Electronic Cigarette Use and Associated Risk Factors in U.S.-Dwelling Pacific Islander Young Adults.

Background: E-cigarette use is rapidly increasing among US young adults, heightening their risk for vaping-related illnesses. Yet, little is known about e-cigarette use among young adult Native Hawaiians and Pacific Islanders (NHPI): an indigenous-colonized US racial group rarely described in research literature. This exploratory study provides the first known data on e-cigarette use and potential risk factors in NHPI young adults. Method: Self-report data were collected from 143 NHPI young adults (age 18-30 years) living in two large NHPI communities: Samoans in urban Los Angeles County and Marshallese in rural Arkansas. We assessed rates of e-cigarette, cigarette, alcohol, and marijuana use, and positive and negative outcome expectancies from e-cigarettes, that is expected outcomes from e-cigarette use. To identify potential risk factors for NHPI e-cigarette use, regressions explored associations between participants' current e-cigarette use with current cigarette, alcohol, and marijuana use, and e-cigarette outcome expectancies. Results: Among NHPI young adults, lifetime e-cigarette use rate was 53% and current use rate was 39%. Current rate of dual e-cigarette/cigarette, e-cigarette/alcohol, and e-cigarette/marijuana use was 38%, 35%, and 25%, respectively. In our regression models, current marijuana use and positive e-cigarette outcome expectancies were significantly associated with current e-cigarette use. Conclusions: E-cigarette use is common among NHPI young adults, exceeding rates for other at-risk racial groups. Marijuana use and positive expectations about e-cigarette use may represent potential e-cigarette use risk factors. Collectively, findings underscore the need for additional research to further explore the scope of, and risk and protective factors for, e-cigarette use in this understudied high-risk population

E-cigarette use among women of reproductive age: Impulsivity, cigarette smoking status, and other risk factors.

INTRODUCTION: The study aim was to examine impulsivity and other risk factors for e-cigarette use among women of reproductive age comparing current daily cigarette smokers to never cigarette smokers. Women of reproductive age are of special interest because of the additional risk that tobacco and nicotine use represents should they become pregnant. METHOD: Survey data were collected anonymously online using Amazon Mechanical Turk in 2014. Participants were 800 women ages 24-44years from the US. Half (n=400) reported current, daily smoking and half (n=400) reported smokingsociodemographics, tobacco/nicotine use, and impulsivity (i.e., delay discounting & Barratt Impulsiveness Scale). Predictors of smoking and e-cigarette use were examined using logistic regression. RESULTS: Daily cigarette smoking was associated with greater impulsivity, lower education, past illegal drug use, and White race/ethnicity. E-cigarette use in the overall sample was associated with being a cigarette smoker and greater education. E-cigarette use among current smokers was associated with increased nicotine dependence and quitting smoking; among never smokers it was associated with greater impulsivity and illegal drug use. E-cigarette use was associated with hookah use, and for never smokers only with use of cigars and other nicotine products. CONCLUSIONS: E-cigarette use among women of reproductive age varies by smoking status, with use among current smokers reflecting attempts to quit smoking whereas among non-smokers use may be a marker of a more impulsive repertoire that includes greater use of alternative tobacco products and illegal drugs

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

Increasing Providers\u27 Intent to Perform E-Cigarette Screening in the Adolescent Population

Youth e-cigarette use has increased significantly in recent years. E-cigarette use has many negative health effects supported by the literature including increased risk of respiratory infections, nicotine addiction, and the potential for cancer. E-cigarette screening creates an opportunity for patient education and counseling, as well as potentially decreases e-cigarette use. However, healthcare providers do not regularly screen adolescents for e-cigarette use. According to previous studies, the main barrier to e-cigarette screening is healthcare providers’ knowledge regarding e-cigarette health effects. This project sought to increase healthcare providers’ intent to screen for e-cigarette use in the adolescent population, through the provision of an educational offering which highlighted the literature to date regarding e-cigarette health effects. Healthcare providers were recruited in collaboration with the University of Kansas Area Health Education Center. Participants’ e-cigarette screening practices were measured before, after, and six-weeks following the educational offering. According to the findings, the study indicated that improving providers’ e-cigarette knowledge led to an increased provider intent to screen for e-cigarette use, increased provider willingness to provide patient educational materials, and increased provider inclination to counsel against e-cigarette use, which could ultimately lead to decreased e-cigarette use in the adolescent population

Electronic cigarette use and its association with smoking in Hong Kong Chinese adolescents

BACKGROUND: Electronic cigarettes (e-cigarettes) are increasingly used in adolescents with unknown impacts on conventional cigarette smoking. We examined the associations of e-cigarette use with smoking intention, nicotine addiction and smoking cessation in Chinese adolescents. METHODS: A total of 45,128 students (age 14.6±1.9; boys 51.4%) from 75 randomly selected schools in Hong Kong reported e-cigarette use (in the past 30days), conventional cigarette use and socio-demographic characteristics in an anonymous questionnaire survey. Adjusted odds ratios (AORs) of intention to smoke, morning smoking urge, intention to quit and quit attempts; and beta-coefficient (β) of cigarette consumption per day were calculated in relation to e-cigarette use. RESULTS: E-cigarette use was associated with intention to smoke with an AOR (95% CI) of 1.74 (1.30-2.31) in all students, 2.18 (1.12-4.23) in never and 2.79 (2.05-3.79) in ever smokers (non-significant interaction by smoking status). The associations were also significant in experimental and former smokers but not in current smokers. In current smokers, e-cigarette use was significantly associated with heavier smoking (β 2.54, 95% CI 1.28-3.81) and morning smoking urge (AOR 2.54, 95% CI 1.50-3.11), and non-significantly associated with lower quit intention (0.76, 0.52-1.09) and attempts (0.80, 0.56-1.23). CONCLUSIONS: E-cigarette use was associated with smoking intention in never, experimental and former smokers in Hong Kong Chinese adolescents. In current smokers, e-cigarette use was associated with nicotine addiction but not quit intention and attempts. Prospective studies with detailed measurements on e-cigarette use are warranted for further studies. Copyright © 2015 Elsevier Ltd. All rights reserved.postprin

Examining the Psychometric Properties of the CEAC (Comparing e-Cigarette and Cigarette) Questionnaire and Its Usefulness as a Predictor of e-Cigarette Use

Background: Electronic cigarette (e-cigarette) use continues to rise, while there is conflicting evidence about the health effects of its use. As such, research is needed to better determine risks factors for e-cigarette use. Accumulating evidence suggests that attitudes toward e-cigarette use could be a potential risk factor for e-cigarette use. Objectives: This study sought to examine the psychometric properties of the Comparing E-cigarette And Cigarette questionnaire (CEAC), and to replicate a structural model of the relationship between impulsive-related personality traits and e-cigarette use mediated by positive attitudes toward e-cigarettes. Methods: Participants were 525 adults (mean age = 33.42, SD = 11.27) who completed the CEAC and UPPS-P (trait impulsivity) questionnaires online. Results: Confirmatory factor analysis of the CEAC replicated the a priori factor structure of the questionnaire reasonably well (χ2(df = 32) =172.85, CFI = 0.94, TLI = 0.91, RMSEA = 0.09 (0.08–0.11, 90% Confidence Interval, SRMR = 0.06). Structural path analysis showed that deficits in conscientiousness was significantly negatively related to e-cigarette attitudes (β = –0.20, p = .01), while urgency (β = 0.19, p = .018) showed a significant positive relationship to e-cigarette attitudes. E-cigarette users showed significantly more positive attitudes toward e-cigarettes than nonusers (β = 0.59, p < .001). No significant direct effects were found between impulsivity-related traits and e-cigarette use. Conclusions: The present study suggests that impulsivity-related traits and attitudes toward e-cigarettes are likely to be important risk factors for e-cigarette use. Future prospective and experimental studies should test if the causal model described in this study predicts risk for e-cigarette use, and whether this model could therefore be used to guide strategies for reducing risk for e-cigarette use

Electronic Cigarette Use Among High School Students and Its Association With Cigarette Use And Smoking Cessation, North Carolina Youth Tobacco Surveys, 2011 and 2013

Although adolescent cigarette use continues to decline in the United States, electronic cigarette (e-cigarette) use among adolescents has escalated rapidly. This study assessed trends and patterns of e-cigarette use and concurrent cigarette smoking and the relationships between e-cigarette use and smoking cessation intentions and behaviors among high school students in North Carolina

Electronic Cigarettes: Associated Beliefs and Reasons for Use among US Adults

The three research studies included in this dissertation aimed to examine the reasons for e-cigarette use among U.S. adults, and to examine the U.S. public opinion on allowing e-cigarette use where smoking is otherwise prohibited. Mixed (quantitative and qualitative) research methods were used. Data from an online survey (2012) and focus groups (2014) were analyzed. Among 307 survey respondents who had ever used e-cigarettes, the three most common reasons for e-cigarette use were curiosity (40.8%), the belief that “it helps people quit smoking” (19.1%), and perceiving e-cigarettes “less harmful than regular cigarettes” (9.3%). About 40% of U.S. adults were uncertain whether e-cigarette use should be allowed in smoke-free public areas, 37% opposed, while 23% favored allowing their use in smoke-free environments. The majority of the focus group participants have used e-cigarettes to complement regular cigarette smoking and intake nicotine where smoking is restricted. E-cigarette use was viewed to be less harmful and more convenient than smoking regular cigarettes. The findings of the three studies suggest that curiosity about e-cigarettes lead to experimentation and the convenience to use e-cigarettes in smoke-free areas lead to continual use. With impending regulation and the changing e-cigarette landscape, there is a need for continued monitoring and research on reasons for and attitudes about e-cigarette use, and on public opinion pertaining to e-cigarette use in smoke-free areas

Association between electronic cigarette use and changes in quit attempts, success of quit attempts, use of smoking cessation pharmacotherapy, and use of stop smoking services in England: time series analysis of population trends

Objectives To estimate how far changes in the prevalence of electronic cigarette (e-cigarette) use in England have been associated with changes in quit success, quit attempts, and use of licensed medication and behavioural support in quit attempts. Design Time series analysis of population trends. Participants Participants came from the Smoking Toolkit Study, which involves repeated, cross sectional household surveys of individuals aged 16 years and older in England. Data were aggregated on about 1200 smokers quarterly between 2006 and 2015. Monitoring data were also used from the national behavioural support programme; during the study, 8 029 012 quit dates were set with this programme. Setting England. Main outcome measures Prevalence of e-cigarette use in current smokers and during a quit attempt were used to predict quit success. Prevalence of e-cigarette use in current smokers was used to predict rate of quit attempts. Percentage of quit attempts involving e-cigarette use was also used to predict quit attempts involving use of prescription treatments, nicotine replacement therapy (NRT) on prescription and bought over the counter, and use of behavioural support. Analyses involved adjustment for a range of potential confounders. Results The success rate of quit attempts increased by 0.098% (95% confidence interval 0.064 to 0.132; P<0.001) and 0.058% (0.038 to 0.078; P<0.001) for every 1% increase in the prevalence of e-cigarette use by smokers and e-cigarette use during a recent quit attempt, respectively. There was no clear evidence for an association between e-cigarette use and rate of quit attempts (β 0.025; 95% confidence interval −0.035 to 0.085; P=0.41), use of NRT bought over the counter (β 0.006; −0.088 to 0.077; P=0.89), use of prescription treatment (β −0.070; −0.152 to 0.013; P=0.10), or use of behavioural support (β −0.013; −0.102 to 0.077; P=0.78). A negative association was found between e-cigarette use during a recent quit attempt and use of NRT obtained on prescription (β −0.098; −0.189 to −0.007; P=0.04). Conclusion Changes in prevalence of e-cigarette use in England have been positively associated with the success rates of quit attempts. No clear association has been found between e-cigarette use and the rate of quit attempts or the use of other quitting aids, except for NRT obtained on prescription, where the association has been negative. Study registration The analysis plan was preregistered (https://osf.io/fbgj2/)