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Disclosures: Halpern-Felsher reports being a paid expert scientist in some e-cigarette litigation and an unpaid scientific advisor and expert witness regarding some tobacco-related policies. Halpern-Felsher reported receiving grants from the NIH and other funding from the Taube Family in support of her Taube Endowed Research Faculty Scholar during the conduct of this study. The other authors report no relevant financial disclosures. Stokes reports no relevant financial disclosures.
December 03, 2020
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Teens and young adults quitting e-cigarettes during pandemic

Disclosures: Halpern-Felsher reports being a paid expert scientist in some e-cigarette litigation and an unpaid scientific advisor and expert witness regarding some tobacco-related policies. Halpern-Felsher reported receiving grants from the NIH and other funding from the Taube Family in support of her Taube Endowed Research Faculty Scholar during the conduct of this study. The other authors report no relevant financial disclosures. Stokes reports no relevant financial disclosures.
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Results from a national, cross-sectional survey showed a decrease in e-cigarette use among teens and young adults during the COVID-19 pandemic, according to a study published in JAMA Network Open.

Bonnie Halpern-Felsher, PhD, professor of pediatrics at Stanford University, and colleagues surveyed 4,351 participants aged 13 to 24 years from May 6 to 14 this year, including 2,167 participants who had ever used e-cigarettes. Of those 2,167 participants, 1,442 were aged younger than 21 years (66.5%) and 1,397 were female (64.5%).

Since the beginning of the COVID-19 pandemic, 1,198 of the 2,125 (56.4%) e-cigarette users included in the study reported changing the amount of their use — 388 (32.4%) quit and 422 (35.3%) reduced the amount of nicotine intake.

Bonnie Halpern-Felsher

“Users least likely to quit or cut back e-cigarette use were those showing higher levels of nicotine dependence and those who had used e-cigarettes a large number of times,” Halpern-Felsher told Healio.

Among 1,331 (61.4%) who reported that they were nicotine dependent, 51% were less likely to quit (adjusted OR = 0.49; 95% CI, 0.35-0.70). Of the 1,714 individuals who reported on nicotine strength, 813 (47.4%) reported that they did not change the strength, whereas 262 (15.3%) reduced the strength.

There were 895 individuals who reported on why they reduced their e-cigarette use during the pandemic — 224 (25%) cited lung strength, 136 (15.2%) did not want their parents finding out and 287 (32.1%) listed a combination of both of those reasons.

“One of the key reasons why adolescents and young adults quit or cut back on e-cigarette use is that they were worried about lung health, suggesting that discussing and educating about lung health can be a way to reduce [and/or] prevent use,” Halpern-Felsher said.

Halpern-Felsher said that because few respondents reported worrying about their parents finding out, respondents may feel comfortable hiding their e-cigarette use from parents, as other research suggests that newer e-cigarette devices are becoming easier to hide.

“The FDA should consider whether e-cigarette and other tobacco products are easy to conceal before issuing an authorization to market the product,” she said.

In a related editorial, Andrew C. Stokes, PhD, an assistant professor in the department of global health at the Boston University School of Public Health, said the findings are consistent with other evidence.

“Data from the 2020 National Youth Tobacco Survey indicate that approximately 20% of high school students and 5% of middle school students were current users of e-cigarettes in early 2020, compared with 27.5% of high school students and 10.5% of middle school students in 2019,” Stokes wrote. “These data, collected between Jan. 16 and March 16, 2020, suggest that substantial declines in e-cigarette use may have occurred even prior to the period of the study.”

References:

Halpern-Felsher B, et al. JAMA Netw Open. 2020;doi:10.1001/jamanetworkopen.2020.27572.

Stokes AC, et al. JAMA Netw Open. 2020;doi:10.1001/jamanetworkopen.2020.28221.