Physical Activity and Use of Cigarettes and E-Cigarettes Among Young Adults

Published:December 19, 2019DOI:


      Physical activity is known to be inversely associated with cigarette smoking among young people. However, evidence is not clear about the association between physical activity and e-cigarette use. Young people who otherwise lead a healthy lifestyle are attracted to e-cigarettes for nicotine or flavor consumption given the low harm perceptions associated with e-cigarette use. This is of concern given the potentially serious adverse health consequences of some forms of e-cigarette use. This study tested the hypotheses that increased physical activity is associated with lower levels of cigarette and e-cigarette use, both cross-sectionally and prospectively.


      Self-reported physical activity data and past-30-day cigarette smoking and e-cigarette use data were collected in 2018–2019 from 2,401 young adults (mean age=21.2 years, SD=2.2 years, 55% women) at 2 timepoints, 6 months apart. Data were analyzed between May and August 2019, using ordered logistic regression.


      Higher moderate or vigorous physical activity was inversely associated with cigarette and e-cigarette use cross-sectionally. Only higher moderate physical activity was statistically significantly associated with reduced cigarette smoking 6 months later, after adjusting for baseline cigarette smoking, sensation seeking, BMI, and demographic variables. Higher physical activity at baseline was associated with increased e-cigarette use at follow-up, adjusting for baseline e-cigarette use, sensation seeking, BMI, and demographic variables.


      The prospective association between increased physical activity at baseline and higher e-cigarette use 6 months later is of concern. More research is needed to determine if this finding is replicable. Some plausible reasons for the observed associations are discussed.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Gentzke AS
        • Creamer M
        • Cullen KA
        • et al.
        Vital Signs: tobacco product use among middle and high school students—United States, 2011‒2018.
        MMWR Morb Mortal Wkly Rep. 2019; 68: 157-164
        • Audrain-McGovern J
        • Rodriguez D
        • Moss HB
        Smoking progression and physical activity.
        Cancer Epidemiol Biomarkers Prev. 2003; 12: 1121-1129
        • Audrain-McGovern J
        • Rodriguez D
        • Cuevas J
        • Sass J
        Initial insight into why physical activity may help prevent adolescent smoking uptake.
        Drug Alcohol Depend. 2013; 132: 471-478
        • Audrain-McGovern J
        • Rodriguez D
        All physical activity may not be associated with a lower likelihood of adolescent smoking uptake.
        Addict Behav. 2015; 51: 177-183
        • Kujala UM
        • Kaprio J
        • Rose RJ
        Physical activity in adolescence and smoking in young adulthood: a prospective twin cohort study.
        Addiction. 2007; 102: 1151-1157
        • Papathanasiou G
        • Georgakopoulos D
        • Georgoudis G
        • Spyropoulos P
        • Perrea D
        • Evangelou A
        Effects of chronic smoking on exercise tolerance and on heart rate-systolic blood pressure in young healthy adults.
        Eur J Cardiovasc Prev Rehabil. 2007; 14: 646-652
        • Strong DR
        • Messer K
        • White M
        • et al.
        Youth perception of harm and addictiveness of tobacco products: findings from the Population Assessment of Tobacco and Health Study (Wave 1).
        Addict Behav. 2019; 92: 128-135
        • Pokhrel P
        • Herzog TA
        • Muranaka N
        • Fagan P
        Young adult e-cigarette users’ reasons for liking and not liking e-cigarettes: a qualitative study.
        Psychol Health. 2015; 30: 1450-1469
        • Milicic S
        • Piérard E
        • DeCicca P
        • Leatherdale ST
        Examining the association between physical activity, sedentary behavior and sport participation with e-cigarette use and smoking status in a large sample of Canadian youth.
        Nicotine Tob Res. 2019; 21: 285-292
        • Veliz P
        • McCabe SE
        • McCabe VV
        • Boyd CJ
        Adolescent sports participation, e-cigarette use and cigarette smoking.
        Am J Prev Med. 2017; 53: e175-e183
        • Miller C
        • Smith DM
        • Goniewicz ML
        Physical activity among adolescent tobacco and electronic cigarette users: cross-sectional findings from the Population Assessment of Tobacco and Health Study.
        Prev Med Rep. 2019; 15100897
        • Zuckerman M
        Sensation seeking.
        in: Leary MR Hoyle RH Handbook of Individual Differences in Social Behavior. The Guildford Press, New York, NY2009: 455-465
        • Kopstein AN
        • Crum RM
        • Celentano DD
        • Martin SS
        Sensation seeking needs among 8th and 11th graders: characteristics associated with cigarette and marijuana use.
        Drug Alcohol Depend. 2001; 62: 195-203
        • Hansen EB
        • Breivik G
        Sensation seeking as a predictor of positive and negative risk behavior among adolescents.
        Pers Individ Dif. 2001; 30: 627-640
        • Sallis JF
        • Prochaska JJ
        • Taylor WC
        A review of correlates of physical activity of children and adolescents.
        Med Sci Sports Exerc. 2000; 32: 963-975
        • Hoyle RH
        • Stephenson MT
        • Palmgreen P
        • Lorch EP
        • Donohew RL
        Reliability and validity of a brief measure of sensation seeking.
        Pers Individ Dif. 2002; 32: 401-414
        • American College Health Association
        American College Health Association-National College Health Assessment II: Reference Group Executive Summary Fall 2018.
        American College Health Association, Silver Spring, MD2018
        • Morean ME
        • Wedel AV
        Vaping to lose weight: predictors of adult e-cigarette use for weight loss or control.
        Addict Behav. 2017; 66: 55-59
        • Morean ME
        • L'Insalata A
        Electronic cigarette use among individuals with a self-reported eating disorder diagnosis.
        Int J Eat Disord. 2018; 51: 77-81
        • Killen JD
        • Taylor CB
        • Hayward C
        • et al.
        Pursuit of thinness and onset of eating disorder symptoms in a community sample of adolescent girls: a three-year prospective analysis.
        Int J Eat Disord. 1994; 16: 227-238