Electronic and Combustible Cigarette Use in Adolescence: Links With Adjustment, Delinquency, and Other Substance Use

Abstract

Objective: Identify proximal links between e-cigarette use and numerous indicators of adjustment, delinquency, and other substance use in adolescence, beyond prior levels and confounders. Method:The ongoing Millennium Cohort Study is a nationally representative, intergenerational, longitudinal study of children born 2000-2001 in the United Kingdom followed from birth to age 14 (n=11,564 adolescents and their parents). A series of OLS and logistic regressions compared 14-year old e-cigarette only users to never users and to combustible/dual users on 10 measures of adjustment (school engagement, wellbeing, self-esteem), delinquency (theft, vandalism, disorderly conduct, graffitiing), and other substance use (frequent alcohol use, heavy drinking, marijuana use). Controls included each outcome variable measured at age 11 and prospectively assessed parent-and child-confounders (e.g., parent education; child externalizing and internalizing behaviors, cognitive test scores, gender, race/ethnicity).Results: At age 14, e-cigarette only users (approximately 7% of youth) had a higher risk of adolescent adjustment problems, delinquent behavior, and substance use relative to non-users (75% of youth), but lower risk relative to combustible cigarette/dual users (18% of youth), even after controlling for a host of childhood confounders. Conclusions:Positive links shown here between e-cigarette use and poor adjustment, delinquency, and other substance use in adolescence, coupled with accumulating evidence that ecigarettes substantially increase youths' likelihood of combustible smoking, indicate that ecigarettes are part of an emerging pattern of health-risk behaviors and poor adjustment for some youth.

Physical Disorders are Associated with Health Risk Behaviors in Chinese Adolescents: A Latent Class Analysis

“…than children, which is consistent with the study of Staff, J. [42]. However, the prevalence of diarrhea in this study was close to that of the previous study (24.8%) [43].…”

Escalating Safety Concerns Are Not Changing Adolescent E-Cigarette Use Patterns: The Possible Role of Adolescent Mental Health

“…Results from three new studies in this issue of the Journal of Adolescent Health suggest that adolescent mental health is another important aspect linked to e-cigarette use. A study by Staff et al [26] showed that adjustment problems, delinquent behavior, and substance use were associated with adolescent dual users (those using both e-cigarettes and cigarettes) and e-cigaretteeonly users, compared with nonusers. The study by Veliz et al [10] showed that adolescent dual use of ecigarettes likely contributed to tobacco and substance use disorders.…”

Prospective associations of e-cigarette use with cigarette, alcohol, marijuana, and nonmedical prescription drug use among US adolescents

“…A third study used a national sample of U.S. adults and found associations of risky alcohol use with dual cigarette and e-cigarette users and e-cigarette only users compared with nonusers (Roberts et al, 2020). Despite scarce prospective research, cross-sectional studies suggest associations of e-cigarette use with alcohol and other substance use (Demissie et al, 2017;McCabe et al, 2017;Miech et al, 2016;Staff et al, 2020;Wills et al, 2015). For example, in a national sample of U.S. high school students, those who used e-cigarettes were more likely to also use alcohol and to binge drink (Demissie et al, 2017).…”