Subjective experiences at first use of cigarette, e-cigarettes, hookah, and cigar products among Texas adolescents

Abstract

Introduction Subjective experiences (“SEs”) at first cigarette use have been thoroughly examined; however, limited research has examined SEs at first use of non-cigarette products. This study addresses this gap in the literature. Methods Cross-sectional data from 6th, 8th and 10th grade students in four metropolitan areas of Texas (n = 3907/N = 461,069). Nausea, coughing, relaxation, rush/buzz, and dizziness at first use were assessed for cigarettes, e-cigarettes, hookah, and cigar products. Chi-square analyses examined differences in the prevalence of first use SEs by product. Weighted multiple logistic regression analyses examined the association of SEs and current product use. Covariates were grade, gender, race/ethnicity, and current other tobacco product use. Results Exploratory factor analysis of SEs determined differing factor structures across tobacco products. For example, the following items loaded onto the positive SE factor: 1) relaxation, rush, and dizziness for cigarettes, and 2) relaxation and rush for e-cigarettes, hookah, and cigar products. Prevalence of negative SEs (coughing and nausea) were higher for cigarette and cigar products compared to e-cigarettes and hookah. Positive SEs for cigarettes were associated with increased odds of current cigarette use (AOR = 1.51); similarly positive SEs for cigars were associated with increased odds of current cigar use (AOR = 2.11). Feeling nauseous at first use of cigars was associated with decreased odds of current cigar use (AOR = 0.18). No SEs were associated with current e-cigarette or hookah use. Conclusions Subjective experiences at first use differ by tobacco product. Longitudinal studies are needed to examine temporal relationships between SEs at first use and sustained tobacco use.

Symptoms during Adolescents’ First Use of Cigarettes and E-Cigarettes: A Pilot Study

“…E-cigarettes appear to be less off-putting than conventional cigarettes, which may contribute to their growing popularity among adolescents. Adolescents in two U.S. cities reported experiencing fewer negative symptoms from e-cigarettes than conventional cigarettes in our small pilot study, findings that are consistent with previous studies of a national sample of adults [ 7 ] and of adolescents in Texas [ 8 ]. A novelty of our study is the use of open-ended questions, in which adolescents made unprompted comments about experiencing fewer negative symptoms from e-cigarettes.…”

“…In contrast, symptoms experienced at first e-cigarette use were not associated with current e-cigarette use. In the only other study to examine the influence of adolescents’ first experiences with e-cigarettes on current use, Mantey et al also found that positive and negative initial experiences at first use had no effect on past 30-day e-cigarette use [ 8 ]. Together, these findings suggest that the mechanisms leading to regular use of e-cigarettes and cigarettes among adolescents may have important differences.…”

“…Given the differences in nicotine intake methods between e-cigarettes and conventional cigarettes, it is possible that e-cigarettes may not elicit the same symptoms that adolescents typically experience during first cigarette use. Supporting this idea, two studies have found that negative symptoms were more common during first use of conventional cigarettes compared to e-cigarettes [ 7 , 8 ]. Furthermore, it is unclear whether initial experiences with e-cigarettes might influence likelihood of continued use.…”

Lessons and Guidance from the Special Issue on Electronic Cigarette Use and Public Health

“…Although risk factors for experimenting with e-cigs and cigarettes may be similar, a small telephone survey of high-risk adolescents by Chen et al agrees that initial experiences are not [ 27 ]. In findings consistent with a large printed survey of unselected 6th through 10th grade students [ 28 ], cigarettes had more negative effects and were less calming than e-cigs, but delivered a better “buzz”. The studies also agree that adolescents’ positive and negative experiences with cigarettes were associated with increased and decreased odds of smoking, respectively, but initial experiences with e-cigs had no association with subsequent use.…”

Rural Versus Urban Use of Traditional and Emerging Tobacco Products in the United States, 2013–2014

“…As all emerging tobacco products bear their own health risks and offer additional possibilities for dual/poly use, it is critical to monitor rural trends in the use of these emerging products. Yet most research on emerging tobacco products has either looked at overall, national trends, 15–18 or focused on heavily populated areas, 19–21 with very little focus on rural use of emerging tobacco products. Likewise, although there are extremely high rates of both cigarette and smokeless tobacco use among rural populations (e.g., one study on daily tobacco users in Appalachia found that one-third of the male participants used smokeless tobacco 22 ), research has paid little attention to rural individuals engaged in the dual- or poly-use of tobacco products.…”