Psychosocial Factors Associated With Adolescent Electronic Cigarette and Cigarette Use

• Published in: Pediatrics (Evanston) Vol. 136; no. 2; pp. 308 - 317
• Main Authors: Barrington-Trimis, Jessica L, Berhane, Kiros, Unger, Jennifer B, Cruz, Tess Boley, Huh, Jimi, Leventhal, Adam M, Urman, Robert, Wang, Kejia, Howland, Steve, Gilreath, Tamika D, Chou, Chih-Ping, Pentz, Mary Ann, McConnell, Rob
• Format: Journal Article
• Language: English
• Published: United States American Academy of Pediatrics 01-08-2015
• Subjects: Adolescent; Cross-Sectional Studies; Electronic cigarettes; Electronic Nicotine Delivery Systems - psychology; Electronic Nicotine Delivery Systems - statistics & numerical data; Female; Health aspects; Humans; Influence; Male; Pediatrics; Risk Assessment; Smoking - epidemiology; Smoking - psychology; Social psychology; Surveys and Questionnaires; Teenagers; Youth; United States; Southern California
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2015-0639

Use of electronic cigarettes (e-cigarettes) among adolescents has increased since their introduction into the US market in 2007. Little is known about the role of e-cigarette psychosocial factors on risk of e-cigarette or cigarette use in adolescence.
Information on e-cigarette and cigarette psychosocial factors (use and attitudes about use in the home and among friends) was collected from 11th- and 12th-grade participants in the Southern California Children's Health Study during the spring of 2014.
Of 2084 participants, 499 (24.0%) had used an e-cigarette, including 200 (9.6%) current users (past 30 days); 390 participants (18.7%) had smoked a combustible cigarette, and 119 (5.7%) were current cigarette smokers. Cigarette and e-cigarette use were correlated. Nevertheless, 40.5% (n = 81) of current e-cigarette users had never smoked a cigarette. Psychosocial factors (home use of each product, friends' use of and positive attitudes toward e-cigarettes and cigarettes) and participant perception of the harm of e-cigarettes were strongly positively associated both with e-cigarette and cigarette use. Most youth who reported e-cigarette use had friends who used e-cigarettes, and almost half of current users reported that they did not believe there were health risks associated with e-cigarette use.
Longitudinal studies of adolescents are needed to determine whether the strong association of e-cigarette psychosocial factors with both e-cigarette and cigarette use will lead to increased cigarette use or dual use of cigarettes and e-cigarettes, or whether e-cigarettes will serve as a gateway to cigarette use.