Adolescents' Perceptions of Risks and Benefits of Conventional Cigarettes, E-cigarettes, and Marijuana: A Qualitative Analysis

Abstract

Purpose While rates of adolescent cigarette use have remained constant, rates of marijuana and e-cigarette use are rising. Knowledge and perceptions of risks and benefits of tobacco products impacts adolescents’ decisions to use these products. However, little is known regarding adolescents’ knowledge and perceptions of risks of e-cigarettes and marijuana nor how these perceptions are formed. This study uses qualitative techniques to assess and compare adolescents’ perceptions of the risks and benefits of cigarettes, e-cigarettes, and marijuana. Methods 24 adolescents (9 females and 15 males) from Northern California participated in 6 small-groups discussions. Adolescents were asked what good or bad things might happen from using these products. To assess how perceptions and knowledge of risks and benefits were formed, participants were asked where and from whom they had learned about these products. Results Adolescents described negative consequences of cigarette use, but were much less sure regarding risks of marijuana and e-cigarette use. Conversely, they described few benefits of cigarettes but described a number of benefits of e-cigarette and marijuana use. Adolescents described learning about these products from the media, from family and friends, and from the school environment. Conclusion Adolescents have learned from multiple sources about risks of using cigarettes, but they receive much less and often incorrect information regarding marijuana and e-cigarettes, likely resulting in their positive and often ambivalent perceptions of marijuana and e-cigarettes.

Use and Perceived Risk of Electronic Cigarettes Among North Carolina Middle and High School Students

“…Despite this finding, several factors appear to foster the use of e-cigarettes in this population, including an uncertainty about the risks of e-cigarettes, a reported number of social benefits associated with their use, and limited direct education on the potential risks of e-cigarettes [19,33]. While the longitudinal risks associated with the use of e-cigarettes have yet to be determined, many have underscored the importance of developing public health measures and education programs on e-cigarettes targeted at the vulnerable adolescent population as part of an effort to combat the current observed rise in tobacco product use among youth [9,19,[33][34][35][36][37].…”

“…While the longitudinal risks associated with the use of e-cigarettes have yet to be determined, many have underscored the importance of developing public health measures and education programs on e-cigarettes targeted at the vulnerable adolescent population as part of an effort to combat the current observed rise in tobacco product use among youth [9,19,[33][34][35][36][37]. Our survey results suggest that a critical time for adolescent education on this issue would be prior to high school matriculation, at which time the prevalence of everuse of e-cigarettes surpasses perceived risk.…”

Use of Electronic Nicotine Delivery Systems Among Adolescents: Status of the Evidence and Public Health Recommendations

“…8,17,18 Regulators are growing increasingly concerned that ENDS advertisements glamorize the use of e-cigarettes and will lead to the renormalization of smoking after years of progress in antismoking public health campaigns. Particularly alarming is the targeting of advertisements to children and the child-friendly ENDS flavorings such as fruit, bubble gum, cinnamon, and piña colada.…”

“…8,19 According to the 2014 National Youth Tobacco Survey of middle school and high school students in the US, approximately 70% have been exposed to ENDS advertising including via stores, the Internet, television, movies, and newspapers and magazines. 18,20 Advertisements for traditional tobacco products are a risk factor for youth to begin smoking, as shown in the Global Youth Tobacco Survey, a measure for monitoring international tobacco use control efforts. 21,22 Moreover, ENDS advertising spending in the US rose from $6.4 million in 2011 to $115 million in 2014.…”

“…8,17,18 One longitudinal study found a 2-fold increased risk of having used ENDS on follow-up among participants who believed e-cigarettes to be less harmful than traditional combustible cigarettes. 17 Another study of e-cigarette beliefs among high school students in North Carolina reported that 60% of participants surveyed reported that e-cigarettes were safe or have minimal health risks.…”