Associations between e-cigarette access and smoking and drinking behaviours in teenagers

Abstract

BackgroundPublic health concerns regarding e-cigarettes and debate on appropriate regulatory responses are focusing on the need to prevent child access to these devices. However, little is currently known about the characteristics of those young people that are accessing e-cigarettes.MethodsUsing a cross-sectional survey of 14-17 year old school students in North West England (n = 16,193) we examined associations between e-cigarette access and demographics, conventional smoking behaviours, alcohol consumption, and methods of accessing cigarettes and alcohol. Access to e-cigarettes was identified through a question asking students if they had ever tried or purchased e-cigarettes.ResultsOne in five participants reported having accessed e-cigarettes (19.2%). Prevalence was highest among smokers (rising to 75.8% in those smoking >5 per day), although 15.8% of teenagers that had accessed e-cigarettes had never smoked conventional cigarettes (v.13.6% being ex-smokers). E-cigarette access was independently associated with male gender, having parents/guardians that smoke and students’ alcohol use. Compared with non-drinkers, teenagers that drank alcohol at least weekly and binge drank were more likely to have accessed e-cigarettes (adjusted odds ratio [AOR] 1.89, P < 0.001), with this association particularly strong among never-smokers (AOR 4.59, P < 0.001). Among drinkers, e-cigarette access was related to: drinking to get drunk, alcohol-related violence, consumption of spirits; self-purchase of alcohol from shops or supermarkets; and accessing alcohol by recruiting adult proxy purchasers outside shops.ConclusionsThere is an urgent need for controls on the promotion and sale of e-cigarettes to children. Findings suggest that e-cigarettes are being accessed by teenagers more for experimentation than smoking cessation. Those most likely to access e-cigarettes may already be familiar with illicit methods of accessing age-restricted substances.

Heterogeneity in the measurement and reporting of outcomes in studies of electronic cigarette use in adolescents: a systematic analysis of observational studies

“…The median number of participants was 3127 (IQR=1320 to 16 193). Participants’ ages were reported as: (A) middle and high school age,14 18 19 high school age only20; (B) aged 9–18+,17 10–16,33 11–18,15 12–18,29 13–18,32 ‘predominantly 14 to 15’,39 14–17,28 14–18,24 15,25 15–19,26 16–17,12 and 17–25 years37 ;and (C) a mean age (SD) of 12.2 (0.9) and 15.6 (1.2) for middle and high school students,31 14.0 (0.87) and 16.5 (0.77) for middle and high school students,22 12.4 (0.5),34 12.5 (0.6),27 14.5 (2.0),23 14.6 (0.7),40 14.6 (1.9),38 ∼14.7 (0.1),16 15.1 (2.1),41 16.2,36 and 16.4 (1.4) 11. All studies were funded by non-industry sources.…”

A framework for evaluating the public health impact of e-cigarettes and other vaporized nicotine products

“…Young VNP experimenters are more likely to engage in other risky behaviors (30, 53, 54) and have executive function deficits (55, 56) like those found in cigarette smokers (56, 57). These findings suggest a common liability model is more plausible than a gateway from VNP use to cigarette smoking (58, 59).…”

Electronic cigarette use among Korean adults

“…An earlier study conducted in Northwest England reported that the use of e-cigarettes in teenagers was associated with both heavy drinking and drinking to get drunk (Hughes et al 2015). Teenagers who use e-cigarettes may be more vulnerable to other forms of substance use and risk-taking behaviors.…”