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. 2019 Jun;64(6):770-775.
doi: 10.1016/j.jadohealth.2019.02.019.

Adolescents' E-Cigarette Use: Increases in Frequency, Dependence, and Nicotine Exposure Over 12 Months

Erin A Vogel  1 , Judith J Prochaska  2 , Danielle E Ramo  1 , Jerome Andres  3 , Mark L Rubinstein  4
Affiliations

Adolescents' E-Cigarette Use: Increases in Frequency, Dependence, and Nicotine Exposure Over 12 Months

Erin A Vogel et al. J Adolesc Health. 2019 Jun.

Abstract

Purpose: This study examined changes in e-cigarette and dual-use frequency, levels of nicotine exposure and e-cigarette dependence, and device and e-liquid preferences over 12 months.

Methods: Adolescents (N = 173, aged 13-18 years) who reported past-month e-cigarette use and at least 10 lifetime uses were recruited from the San Francisco Bay Area. The sample was 75.1% male, 54.9% non-Hispanic White, mean age 16.6 years (standard deviation = 1.2); 26.6% reported past-month cigarette smoking at baseline (i.e., dual use). At baseline, 6-month, and 12-month follow-up, participants provided saliva samples for cotinine testing and self-reported e-cigarette use frequency, dependence, past-month smoking, product preference, and flavor preference.

Results: Most (80.3%) were still using e-cigarettes at 12 months, and daily use increased from 14.5% to 29.8%. Model testing indicated an overall increase from baseline to 12 months in frequency of e-cigarette use (F(2, 166) = 5.69, p = .004), dependence (F(2, 164) = 5.49, p = .005), and cotinine levels (F(2, 103) = 4.40, p = .038). Among those reporting only e-cigarette use at baseline, 28.8% reported combustible cigarette use during follow-up. Among those reporting dual use at baseline, 57.1% were still dual using at 12 months, 31.4% reported e-cigarette use only, and none abstained from both products. Higher nicotine delivering e-cigarette devices (i.e., Juul, mods) became more popular over time, whereas flavor preferences (i.e., fruit, mint/menthol, and candy) remained stable.

Conclusions: Adolescents' e-cigarette use persisted over a 12-month period with significant increases in frequency of use, nicotine exposure, and e-cigarette dependence. Transitions from single to dual and dual to single nicotine product use were observed in approximately one in three users over the study period.

Keywords: Addiction; Adolescent; Cigarettes; Dependence; E-cigarette; ENDS; Nicotine.

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Figures

Figure 1.
Figure 1.
Use of e-cigarettes and cigarettes reported at each time point.
Figure 2.
Figure 2.
Preferred devices at each time point. Note: Includes data from all responding at each follow-up.
See this image and copyright information in PMC

References

    1. National adolescent drug trends in 2018 [press release]. Ann Arbor, MI: Monitoring the Future; 2018.
    1. Cullen KA, Ambrose BK, Gentzke AS, Apelberg BJ, Jamal A, King BA. Use of electronic cigarettes and any tobacco product among middle and high school students — United States, 2011–2018. Atlanta, GA: 2018. - PMC - PubMed
    1. Department of Health & Human Services (US). Preventing tobacco use among youth and young adults: a report of the Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention;2012. - PubMed
    1. Barrington-Trimis JL, Kong G, Leventhal AM, et al. E-cigarette use and subsequent smoking frequency among adolescents. Pediatrics. 2018:e20180486. - PMC - PubMed
    1. Lanza ST, Vasilenko SA. New methods shed light on age of onset as a risk factor for nicotine dependence. Addictive Behaviors. 2015;50:161–164. - PMC - PubMed

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