Trends in characteristics and multi-product use among adolescents who use electronic cigarettes, United States 2011-2015

Abstract

ObjectivesEvaluate trends from 2011–2015 in electronic cigarette (e-cigarette) use among U.S. adolescents, grades 6–12, including prevalence and associations with past month use of cigarettes and other tobacco products, cigarette smoking intensity, quit attempts, and quit contemplation.MethodsFive consecutive waves from the National Youth Tobacco Survey (N = 101,011) were used to estimate the grade- and race/ethnicity-standardized prevalence of past month use of e-cigarettes and nine non e-cigarette tobacco products. We assessed linear trends by year and compared outcomes (e.g., tobacco use, smoking intensity) by e-cigarette past month use.ResultsPast month e-cigarette use rose sharply from 2011–2015. In all years and both sexes, e-cigarette past month use and ever use were positively associated with use of cigarettes and other tobacco products, with past month e-cigarette use reaching 52% in 2015 among individuals who used ≥1 non e-cigarette tobacco product in the past month. Meanwhile, from 2011–2015, the population of adolescent past month e-cigarette users increasingly encompassed adolescents who were not past month users of other products (females: 19.0% to 41.7%; males: 11.1% to 36.7%) or had never used other products (females: 7.1% to 13.5%; males: 6.7% to 15.0%). Among male (but not female) past month cigarette users, there was a statistically significant positive association between past month e-cigarette use and daily cigarette smoking but not in all individual years. Past month e-cigarette use among past month cigarette smokers was not associated with cigarette quit attempts or quit contemplation, with no temporal trend.ConclusionAdolescent past month e-cigarette use is associated with past month use of other tobacco but not with cigarette quit attempts or quit contemplation among cigarette users. Over five years, the average characteristics of U.S. adolescents who use e-cigarettes have shifted, increasingly including more adolescents who do not use non e-cigarette tobacco products.

Patterns of concurrent cigarette, alcohol, and e‐cigarette use: Off‐setting or additive behaviors?

“…With the perceived safety of e-cigarettes, 15 their use has increased dramatically, even as conventional cigarette smoking rates have declined. 7 Here, we utilize the NHIS to investigate patterns of concurrent use of ecigarettes with conventional cigarettes and alcohol. The NHIS is a cross-sectional household interview survey that utilizes a face-to-face interview format.…”

“…From 2011 to 2015, the use of e‐cigarettes by 18‐ to 24‐year‐old young adults rose 2.5‐fold in the Truth Initiative Young Adult Cohort Study . Over this same period, the past month use of e‐cigarettes by adolescents in grades 6 to 12 rose 8‐fold in males and 16‐fold in females in the National Youth Tobacco Survey …”

“…The patterns of concurrent use of tobacco cigarettes and alcohol are well described . Recently, in adolescents and youths, e‐cigarette use was also shown to be associated with conventional cigarette and alcohol use . In older adults, who tend to use e‐cigarettes as smoking cessation aids, e‐cigarette use has been demonstrated to be significantly associated with tobacco cigarette use; longitudinal studies suggest that e‐cigarettes are not effective for smoking cessation .…”

“…6 Over this same period, the past month use of e-cigarettes by adolescents in grades 6 to 12 rose 8-fold in males and 16-fold in females in the National Youth Tobacco Survey. 7 However, due to the relative infancy of this technology, long-term data on the safety of e-cigarettes and the concurrent use of e-cigarettes with other addictive substances is lacking. The patterns of concurrent use of tobacco cigarettes and alcohol are well described.…”

“…8 Recently, in adolescents and youths, e-cigarette use was also shown to be associated with conventional cigarette and alcohol use. 7 In older adults, who tend to use ecigarettes as smoking cessation aids, 9 e-cigarette use has been demonstrated to be significantly associated with tobacco cigarette use [10][11][12][13][14][15] ; longitudinal studies suggest that e-cigarettes are not effective for smoking cessation. 9,10 However, the relationship between e-cigarettes and alcohol use in adults is less clearly documented, with studies finding mixed results.…”