Marijuana and e-cigarette use in a US national sample of 8th and 10th grade never-smokers of conventional cigarettes

Introduction: E-cigarette use remains a controversial topic in public health and medicine. Historically, cigarette smoking was identified as a gateway to marijuana use among adolescents. Recently, the prevalence of adolescent cigarette smoking has declined, but that of e-cigarette use continues to increase. As e-cigarettes eclipse cigarettes among adolescents, e-cigarette use may predispose adolescents to marijuana use. This study examines the relationship between e-cigarette use and marijuana use in a national sample of adolescents who have never smoked conventional cigarettes. Methods: A national sample of 8th and 10th grade never-smokers of conventional cigarettes (N=12,743) was obtained from 2014-2015 Monitoring the Future surveys. The dependent variable was past 30-day marijuana use (dichotomized Yes/No), and the independent variables were past 30-day e-cigarette use (dichotomized Yes/No), perceived availability of marijuana, peer marijuana use, parental monitoring, and religiosity. A multivariable logistic regression was conducted with marijuana use regressed on e-cigarette use, and other independent variables while controlling for covariates such as paid employment, risk-taking propensity, and sociodemographic variables. Additional regression analysis was conducted on e-cigarette users only. Results: Among adolescent never-smokers of conventional cigarettes, 5.2% and 5.6% had used marijuana and e-cigarettes, respectively, in the past 30 days. Among never-smokers who are current e-cigarette users, 24.2% had used marijuana at least once in the past 30-days, compared to 3.9% of non-e-cigarette users. Logistic regression analyses showed that e-cigarette users were three times more likely than non-users to be current marijuana users after adjusting for other variables. Perceived availability of marijuana and peer marijuana use increased the likelihood of marijuana use, while parental monitoring and religiosity were protective against marijuana use. Among e-cigarette users, the predictors of marijuana use were peer marijuana use and perceived availability of marijuana. Conclusion & Implications: A significant proportion of adolescents who have never smoked conventional cigarettes are current marijuana users. Among these adolescents, e-cigarette use is associated with a threefold increase in odds of marijuana use, suggesting a link between e-cigarette and marijuana use that is independent of conventional cigarette smoking. Among e-cigarette users, peer marijuana use and perceived availability of marijuana are particularly predictive of marijuana use and are potential foci for targeted interventions focused on reducing dual e-cigarette and marijuana use among adolescents

Adolescent E-Cigarette Users’ Perceptions of the Harm and Addictiveness of Conventional Cigarette Smoking

As the popularity of e-cigarettes continues to rise and their link with conventional cigarette smoking becomes clearer, it is important to understand how e-cigarette users compare with non-users, conventional cigarette smokers, and dual users on perceptions of addiction risk of conventional cigarette smoking as well as on other risk factors associated with smoking. PRC graduate student trainee Olusegun Owotomo, PRC faculty research associate Julie Maslowsky, and co-author Alexandra Loukas found that adolescent e-cigarette users endorsed a number of attitudes, perceptions, and characteristics that are risk factors for conventional cigarette smoking. These perceptions may leave them vulnerable to becoming conventional cigarette smokers or dual users in the future and potentially increase their risk for nicotine addiction.Population Research Cente

Children Are Researchers, Too

Latrice Sales writes about an exercise for young students that engaged them in the Whole Communities-Whole Health project in an article published in 2018.Office of the VP for Researc

Progression from e-cigarette use to conventional cigarette smoking among adolescents in the United States

Conventional cigarette smoking remains a major cause of significant morbidity and mortality in the United States. Although adolescent cigarette smoking rates have declined over the past decades, e-cigarette use is an emerging public health threat that can potentially stall or reverse this decline. Currently, e-cigarette use has become a social norm with its prevalence surpassing that of conventional cigarette smoking among adolescents. Adolescent e-cigarette users are at heightened risk of nicotine addiction and progressing to conventional cigarette smoking. However, factors underlying this progression are yet to be fully elucidated. Using the Theory of Planned Behavior as a conceptual framework, I conducted three studies that aimed to identify factors that potentially underlie progression from e-cigarette use to conventional cigarette smoking among US adolescents. With data obtained from two national surveys on adolescent risk behaviors: Monitoring the Future Survey and Population Assessment on Tobacco and Health, I examined smoking-related perceptions that make adolescent e-cigarette users susceptible to conventional cigarette smoking (Study 1); identified subgroups of adolescent e-cigarette users at most risk of exhibiting smoking intention (Study 2); and investigated how e-cigarette use moderates the transition from smoking intention to conventional cigarette smoking (Study 3). These three studies identify actionable predictors of conventional cigarette smoking among adolescent e-cigarette users and highlight potential foci for smoking prevention efforts. Findings suggest that negative attitudes and norms toward conventional cigarette smoking are major factors underlying progression to smoking among adolescent e-cigarette users. Also, three distinct subgroups of adolescent e-cigarette users were identified with each having particular smoking-related characteristics that determine their intention to smoke conventional cigarettes. Finally, transition from smoking intention to smoking initiation is moderated by e-cigarette use status, with smoking intention predicting smoking initiation only among adolescent never e-cigarette users. Adolescent e-cigarette users are at risk of progressing to smoking initiation whether or not they exhibit smoking intention, an indication that the influence of e-cigarette use on cigarette smoking may potentially override the protective effect of lack of smoking intention. Adolescents least likely to initiate conventional cigarette smoking in the current tobacco landscape do not have smoking intention and are abstaining from e-cigarettesKinesiology and Health Educatio

The youth e-cigarette epidemic: updates and review of devices, epidemiology and regulation

Adolescent e-cigarette use constitutes a major public health challenge that has reversed the steady progress made in the past three decades to reduce youth tobacco use in the United States (U.S.). Although the prevalence of e-cigarette use has declined in the past two years, 24% of 12th grade students and 8.9% of 8th grade students in 2021 used e-cigarettes or engaged in vaping of any kind in the prior 30 days. The current e-cigarette landscape is dominated by discrete and stylish pod-based e-cigarettes with varying capacity for customized nicotine delivery, vapor concealment, and child-appealing e-liquid flavors. E-cigarettes continue to evolve rapidly with innovative technology as manufacturers seek loopholes in regulatory efforts and to maximize existing marketing opportunities. Regulatory efforts so far have focused largely on marketing restrictions with enforcement decisions prioritizing smoking cessation potential of e-cigarettes for adult smokers over risk of nicotine addiction in adolescents. Disposable e-cigarette products advertising synthetic nicotine and menthol-containing products remain on the market and continue to gain popularity among adolescents. This article describes e-cigarette devices, provides an overview on epidemiology of U.S. adolescent e-cigarette use, and reviews the existing federal, state, and local e-cigarette regulations with future recommendations for stakeholders

Adolescent e-cigarette users are more likely than never-users to progress to cigarette smoking, even among those who had no intention to start smoking

E-cigarette use is a relatively new risk factor for nicotine use disorder among U.S. adolescents. Adolescents who use e-cigarettes are at increased risk of developing nicotine use disorder and progressing to smoke conventional cigarettes. In this brief, former PRC trainee Olusegun Owotomo, current PRC trainee Haley Stritzel, PRC faculty research associate Julie Maslowsky, and colleagues explore which e-cigarette users progress to cigarette smoking, and why. They find that more adolescent e-cigarette users started smoking cigarettes one year later than adolescents who had never used e-cigarettes, including those who had no intention to start smoking. The authors call on health care providers, parents, and education campaigns to emphasize the dangers associated with e-cigarette use, including the risk of progressing to cigarette smoking even among those without an intention to do so.Population Research Cente