E-cigarette prevention efforts toward youth should include limiting e-cigarette flavors, communicating messages emphasizing the health risks of use, and changing social norms surrounding the use of e-cigarettes. The results should be interpreted in light of the limitations of this study.

BACKGROUND AND OBJECTIVES: Electronic cigarette (e-cigarette) use is increasing rapidly among high school (HS) students. Of concern, e-cigarettes can be used to vaporize cannabis, although use rates among adolescents are unknown. We evaluated lifetime rates of using e-cigarettes to vaporize cannabis among all lifetime e-cigarette users (27.9%), all lifetime cannabis users (29.2%), and lifetime users of both e-cigarettes and cannabis (18.8%); common means of vaporizing cannabis including hash oil, wax infused with D-9-tetrahydrocannabinol (THC), and dried cannabis; and demographic predictors of using e-cigarettes to vaporize cannabis.

Introduction: There is limited evidence on electronic cigarette (e-cigarette) use among U.S. adolescents. Methods: Cross-sectional, anonymous surveys conducted in 4 high schools (HS; n = 3,614) and 2 middle schools (MS; n = 1,166) in Connecticut in November 2013 examined e-cigarette awareness, use patterns, susceptibility to future use, preferences, product components used (battery type, nicotine content, flavors), and sources of marketing and access. Results: High rates of awareness (MS: 84.3%; HS: 92.0%) and of lifetime (3.5% MS, 25.2 % HS) and current (1.5% MS, 12% HS) use of e-cigarettes was observed. Among those who had not tried e-cigarettes, 26.4% of MS and 31.7% of HS students reported being susceptible to future use. Males (OR = 1.70, p < .01), older students (OR = 1.39, p < .05), Caucasians (OR = 2.01, p < .001), ever cigarette smokers (OR = 13.04, p < .001), and current cigarette smokers (OR = 65.11, p < .001) were more likely to be lifetime e-cigarette users and to report greater future susceptibility (males: OR = 1.30; Caucasians: OR = 1.14; ever cigarette smokers; OR = 3.85; current cigarette smokers; OR = 9.81; ps < .01-.001). Among MS students who were lifetime e-cigarette users, 51.2% reported that e-cigarette was the first tobacco product they had tried. E-cigarettes that were rechargeable and had sweet flavors were most popular. Smokers preferred e-cigarettes to cigarettes. Current cigarette smokers were more likely to initiate with nicotine-containing e-cigarettes, and ever and never cigarette smokers to initiate with e-cigarettes without nicotine. Primary sources for e-cigarette advertisements were televisions and gas stations and, for acquiring e-cigarettes, were peers. Conclusions: Longitudinal monitoring of e-cigarette use among adolescents and establishment of policies to limit access are imperatively needed.

Diagnosis and treatment of depressive symptoms may improve medication adherence in patients after ACS.

E-cigarette use was associated with future cigarette use across 3 longitudinal waves, yet cigarette use was not associated with future e-cigarette use. Future research needs to examine mechanisms through which e-cigarette use leads to cigarette use. E-cigarette regulation and prevention programs may help prevent future use of cigarettes among youth.

BACKGROUND: Longitudinal research is needed to identify predictors of continued electronic cigarette (e-cigarette) use among youth. We expected that certain reasons for first trying e-cigarettes would predict continued use over time (eg, good flavors, friends use), whereas other reasons would not predict continued use (eg, curiosity).

Background: E-cigarette use is associated with cigarette initiation among adolescents. However, it is unclear whether e-cigarette use is associated with more frequent cigarette use following initiation. Also, the extent to which cigarette or dual cigarette and e-cigarette users transition to exclusive e-cigarette use or to non-use of either product is not yet known. Methods: Data were pooled from three prospective cohort studies in California and Connecticut (baseline: 2013–2014; follow-up: 2014–2016; N=6258). Polytomous regression models evaluated the association of baseline e-cigarette use (never/ever) with cigarette use frequency at follow-up (experimental: initiation, but no past 30-day use; infrequent: 1–2 of the past 30 days; frequent: 3–5 or more of the past 30 days). Polytomous regression models also evaluated transitions between baseline ever or past 30-day single or dual product use and past 30-day single or dual product use at follow-up. Results: Among baseline never-smokers, e-cigarette users had greater odds of subsequent experimental (OR=4.58; 95% CI: 3.56, 5.88), infrequent (OR=4.27; 95% CI: 2.75, 6.62) or frequent (OR=3.51; 95% CI: 1.97, 6.24) cigarette use; the three OR estimates were not significantly different. Baseline past 30-day exclusive cigarette use was associated with higher odds at follow-up of exclusive cigarette or dual product use, compared with exclusive e-cigarette use. Conclusions and relevance: Tobacco control policy to reduce adolescent use both of e-cigarettes and cigarettes is needed to prevent progression to more frequent tobacco use patterns, and to reduce combustible cigarette use (with or without concurrent e-cigarette use) to lessen the adverse public health impact of e-cigarettes.

This study provides one of the first longitudinal examinations demonstrating that exposure to e-cigarette advertising on social networking sites among youth who had never used e-cigarettes increases the likelihood of subsequent e-cigarette use.