigarettes and having one or more family members or friends who currently used e-cigarettes. Exposure to online e-cigarette information was also associated with increased odds of e-cigarette use. The study findings have important implications for e-cigarette control among adolescents and young adults. Service learning students can take an active role in developing social norms marketing campaigns designed to communicate the risks of e-cigarette use and counter marketing ploys that foster unsubstantiated beliefs regarding the benefits of e-cigarette use.

E-Cigarettes: A 1-Way Street to Traditional Smoking and Nicotine Addiction for Youth.

* Abbreviation: E-cigarette — : electronic cigarette In a longitudinal study in this month’s issue of Pediatrics , Bold et al1 examined past-month cigarette and electronic cigarette (e-cigarette) use in high school students from 2013 to 2015 in Connecticut. They found that having used an e-cigarette in the past month significantly and strongly predicted combustible cigarette use. The odds of e-cigarette use at each wave predicting future cigarette use was 7.08 from wave 1 to 2 and 3.87 from wave 2 to 3. Not surprisingly, e-cigarette use leads to traditional product use. In contrast, traditional combustible cigarette use did not predict future e-cigarette use. And a substantial proportion of both cigarette and e-cigarette users progressed to heavy use, reporting that they smoked 21 to 30 days in the past month at the 2-year follow-up. This is consistent with patterns of use seen with young people’s increasing addiction to nicotine in numerous studies.2 E-cigarette products were not part of … Address correspondence to Jonathan D. Klein, MD, MPH, Pediatrics, University of Illinois at Chicago, 820 S. Wood St, Chicago, IL 60612. E-mail: jonklein{at}uic.edu

A longitudinal study of the relationship between receptivity to e-cigarette advertisements and e-cigarette use among baseline non-users of cigarettes and e-cigarettes, United States

BackgroundWe investigated the relationship between receptivity to electronic cigarette (e-cigarette) advertisements at baseline and e-cigarette use at follow-up among adult baseline non-users of cigarettes and e-cigarettes.MethodsA nationally representative online panel was used to survey non-users of cigarettes and e-cigarettes (n = 2191) at baseline and 5-month follow-up. At baseline, respondents were shown an e-cigarette advertisement and asked if they were aware of it (exposure). Among those exposed, receptivity was self-rated for each ad using a validated scale of 1 to 5 for agreement with each of six items: “worth remembering,” “grabbed my attention,” “powerful,” “informative,” “meaningful,” and “convincing.” Logistic regression was used to measure the relationship between receptivity at baseline and e-cigarette use at follow-up.ResultsAmong baseline non-users of cigarettes and e-cigarettes, 16.6% reported exposure to e-cigarette advertisements at baseline; overall mean receptivity score was 2.77. Among baseline non-users who reported exposure to e-cigarette advertisements, incidence of e-cigarette use at follow-up was 2.7%; among baseline non-users who reported not being exposed to e-cigarette advertisements, incidence of e-cigarette use at follow-up was 1.3%. The attributable risk percentage for e-cigarette initiation from e-cigarette advertisement exposure was 59.3%; the population attributable risk percentage from e-cigarette advertisement exposure was 22.6%. Receptivity at baseline was associated with e-cigarette use at follow-up (aOR = 1.57; 95% CI = 1.04–2.37).ConclusionsReceptivity to e-cigarette advertisements at baseline was associated with greater odds of e-cigarette use at follow-up among baseline non-users of cigarettes and e-cigarettes. Understanding the role of advertising in e-cigarette initiation could help inform public health policy.

Adolescent Sports Participation, E-cigarette Use, and Cigarette Smoking

Although sport participation among adolescents has been found to lower the risk of traditional cigarette smoking, no studies to date have assessed if this type of physical activity lowers the risk of e-cigarette use among adolescents. National data from the 2014 and 2015 Monitoring the Future study of 12th-grade students were used and analyses were conducted in 2016. Measures for past 30-day e-cigarette use and traditional cigarette smoking were used to assess differences between adolescents who participated in at least one competitive sport during the past year and adolescents who did not. Differences in e-cigarette use and traditional cigarette smoking were assessed between 13 different sports to determine which sports were associated with a greater or lower risk of these behaviors. Adolescents who participated in at least one competitive sport were less likely to engage in past 30-day traditional cigarette smoking (AOR=0.73, 95% CI=0.538, 0.973) and past 30-day dual use of traditional cigarettes and e-cigarettes (AOR=0.66, 95% CI=0.438, 0.982) when compared with their nonparticipating peers. Adolescents who participated in baseball/softball and wrestling were at greatest risk of e-cigarette use. Of the 13 assessed sports, none were found to lower the odds of e-cigarette use. No significant evidence was found that participation in a sport was a protective factor against e-cigarette use. Certain types of athletes are at an elevated risk of e-cigarette use, and prevention efforts targeted at these specific sports should be considered by school administrators.

Use of Electronic Cigarettes Among U.S. Adults With Medical Comorbidities.

Electronic cigarette (e-cigarette) use is rising in the U.S. Smokers with comorbidities may increasingly use e-cigarettes if they believe e-cigarettes reduce smoking-related harm. This study examined e-cigarette use among adults with medical comorbidities. In 2016, this study analyzed 68,136 U.S. adults in the 2014 and 2015 National Health Interview Survey. Prevalent e-cigarette use by medical comorbidities and adjusted odds of e-cigarette use were calculated. Among current cigarette smokers, ever use of e-cigarettes was more often reported by adults with one or more medical comorbidity versus those without comorbidity (18-24 years: 73.5% vs 61.4%; 25-44 years: 60.6% vs 54.3%; 45-64 years: 46.5% vs 40.3%; ≥65 years: 35.2% vs 19.4%; all p<0.05). Current smokers aged 25-64 years with one or more comorbidity reported current e-cigarette use more often than those without comorbidity (25-44 years, 17.8% vs 14.3%, p=0.03; 45-64 years, 15.9% vs 11.5%, p=0.02). Current smokers with chronic obstructive pulmonary disease, asthma, and cardiovascular disease had higher odds of ever e-cigarette use versus those without comorbidity. Current smokers with asthma and cardiovascular disease had higher odds of current e-cigarette use. Former smokers with chronic obstructive pulmonary disease had higher odds of ever and current e-cigarette use and former smokers with cancer had lower odds of current e-cigarette use. E-cigarette use by current and former smokers with medical comorbidities is substantial, especially among individuals with chronic lung or cardiovascular disease. Clinicians should routinely ask these patients about e-cigarette use, actively consider all pathways to help their patients quit combustible cigarettes, and recommend evidence-based treatments.

PRS16 - Predictors Of Electronic Cigarette Use Among Individuals With Asthma

This study assessed predictors of electronic cigarette use among individuals with asthma, from nationally representative sample. Using the 2014 National Health Interview Survey (NHIS), we identified (N = 8,154) survey participants, aged ≥18 years. Weighted adjusted multivariable logistic regression was used to assess predictors of e-cigarette use. The prevalence of e-cigarette use was 16.57% among study sample. Compared to never smokers, current cigarette smokers had 35.07 times (95% CI: 27.17-45.25) and former cigarette smokers had 6.38 times (95% CI: 4.95-8.23) higher odds of using e-cigarettes. Furthermore, compared to individuals aged ≥ 65 years, those aged 18-24 (aOR = 8.62; 95% CI: 5.63-13.21), 25-24 (aOR = 5.99; 95% CI: 4.05-8.86), 35-49 (aOR = 3.52; 95% CI: 2.45-5.04), and 50-64 years (aOR = 2.19; 95% CI: 1.53-3.13) all had higher odds of using e-cigarettes. Males, compared to females, had 1.20 times (95% CI: 1.00-1.45) higher odds of use. Both Hispanics (aOR = 0.72; 95% CI: 0.53-0.97) and Non-Hispanic Blacks (aOR = 0.26; 95% CI: 0.19-0.35) had lower odds compared to Non-Hispanic Whites, however, only Non-Hispanic Others (e.g. multiple race/ethnicity) had 1.52 times (95% CI: 1.03-2.42) higher odds of use. Compared to graduate students, only college students, had significantly higher odds of using e-cigarettes (aOR = 1.53; 95% CI: 1.07-2.18). Additionally, current alcohol users, compared to lifetime abstainers, had 2.37 times (95% CI: 1.75-3.97) higher odds of e-cigarette use. Self-reported health was a significant predictor of usage; those in very good/good health (aOR = 1.65; 95% CI: 1.27-2.14) and fair/poor health (aOR = 2.21; 95% CI: 1.60-3.04) had higher odds of using e-cigarettes, compared to self-reported excellent health. Self-reported cigarette smokers and young adults had the highest odds of e-cigarette use. Future research should determine factors associated with initiation and impact of e-cigarettes on wellbeing and better understand e-cigarettes for future interventions and health promotion activities.

Ever Use of Nicotine and Nonnicotine Electronic Cigarettes Among High School Students in Ontario, Canada.

There are limited data on the use of electronic cigarettes (e-cigarettes) among youth, particularly with regard to the use of nicotine versus nonnicotine products. This study investigates ever use of nicotine and nonnicotine e-cigarettes and examines the demographic and behavioral correlates of e-cigarette use in Ontario, Canada. Data for 2,892 high school students were derived from the 2013 Ontario Student Drug Use and Health Survey. This province-wide school-based survey is based on a 2-stage cluster design. Bivariate and multivariate analyses were used to investigate the factors associated with ever use of e-cigarettes. Ever use of e-cigarettes was derived from the question, "Have you ever smoked at least one puff from an electronic cigarette?" All analyses included appropriate adjustments for the complex study design. Fifteen percent of high school students reported using e-cigarettes in their lifetime. Most students who ever used e-cigarettes reported using e-cigarettes without nicotine (72%), but 28% had used e-cigarettes with nicotine. Male, White/Caucasian, and rural students, as well as those with a history of using tobacco cigarettes, were at greater odds of e-cigarette use. Seven percent of students who had never smoked a tobacco cigarette in their lifetime reported using an e-cigarette. Five percent of those who had ever used an e-cigarette had never smoked a tobacco cigarette. More students reported ever using e-cigarettes without nicotine than with nicotine in Ontario, Canada. This underscores the need for greater knowledge of the contents of both nicotine and nonnicotine e-cigarettes to better guide public health policies.