Researchers at the UNC School of Medicine, the UNC Gillings School of Global Public Health, and the UNC Lineberger Comprehensive Cancer Center have found that adolescents who are not susceptible to smoking cigarettes and who thought e-cigarettes were less harmful were more likely to use e-cigarettes. Additionally, youth exposed to e-cigarette vapor in public places were also more likely to use e-cigarettes. The study also found that 26 percent of those surveyed were at high risk for future e-cigarette use.
"There's growing concern that youth who use e-cigarettes may transition to smoke conventional cigarettes or use other tobacco products," said first author Sarah Kowitt, MPH, a doctoral candidate at the UNC Gillings School of Global Public Health and member of Lineberger's Center for Regulatory Research on Tobacco Communication. "This work helps identify risk factors for e-cigarette use among youth who might not otherwise smoke cigarettes."
Adolescents who are not susceptible to smoking cigarettes but who use e-cigarettes are a priority population for prevention of future tobacco product use. This is believed to be one of the first studies to analyze correlates of e-cigarette use among adolescents not susceptible to smoking cigarettes.
The study, published in Preventing Chronic Disease, suggests that a lot of youth who are not interested in regular cigarettes are susceptible to using e-cigarettes, despite the fact that very little is known about long-term health consequences of vaping. And once youth are hooked on the nicotine in e-cigarettes, researchers believe this could increase the chances of adolescents switching over to traditional tobacco products.
"We want to prevent youth from using harmful tobacco products," said Kowitt. "Focusing on a group of adolescents who are traditionally at low risk for using cigarettes but who might use e-cigarettes can help prevent youth from transitioning from e-cigarette use to other tobacco product use."
E-cigarette use is a major public health issue, especially among adolescents and teenagers. Nicotine is a highly addictive substance and particularly harmful to adolescent brain-development. And researchers are still discovering the hidden impacts of e-cigarette use. This past summer, UNC School of Medicine scientists found that e-cigarette vapor alters genes that are crucial for immune defense in the upper-airway. The study analyzed data from the 2015 North Carolina Youth Tobacco Survey that included 1,627 high school students not susceptible to smoking cigarettes from across the state. Researchers divided these students into four categories depending on their e-cigarette use and susceptibility to use e-cigarette.
Survey questions were aimed at finding out what factors led youth to be susceptible to e-cigarette use. Students were asked about their exposure to e-cigs in public places, whether someone who lives with them now uses an e-cig, as well as their exposure to online tobacco advertising. They were also asked about the perceived harm of e-cigarette use.
The results showed that:
Increasing perceived harms of e-cigarettes and e-cigarette vapor were associated with lower odds of susceptibility to using e-cigarettes and current use of e-cigarettes.
Exposure to e-cigarette vapor in indoor or outdoor public places was positively associated with susceptibility to using e-cigarettes and with current e-cigarette use.
"E-cigarette use is a major public health issue, especially among adolescents and teenagers," said Adam Goldstein, MD, professor of family medicine at the UNC School of Medicine and senior author of the study. "Nicotine is highly addictive and particularly harmful to adolescent brain-development."
While major national anti-smoking campaigns have helped curb adolescent combustible cigarette use, e-cigarettes present a dangerous gateway to nicotine addiction and tobacco use. Previous research shows that youth susceptible to smoking cigarettes are more likely to believe e-cigs are less harmful than cigarettes, and are more likely to use e-cigarettes than those not susceptible to smoking cigarettes.
"We estimate that there are over 55,000 high school students in North Carolina at low risk of smoking cigarettes but at high risk for sustained e-cigarette use," Kowitt said.