Longitudinal Impact of Perceived Harm and Addiction on E-cigarette Initiation Among Tobacco-naïve Youth: Population Assessment of Tobacco and Health Study (Waves 1-5)

Overview

Journal Public Health

Publisher Elsevier

Specialty Public Health

Date 2024 Mar 20

PMID 38507916

Authors

W Li

M E Kalan

A J Kondracki

P Gautam

R Jebai

O Osibogun

Affiliations

Soon will be listed here.

Abstract

Objectives: This study investigates the effect of e-cigarette-related harm and addiction perceptions on e-cigarette initiation among US tobacco-naïve adolescents.

Study Design: This is a longitudinal study.

Methods: Using data from five waves (2013-2019) of the Population Assessment of Tobacco and Health Study, we created a longitudinal data set for 2775 youth aged 12-17 years who had no prior use of tobacco products at Wave 1. E-cigarette initiation was defined as transitioning from non-use at Wave 1 to ever use in subsequent waves. Kaplan-Meier survival and Cox proportional hazard regression models were used to assess the impact of harm and addiction perceptions on e-cigarette initiation.

Results: Our analytic sample comprised 63.1% of youth who had never used tobacco products at Wave 1 and consequently initiated e-cigarette use in subsequent waves. Over time, fewer individuals perceived e-cigarettes as harmless (14.1%-2.1%), whereas more perceived them as likely to cause addiction (53.7%-76.6%). Compared with perceiving e-cigarettes as a lot of harm, those perceiving some harm (adjusted hazard ratio [aHR] = 1.30, 95% confidence interval [CI]: 1.12-1.52), little harm (aHR = 1.42, 95% CI: 1.20-1.68), or no harm (aHR = 2.09, 95% CI: 1.64-2.65) were more likely to initiate e-cigarette use. Demographic factors for initiation included being Black or Hispanic ethnicity (vs White), younger age (12-14 vs15-17 years), and receiving over $20 per week (vs $0) in pocket money, with P-values <0.05. However, in adjusted results, addiction perceptions did not significantly impact e-cigarette initiation (P-values >0.05).

Conclusions: Among youth without prior tobacco/nicotine use, perceiving e-cigarettes as having low harm significantly predicted initiation over time. Effective prevention strategies, including targeted risk communication interventions, are essential for discouraging e-cigarette use among youth.

References

King B, Gammon D, Marynak K, Rogers T . Electronic Cigarette Sales in the United States, 2013-2017. JAMA. 2018; 320(13):1379-1380. PMC: 6233837. DOI: 10.1001/jama.2018.10488. View

Soneji S, Barrington-Trimis J, Wills T, Leventhal A, Unger J, Gibson L . Association Between Initial Use of e-Cigarettes and Subsequent Cigarette Smoking Among Adolescents and Young Adults: A Systematic Review and Meta-analysis. JAMA Pediatr. 2017; 171(8):788-797. PMC: 5656237. DOI: 10.1001/jamapediatrics.2017.1488. View

Cooper M, Loukas A, Case K, Marti C, Perry C . A longitudinal study of risk perceptions and e-cigarette initiation among college students: Interactions with smoking status. Drug Alcohol Depend. 2018; 186:257-263. PMC: 5911205. DOI: 10.1016/j.drugalcdep.2017.11.027. View

Bhalerao A, Sivandzade F, Archie S, Cucullo L . Public Health Policies on E-Cigarettes. Curr Cardiol Rep. 2019; 21(10):111. PMC: 6713696. DOI: 10.1007/s11886-019-1204-y. View

Hyland A, Ambrose B, Conway K, Borek N, Lambert E, Carusi C . Design and methods of the Population Assessment of Tobacco and Health (PATH) Study. Tob Control. 2016; 26(4):371-378. PMC: 5299069. DOI: 10.1136/tobaccocontrol-2016-052934. View

Honeycutt L, Huerne K, Miller A, Wennberg E, Filion K, Grad R . A systematic review of the effects of e-cigarette use on lung function. NPJ Prim Care Respir Med. 2022; 32(1):45. PMC: 9588082. DOI: 10.1038/s41533-022-00311-w. View

Klein E, Berman M, Hemmerich N, Carlson C, Htut S, Slater M . Online E-cigarette Marketing Claims: A Systematic Content and Legal Analysis. Tob Regul Sci. 2016; 2(3):252-262. PMC: 4950517. DOI: 10.18001/TRS.2.3.5. View

Hartmann-Boyce J, McRobbie H, Lindson N, Bullen C, Begh R, Theodoulou A . Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev. 2021; 4:CD010216. PMC: 8092424. DOI: 10.1002/14651858.CD010216.pub5. View

Visconti M, Ashack K . Dermatologic manifestations associated with electronic cigarette use. J Am Acad Dermatol. 2019; 81(4):1001-1007. DOI: 10.1016/j.jaad.2019.03.088. View

10.

Gautam P, Sharma E, Ebrahimi Kalan M, Li W, Ward K, Sutherland M . Prevalence and Predictors of Waterpipe Smoking Initiation and Progression Among Adolescents and Young Adults in Waves 1-4 (2013-2018) of the Population Assessment of Tobacco and Health (PATH) Study. Nicotine Tob Res. 2022; 24(8):1281-1290. DOI: 10.1093/ntr/ntac051. View

11.

Asfar T, Jebai R, Li W, Oluwole O, Ferdous T, Gautam P . Risk and safety profile of electronic nicotine delivery systems (ENDS): an umbrella review to inform ENDS health communication strategies. Tob Control. 2022; . PMC: 10043882. DOI: 10.1136/tc-2022-057495. View

12.

Iles I, Gillman A, Klein W, Ferrer R, Kaufman A . Associations between absolute and relative electronic cigarette harm perceptions and information-seeking behaviours among US adult current, former and never smokers. Drug Alcohol Rev. 2021; 41(2):356-364. DOI: 10.1111/dar.13368. View

13.

Hammig B, Daniel-Dobbs P, Blunt-Vinti H . Electronic cigarette initiation among minority youth in the United States. Am J Drug Alcohol Abuse. 2016; 43(3):306-310. DOI: 10.1080/00952990.2016.1203926. View

14.

Li W, Osibogun O, Gautam P, Li T, Cano M, Maziak W . Effect of harm perception on ENDS initiation among US adolescents and young adults: Longitudinal findings from the population assessment of tobacco and health (PATH) study, 2013-2018. Drug Alcohol Depend. 2023; 244:109784. DOI: 10.1016/j.drugalcdep.2023.109784. View

15.

Sapru S, Vardhan M, Li Q, Guo Y, Li X, Saxena D . E-cigarettes use in the United States: reasons for use, perceptions, and effects on health. BMC Public Health. 2020; 20(1):1518. PMC: 7545933. DOI: 10.1186/s12889-020-09572-x. View

16.

Brose L, Brown J, Hitchman S, McNeill A . Perceived relative harm of electronic cigarettes over time and impact on subsequent use. A survey with 1-year and 2-year follow-ups. Drug Alcohol Depend. 2015; 157:106-11. PMC: 4686045. DOI: 10.1016/j.drugalcdep.2015.10.014. View

17.

Sharapova S, Reyes-Guzman C, Singh T, Phillips E, Marynak K, Agaku I . Age of tobacco use initiation and association with current use and nicotine dependence among US middle and high school students, 2014-2016. Tob Control. 2018; 29(1):49-54. DOI: 10.1136/tobaccocontrol-2018-054593. View

18.

Amin S, Dunn A, Laranjo L . Social Influence in the Uptake and Use of Electronic Cigarettes: A Systematic Review. Am J Prev Med. 2019; 58(1):129-141. DOI: 10.1016/j.amepre.2019.08.023. View

19.

Augenstein J, Smaldone A, Usseglio J, Bruzzese J . Electronic Cigarette Use and Academic Performance Among Adolescents and Young Adults: A Scoping Review. Acad Pediatr. 2023; 24(2):228-242. DOI: 10.1016/j.acap.2023.09.012. View

20.

Parker M, Villanti A, Quisenberry A, Stanton C, Doogan N, Redner R . Tobacco Product Harm Perceptions and New Use. Pediatrics. 2018; 142(6). PMC: 6317771. DOI: 10.1542/peds.2018-1505. View