Reasons for E-cigarette Use and Their Associations With Frequency, Dependence, and Quit Intentions: Findings From a Youth and Young Adult Sample

Abstract

Introduction: The purpose of this study is to examine associations between reasons for e-cigarette use and e-cigarette use frequency, dependence, and quit intentions.

Methods: Data were obtained from the Truth Longitudinal Cohort, a national probability-based online survey of U.S. youth and young adults (aged 15-24 years, collected from October 2022 to December 2023). The analytic sample (N=815) included participants who reported current e-cigarette use and their most important reason for e-cigarette use (selected from a list of responses, regrouped into categories), use frequency (number of days used in the past 30 days), dependence (E-cigarette Dependence Scale), and quit intentions (any versus none). Linear and logistic regression models were applied to aggregated cross-sectional data, adjusted for age, gender identity, race and ethnicity, perceived financial situation, past 30-day use of other combustible tobacco products, and e-cigarette device type.

Results: The most endorsed reason for using e-cigarettes was coping with mental health challenges (39.6%), followed by sensation seeking (20.4%), lower perceived harms (14.7%), social status/acceptability (10.9%), ease of use/access (10.1%), and peer/family influence (4.3%). All reasons for e-cigarette use were associated with e-cigarette use frequency and dependence. Using e-cigarettes as a means of coping with mental health challenges and social status/acceptability were also associated with greater odds of expressing any quit intentions.

Conclusions: Reasons for e-cigarette use were differentially associated with e-cigarette use behavior outcomes. Findings suggest a need to address mental health challenges and reduce access and appeal of e-cigarettes among young people to facilitate reductions in e-cigarette use.