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. 2020 Feb 5;3(2):e1920961.
doi: 10.1001/jamanetworkopen.2019.20961.

Prevalence of Electronic Cigarette Use Among Adolescents in New Jersey and Association With Social Factors

Mary Hrywna  1   2   3 , Michelle T Bover Manderski  4   2   3 , Cristine D Delnevo  1   2   3
Affiliations

Prevalence of Electronic Cigarette Use Among Adolescents in New Jersey and Association With Social Factors

Mary Hrywna et al. JAMA Netw Open. .

Abstract

Importance: Use of electronic cigarettes (e-cigarettes) is high among adolescents, but the extent to which the JUUL e-cigarette brand accounts for the high prevalence has not been explored using population-based surveys.

Objective: To examine e-cigarette and JUUL use among adolescents in New Jersey.

Design, setting, and participants: Survey study using data from the 2018 New Jersey Youth Tobacco Survey, a cross-sectional statewide representative survey of tobacco use. The survey was school based and sampled New Jersey students in grades 9 to 12.

Exposures: Use of tobacco products; JUUL as first tobacco product tried; exposure to JUUL at school; number of friends perceived as JUUL users; liking or following a tobacco brand on social media; and buying or receiving tobacco-branded merchandise.

Main outcomes and measures: Prevalence ratio (PR) for current and frequent e-cigarette use, inclusive of JUUL.

Results: In this sample of 4183 adolescents, respondents were 49.6% female and 49.6% non-Hispanic white. Students were evenly distributed across grades 9 through 12. Overall, the estimate for current use of e-cigarettes inclusive of JUUL was higher (24.2%; 95% CI, 22.5%-25.9%) compared with current use assessed by use of e-cigarettes only (17.8%; 95% CI, 16.4%-19.4%) or JUUL use only (21.3%; 95% CI, 19.7%-23.0%). Divergence in e-cigarette use estimates was higher for certain subgroups, including female respondents and non-Hispanic black respondents. Also, 88.8% (95% CI, 86.6%-91.1%) of current e-cigarette users reported JUUL as a brand they used. Hispanic students (PR, 0.78; 95% CI, 0.69-0.89) and non-Hispanic students of other races (PR, 0.64; 95% CI, 0.51-0.81) were significantly less likely than non-Hispanic white students to be current e-cigarette users, and students in 12th grade were more likely than those in 9th grade to be current users (PR, 1.29; 95% CI, 1.11-1.48). Current e-cigarette use was positively associated with current use of other tobacco products (PR, 2.57; 95% CI, 2.24-2.95), endorsing a tobacco brand on social media (PR, 1.43; 95% CI, 1.19-1.72), having tobacco-branded merchandise (PR, 1.70; 95% CI, 1.46-1.97), having close friends who used JUUL (PR, 3.81; 95% CI, 3.17-4.58), and seeing JUUL used on school grounds (PR, 1.43; 95% CI, 1.24-1.65). Estimates of prevalence were greater when modeling frequent use.

Conclusions and relevance: This study found that prevalence of current and frequent e-cigarette use among adolescents was higher when inclusive of JUUL use, and JUUL was by far the most common e-cigarette brand used, providing support for inclusion of brand-specific questions when assessing e-cigarette use. The results also identify characteristics of adolescents who may be more likely to use e-cigarettes.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Hrywna reported receiving support from a contract from the New Jersey Department of Health and grants from the National Institutes of Health during the conduct of the study. Dr Bover Manderski reported receiving support from a contract from the New Jersey Department of Health and grants from National Cancer Institute of the National Institutes of Health during the conduct of the study. Dr Delnevo reported receiving grants from the National Institutes of Health during the conduct of the study.

References

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