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Frequency of E-Cigarette Use and Cigarette Smoking by American Students in 2014

  • Kenneth E. Warner
    Correspondence
    Address correspondence to: Kenneth E. Warner, PhD, Department of Health Management and Policy, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor MI 48109-2029
    Affiliations
    Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan
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Published:January 25, 2016DOI:https://doi.org/10.1016/j.amepre.2015.12.004

      Introduction

      High school students’ electronic cigarette (e-cigarette) use rose rapidly in 2014, to levels higher than cigarette smoking, which declined significantly. This study assesses how frequency of e-cigarette use is associated with students’ smoking status.

      Methods

      Using Monitoring the Future data in 2015, this study evaluated the association between students’ smoking and frequency of 30-day e-cigarette use in 2014, focusing on high school seniors. Previous research has considered only whether e-cigarettes were used at all during the past month.

      Results

      Non-smokers were far less likely than smokers to have used an e-cigarette (p<0.001). E-cigarette use frequency rose with the amount of ever smoking (p<0.001). However, among current smokers, there was no difference in e-cigarette use by very light smokers (<1 cigarette/day); light smokers (1–5 cigarettes/day); and heavy smokers (≥1/2 pack/day) (p=0.99). Because most students have never smoked, never smokers constituted 25% of all seniors who used an e-cigarette. Among tenth- and eighth-graders, 43% and 48% of past-month e-cigarette users had never smoked.

      Conclusions

      Non-smoking high school students are highly unlikely to use e-cigarettes; among those who do, most used them only on 1–2 of the past 30 days. By contrast, current smokers are likely to use e-cigarettes and on many more days. It is unclear whether students’ e-cigarette use represents short-term experimentation or future sustained use, and whether it will eventually increase or decrease youth smoking and nicotine addiction. More sophisticated research methods, employing better data, will be essential to unravel the mystery that is the e-cigarette phenomenon.
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      References

        • Johnston L.D.
        • O’Malley P.M.
        • Miech R.A.
        • et al.
        Monitoring the Future National Results on Adolescent Drug Use: Overview of Key Findings, 2014.
        Institute for Social Research, University of Michigan, Ann Arbor, MI2015
        • Arrazola R.A.
        • Singh T.
        • Corey C.G.
        • et al.
        Tobacco use among middle and high school students—United States, 2011–2014.
        MMWR Morb Mortal Wkly Rep. 2015; 64 (Accessed August 10, 2015): 381-385
        • Arrazola R.A.
        • Neff L.J.
        • Kennedy S.M.
        • et al.
        Tobacco use among middle and high school students—United States, 2013.
        MMWR Morb Mortal Wkly Rep. 2014; 63 (Accessed June 22, 2015): 1021-1026
      1. Monitoring the Future. Table 1. Trends in prevalence of use of cigarettes in Grades 8, 10, and 12. www.monitoringthefuture.org/data/14data/14tobtbl1.pdf. Accessed August 10, 2015.

        • Krishnan-Sarin S.
        • Morean M.E.
        • Camenga D.R.
        • et al.
        E-cigarette use among high school and middle school adolescents in Connecticut.
        Nicotine Tob Res. 2014; 17: 810-818https://doi.org/10.1093/ntr/ntu243
        • England L.J.
        • Bunnell R.E.
        • Pechacek T.F.
        • et al.
        Nicotine and the developing human: a neglected element in the electronic cigarette debate.
        Am J Prev Med. 2015; 49: 286-293https://doi.org/10.1016/j.amepre.2015.01.015
        • Leventhal A.M.
        • Strong D.R.
        • Kirkpatrick M.G.
        • et al.
        Association of electronic cigarette use with initiation of combustible tobacco smoking in early adolescence.
        JAMA. 2015; 314: 700-707https://doi.org/10.1001/jama.2015.8950
        • Primack B.A.
        • Soneji S.
        • Stoolmiller M.
        • et al.
        Progression to traditional cigarette smoking after electronic cigarette use among U.S. adolescents and young adults.
        JAMA Pediatr. 2015; 169: 1018-1023https://doi.org/10.1001/jamapediatrics.2015.1742
        • Wills T.A.
        • Knight R.
        • Williams R.J.
        • et al.
        Risk factors for exclusive e-cigarette use and dual e-cigarette use and tobacco use in adolescents.
        Pediatrics. 2015; 135: e43-e51https://doi.org/10.1542/peds.2014-0760
        • Wills T.A.
        • Sargent J.D.
        • Knight R.
        • et al.
        E-cigarette use and willingness to smoke: a sample of adolescent non-smokers.
        Tob Control. 2015; (In press. Online August 10, 2015. http://dx.doi.org/10.1136/tobaccocontrol-2015-052349)
        • Miech R.A.
        • Johnston L.D.
        • O’Malley P.M.
        • et al.
        Monitoring the Future National Survey Results on Drug Use, 1975–2014: Volume I, Secondary School Students.
        Institute for Social Research, University of Michigan, Ann Arbor, MI2015 (Accessed November 7, 2015)
        • Amato M.S.
        • Boyle R.G.
        • Levy D.
        How to define e-cigarette prevalence? Finding clues in the use frequency distribution.
        Tob Control. 2015; (In press. Online June 17, 2015. http://dx.doi.org/10.1136/tobaccocontrol-2015-052236)
        • Brener N.D.
        • Billy J.O.G.
        • Grady W.R.
        Assessment of factors affecting the validity of self-reported health-risk behavior among adolescents: evidence from the scientific literature.
        J Adolesc Health. 2003; 33: 436-457https://doi.org/10.1016/S1054-139X(03)00052-1
        • Garrett B.E.
        • Dube S.R.
        • Winder C.
        • et al.
        Cigarette smoking—United States, 2006-2008 and 2009-2010.
        MMWR Surveill Summ. 2013; 62: 81-84
        • Rigotti N.A.
        E-Cigarette use and subsequent tobacco use by adolescents: new evidence about a potential risk of e-cigarettes.
        JAMA. 2015; 314: 673-674https://doi.org/10.1001/jama.2015.8382
        • Niaura R.S.
        • Glynn T.J.
        • Abrams D.B.
        Youth experimentation with e-cigarettes: another interpretation of the data.
        JAMA. 2014; 312: 641-642https://doi.org/10.1001/jama.2014.6894
        • Farsalinos K.E.
        • Polosa R.
        Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: a systematic review.
        Ther Adv Drug Saf. 2014; 5: 67-86https://doi.org/10.1177/2042098614524430
        • Friedman A.S.
        How does electronic cigarette access affect adolescent smoking?.
        J Health Econ. 2015; 44: 300-308https://doi.org/10.1016/j.jhealeco.2015.10.003
        • USDHHS
        The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General.
        USDHHS, CDC, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta, GA2014 (Accessed August 10, 2015)
        • Gornall J.
        Why e-cigarettes are dividing the public health community.
        BMJ. 2015; 350: h3317https://doi.org/10.1136/bmj.h3317
      2. McNeill A, Brose LS, Calder R, Hitchman SC, Hajek P, McRobbie H. E-cigarettes: an evidence update. A report commissioned by Public Health England. PHE publications gateway number: 2015260. Published August 2015. www.gov.uk/government/uploads/system/uploads/attachment_data/file/454516/Ecigarettes_an_evidence_update_A_report_commissioned_by_Public_Health_England.pdf. Accessed August 19, 2015.

        • McKee M.
        • Capewell S.
        Evidence about electronic cigarettes: a foundation built on rock or sand?.
        BMJ. 2015; 351: h4863https://doi.org/10.1136/bmj.h4863