December 23, 2014
2 min read

E-cigarettes may attract adolescents otherwise unsusceptible to tobacco

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Analysis of electronic cigarette use among Hawaiian high school students suggested that e-cigarettes attract medium-risk adolescents, or those who would otherwise not be susceptible to tobacco use.

“Studies of US adolescents have found that current e-cigarette users are more likely to smoke cigarettes, but there are few published data on psychosocial variables that distinguish e-cigarette users and dual users (ie, people who use both e-cigarettes and cigarettes) from nonusers (people who do not use either product),” study researcher Thomas A. Wills, PhD, interim director of the cancer prevention and control program at the University of Hawaii Cancer Center, and colleagues wrote.

Thomas Wills

Thomas A. Wills

Researchers administered surveys to 1,941 high school students (mean age, 14.6 years; 53% female) in Oahu, Hawaii, that assessed use of e-cigarettes, cigarettes, alcohol and marijuana, along with psychosocial risk and protective variables. These were defined as parental support, academic involvement, smoking expectancies, peer smoking and sensation seeking.

The majority of participants knew what e-cigarettes were (96%) and considered them to be healthier than cigarettes (67%).

Twenty-nine percent of participants reported ever using e-cigarettes, 15% reported ever using cigarettes, 47% reported ever using alcohol, and 18% reported ever using marijuana.

Psychosocial risk and protective variables correlated with cigarette, alcohol and marijuana use (P<.001).

Seventeen percent of participants used only e-cigarettes, 12% were considered dual-users, 3% used only cigarettes, and 68% were considered nonusers.

Participants who used e-cigarettes only had a higher risk status compared with nonusers but lower risk status vs. dual users. These correlations suggested that e-cigarette use represented an intermediate risk status, the researchers said.

Students who used e-cigarettes only had significantly lower scores on parental support and monitoring, academic involvement and grades, and behavioral and emotional self-control compared with nonusers. Dual users scored lower than e-cigarette users on five of these variables. Students who used cigarettes only had lower scores on parental support and monitoring vs. those who used e-cigarettes only.

A similar pattern was found for specific risk factors; dual users scored significantly higher on social-cognitive risk factors and problem behavior risk factors compared with e-cigarette only users. E-cigarette only users had significantly higher risk scores for all risk factors compared with nonusers but scored lower than dual users.

Increased e-cigarette prevalence in this cohort compared with earlier studies may be because of high taxes on cigarettes in Hawaii. Further, E-cigarettes are available in popular flavors in this locale, according to researchers, and are aggressively marketed via radio, shopping malls, television and movie theaters.

“Anecdotal reports from school administrators suggest that some parents perceive e-cigarettes as desirable and buy them for adolescents,” Wills and colleagues wrote. “Attention should be given to the prominence of e-cigarette advertising, the perceived attractiveness of e-cigarettes because of price, policy or flavoring considerations, and differences in attitudes about cigarettes and e-cigarettes (eg, perceptions of users, expectancies about use, and perceived desirability from a health standpoint).”

Disclosure: The researchers report no relevant financial disclosures.