Melissa H. Abadi, Ph.D., mabadi@pire.org
Stephen R. Shamblen, Ph.D., sshamblen@PIRE.org
Kirsten Thompson, M.A., kthompson@PIRE.org
Joel W. Grube, Ph.D., grube@prev.org
Sharon Lipperman-Kreda, Ph.D., skreda@prev.org
Camila Aramburu, M.P.H., caramburu@PIRE.org
Adolescent e-cig use increases risk of tobacco cigarette use and frequency of use. Dual use of tobacco products is associated with greater risk of addiction. Additionally, an environment favorable to e-cig use may cultivate a re-normalization of tobacco use. As such, we examined adolescent exclusive and dual use patterns and individual and environmental predictors of use among 50 vapers (ages 14-17) in Kentucky. An initial survey assessed demographics and e-cig and tobacco use and perceptions.
Daily surveys over two weeks (700 observations) obtained real-time data on adolescents’ e-cig and tobacco use and intentions, and environmental context of e-cig use. Adolescents reported non-use on 38% of days, exclusive vaping on 44%, exclusive smoking on 8%, dual-use (vaping and smoking within 24 hours) on 9%, and concurrent use (any tobacco product use within two hours of vaping) on 12%. On average, adolescents vaped 7 times per day, took 55 total puffs per day, and smoked 2 cigarettes per day.
We used mixed effects random intercept regressions and random intercept generalized linear models to determine use patterns and between and within predictors of use. The linear trend (one-week period, repeated twice) significantly predicted vaping occasions per day, total e-cig puffs per day, and concurrent daily use, indicating greater use on the weekend. Vaping-only days were predicted by same day exposure to peers vaping, higher prior day vaping intentions, and lower prior day tobacco smoking intentions. Tobacco-use-only days were predicted by no exposure to peers vaping on the same day. Dual-use days were predicted by lower negative e-cig expectancies, parental norms favorable to e-cigs, same day exposure to adults vaping, peers vaping, and exposure to e-cig advertising, and higher prior day tobacco intentions. Concurrent-use days were predicted by younger age of e-cig initiation, higher positive e-cig expectancies, lower negative e-cig expectancies, and vaping that day because “tobacco is prohibited.”
Results suggest that regulatory efforts should counter the influence of normative approval of e-cigs, exposure to vaping by parents and peers, and exposure to e-cig marketing.
Funding: This research is supported by the National Institute on Drug Abuse Research (NIDA) and Food and Drug Administration (FDA) Center for Tobacco Products (CTP) grant 1R03DA041899-01A1, as well as grant 25IR-0029 from the California Tobacco-Related Disease Research Program (TRDRP). The content is solely the responsibility of the authors and does not necessarily represent the official views of FDA, NIDA, TRDRP, or NIH.
Topic: Public Health
Keywords: Adolescent; E-cigarette
