E-cigarette use perceptions that differentiate e-cigarette susceptibility and use among high school students

ABSTRACT

Background

E-cigarette use among adolescents is increasingly popular and a growing public health concern.

Objectives

To examine how individual e-cigarette use perceptions differ between adolescents based on e-cigarette use status and susceptibility to future use of e-cigarettes.

Methods

Data were collected using surveys administered across eight Connecticut high schools (grades 9–12), Spring 2015. N = 2592 students (Mage = 16.01, SD = 1.28, Female = 51.7%) reported e-cigarette use and susceptibility and were categorized into non-susceptible never-users (57.8%), susceptible never-users (16.9%) and ever-users (25.4%). Youth also responded to 12 e-cigarette use perceptions describing perceived benefits and risks of e-cigarette use.

Results

A multinomial logistic regression model was used. Eight use perceptions were related to susceptibility or use of e-cigarettes. The benefit-related use perception “feel relaxed” was the only item associated with greater odds of being both susceptible (vs. non-susceptible, p <.001) and an ever-user (vs. susceptible; p <.05). Two other benefit-related use perceptions were related to higher odds of being susceptible to e-cigarette use (“control your weight”; AOR = 1.82, p <.05; “look cool”; AOR = 3.13, p <.05). Results also identified key risk-related use perceptions that related to lower odds of either being susceptible to e-cigarette use (“have a heart attack”; AOR =.43, p <.001) or of ever-use (“have bad breath”; AOR =.28, p <.001; “get lung cancer”; AOR =.58, p <.05).

Conclusion

E-cigarette use perceptions among youth differ by e-cigarette use and susceptibility status. Findings could help identify youth who are vulnerable to e-cigarette use and inform prevention, for example by developing counter-messaging for benefit perceptions associated with susceptibility and ever-use.

KEYWORDS:

• E-cigarette
• susceptibility
• acquisition
• adolescents
• risk perception
• benefit perception

Author’s Contribution

AB contributed to the conceptualization of the study, developed and tested the hypotheses reported in the manuscript, ran all statistical analyses, and wrote the primary manuscript draft; KWB, GK, and RW contributed to the conceptualization of the study, the analysis, and critically reviewed drafts of the manuscript; SKS secured study funding, led the development of the self-report survey, contributed to the conceptualization of the study, and critically reviewed drafts of the manuscript; and all authors approved the final manuscript as submitted.

Disclosure of interest

The authors have indicated they have no potential conflicts of interest to disclose.

Additional information

Funding

Research reported in this publication was supported by the National Institute on Drug Abuse of the National Institutes of Health under award numbers P50DA036151 and U54DA036151 from the NIDA and FDA Center for Tobacco Products (CTP) and K12DA000167 from NIDA. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the Food and Drug Administration.