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. 2022 Aug:161:107111.
doi: 10.1016/j.ypmed.2022.107111. Epub 2022 Jun 16.

Internalizing and externalizing problems on the age of e-cigarette initiation in youth: Findings from the Population Assessment of Tobacco and Health (PATH), 2013-2017

Adriana Pérez  1 , Meagan A Bluestein  2 , Arnold E Kuk  2 , Baojiang Chen  3 , Melissa B Harrell  4
Affiliations

Internalizing and externalizing problems on the age of e-cigarette initiation in youth: Findings from the Population Assessment of Tobacco and Health (PATH), 2013-2017

Adriana Pérez et al. Prev Med. 2022 Aug.

Abstract

Previous research has established an association between internalizing and externalizing problems with e-cigarette use in youth. Secondary analysis of Population Assessment of Tobacco and Health youth waves 1-4(2013-2017). Age of initiation of ever e-cigarette use and age of first report of past 30-day e-cigarette use were prospectively estimated among never e-cigarette users(waves 1-3). Weighted interval-censoring multivariable Cox proportional hazard models were fit to assess differences in each e-cigarette outcome among youth with internalizing and externalizing problems, as well as the interaction between internalizing and externalizing problems, while adjusting for covariates. Weighted interval-censoring survival analyses estimated the age of initiation of ever and age of first report of past 30-day e-cigarette use stratified by internalizing and externalizing problems. Among youth never e-cigarette users, those with high internalizing problems and high externalizing problems had increased risk of initiating ever e-cigarette use at earlier ages compared to youth with none/low internalizing and externalizing problems, respectively. Youth with high internalizing problems and high externalizing problems had increased risk of first reporting past 30-day e-cigarette use at earlier ages compared to youth with none/low internalizing problems, respectively. By age 17, 36.3% of youth with high internalizing problems and 38.5% of youth with high externalizing problems initiated ever e-cigarette use. By age 17, 16.8% of youth with high internalizing and 18.7% of youth with high externalizing problems first reported past 30-day e-cigarette use. Youth with internalizing and externalizing problems should be screened for e-cigarette use and provided with proper resources to prevent onset of e-cigarette use.

Keywords: Adolescents; Health disparities; Mental health; Public health education; Risk factors; Tobacco.

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Conflict of interest statement

Conflict of Interest: The authors have no conflicts of interest to disclose except Dr. Harrell is a consultant in litigation involving the vaping industry. This does not alter our adherence to Preventive Medicine’s insights policies on sharing data and materials.

Figures

Figure 1.
Figure 1.
The age of initiation of ever e-cigarette use stratified by internalizing problems (Panel A) and externalizing problems(Panel B).
Figure 2.
Figure 2.
The age of first report of past 30-day e-cigarette use stratified by internalizing problems (Panel A) and externalizing
See this image and copyright information in PMC

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