Electronic Cigarette Use Among High School Students and Its Association With Cigarette Use And Smoking Cessation, North Carolina Youth Tobacco Surveys, 2011 and 2013

Abstract

IntroductionAlthough adolescent cigarette use continues to decline in the United States, electronic cigarette (e‑cigarette) use among adolescents has escalated rapidly. This study assessed trends and patterns of e‑cigarette use and concurrent cigarette smoking and the relationships between e-cigarette use and smoking cessation intentions and behaviors among high school students in North Carolina.MethodsData came from high school students who completed the school-based, cross-sectional North Carolina Youth Tobacco Survey in 2011 (n = 4,791) and 2013 (n = 4,092). This study assessed changes in prevalence of e-cigarette and cigarette use from 2011 through 2013, and cessation-related factors associated with those students’ current and past use of e‑cigarettes in 2013.ResultsThe prevalence of current e-cigarette use (use in the past 30 days) significantly increased from 1.7% (95% CI, 1.3%–2.2%) in 2011 to 7.7% (95% CI, 5.9%–10.0%) in 2013. Among dual users, current e-cigarette use was negatively associated with intention to quit cigarette smoking for good (relative risk ratio [RRR] = 0.51; 95% CI, 0.29–0.87) and with attempts to quit cigarette smoking in the past 12 months (RRR = 0.69; 95% CI, 0.49–0.97). Current e-cigarette smokers were less likely than those who only smoked cigarettes to have ever abstained from cigarette smoking for 6 months (RRR = 0.42; 95% CI, 0.21–0.82) or 1 year (RRR = 0.21; 95% CI, 0.09–0.51) and to have used any kind of aids for smoking cessation (RRR = 0.46; 95% CI, 0.29–0.74).ConclusionPublic health practitioners and cessation clinic service providers should educate adolescents about the risks of using any nicotine-containing products, including e-cigarettes, and provide adequate tobacco cessation resources and counseling to adolescent tobacco users.

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

“…In fact, nearly 60% of current youth combustible cigarette smokers surveyed in the NCYTS reported that they were attempting to quit smoking [24]. While recent studies of North Carolina youth have suggested that adolescents are perhaps less likely than adults to use e-cigarettes as part of an attempt to quit using tobacco products altogether [2], it is possible that a portion of the rise in e-cigarette use among youth may represent their attempt to mimic their parents' and peers' use of this more socially acceptable use of tobacco products. Moreover, our findings revealed a correlation based on ascending grade level between a perception of decreased risk of e-cigarette use and an increasing prevalence of lifetime use of e-cigarettes.…”

Electronic Cigarette Use Prevalence, Associated Factors, and Pattern by Cigarette Smoking Status in the United States From NHANES (National Health and Nutrition Examination Survey) 2013–2014

“…Consequently, initial growth in the prevalence of use of these products was noted among cigarette smokers 3. Over time, however, extensive marketing,4 improvements in design, extensive flavor options,5 and a widespread perception that e‐cigarettes were safer than cigarettes led to their increased popularity, especially among youth6, 7, 8, 9, 10 and those who never smoked tobacco 9, 10. This increasing popularity has raised public health concerns, given the paucity of high‐quality longitudinal evidence on the health effects of e‐cigarette exposure and uncertainly about the data supporting their use as smoking‐cessation devices 1…”

A Review of Pulmonary Toxicity of Electronic Cigarettes in the Context of Smoking: A Focus on Inflammation

“…About 5% of college students who have never smoked are using e-cigs (6). Fifty percent of adult smokers in the US have tried e-cigs, and 23% currently use both cigarettes and e-cigs (termed dual users) (5, 7–9). For adults and youth who use multiple tobacco products, the most common combination is cigarettes and e-cigs (5).…”