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. 2015 Jan;135(1):e43-51.
doi: 10.1542/peds.2014-0760. Epub 2014 Dec 15.

Risk factors for exclusive e-cigarette use and dual e-cigarette use and tobacco use in adolescents

Thomas A Wills  1 , Rebecca Knight  2 , Rebecca J Williams  3 , Ian Pagano  2 , James D Sargent  4
Affiliations

Risk factors for exclusive e-cigarette use and dual e-cigarette use and tobacco use in adolescents

Thomas A Wills et al. Pediatrics. 2015 Jan.

Abstract

Objective: To describe electronic cigarette (e-cigarette) use and cigarette use among adolescents and determine whether established risk factors for smoking discriminate user categories.

Methods: School-based survey of 1941 high school students (mean age 14.6 years) in Hawaii; data collected in 2013. The survey assessed e-cigarette use and cigarette use, alcohol and marijuana use, and psychosocial risk and protective variables (eg, parental support, academic involvement, smoking expectancies, peer smoking, sensation seeking). Analysis of variance and multinomial regression examined variation in risk and protective variables across the following categories of ever-use: e-cigarette only, cigarette only, dual use (use of both products), and nonuser (never used either product).

Results: Prevalence for the categories was 17% (e-cigarettes only), 12% (dual use), 3% (cigarettes only), and 68% (nonusers). Dual users and cigarette-only users were highest on risk status (elevated on risk factors and lower on protective factors) compared with other groups. E-cigarette only users were higher on risk status than nonusers but lower than dual users. E-cigarette only users and dual users more often perceived e-cigarettes as healthier than cigarettes compared with nonusers.

Conclusions: This study reports a US adolescent sample with one of the largest prevalence rates of e-cigarette only use in the existing literature. Dual use also had a substantial prevalence. The fact that e-cigarette only users were intermediate in risk status between nonusers and dual users raises the possibility that e-cigarettes are recruiting medium-risk adolescents, who otherwise would be less susceptible to tobacco product use.

Keywords: adolescence; cigarettes; electronic cigarettes; prevalence; protective factors; risk factors.

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References

    1. Fairchild AL, Bayer R, Colgrove J. The renormalization of smoking? E-cigarettes and the tobacco “endgame.” N Engl J Med. 2014;370(4):293–295 - PubMed
    1. Grana R, Benowitz N, Glantz SA. E-cigarettes: a scientific review. Circulation. 2014;129(19):1972–1986 - PMC - PubMed
    1. Choi K, Forster J. Characteristics associated with awareness, perceptions, and use of electronic nicotine delivery systems among young US Midwestern adults. Am J Public Health. 2013;103(3):556–561 - PMC - PubMed
    1. Dockrell M, Morrison R, Bauld L, McNeill A. E-cigarettes: prevalence and attitudes in Great Britain. Nicotine Tob Res. 2013;15(10):1737–1744 - PMC - PubMed
    1. King BA, Alam S, Promoff G, Arrazola R, Dube SR. Awareness and ever-use of electronic cigarettes among U.S. adults, 2010–2011. Nicotine Tob Res. 2013;15(9):1623–1627 - PMC - PubMed

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