Brief ReportBeliefs and Experimentation with Electronic Cigarettes: A Prospective Analysis Among Young Adults
Introduction
Tobacco use remains a prominent public health issue in the U.S.; 25.2% of all adults (aged ≥18 years) and 35.6% of young adults (aged 18–24 years) reported current tobacco use in 2010.1 Although the public health community is continuously working on reducing the prevalence of tobacco use in the nation, recent introduction of electronic cigarettes (e-cigarettes, also known as electronic nicotine delivery systems) in the U.S. may hamper this effort,2 with about 3% of U.S. adults (aged ≥18 years) and 7% of U.S. Midwest young adults (aged 20–28) ever using e-cigarettes.3, 4, 5 This is problematic because young adults are still developing their tobacco use behaviors,6, 7 and e-cigarettes may introduce young adults to tobacco use or promote dual use of cigarettes and smokeless tobacco products.
Although some studies found that smokers who used e-cigarettes reported that e-cigarettes were helpful in smoking cessation and had used e-cigarettes to quit smoking,8, 9, 10 other studies showed that ever using e-cigarette is not associated with intention to quit, quit attempt, and smoking cessation.3, 4, 10, 11, 12 Addictiveness and long-term harmfulness of e-cigarettes are also unknown. Nonetheless, some young adults already hold positive beliefs about the products. A study in a U.S. regional sample of young adults found that 44.5% of the participants who were aware of e-cigarettes believed e-cigarettes can help people quit smoking, 52.8% believed that e-cigarettes are less harmful than cigarettes, and 26.3% believed that e-cigarettes are less addictive than cigarettes.5 Young adults who held these beliefs were more likely than those who did not to have tried e-cigarettes.5 However, given the cross-sectional design of previous analysis, it s unclear whether these beliefs and perceptions precede or follow the experimentation with the products. The objective of the current analysis is therefore to assess the longitudinal associations between these beliefs and subsequent experimentation with e-cigarettes.
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Study Population
Data are from the Minnesota Adolescent Community Cohort (MACC). The design of the study has been detailed elsewhere.13, 14 Briefly, participants in the MACC study were selected in 2000–2001 through cluster random sampling of household phone numbers. Sixty geopolitical units (GPUs) in Minnesota (out of 126) were randomly selected. Five GPUs from four comparison states (North and South Dakota, Michigan, and Kansas) were chosen because of their similarity to Minnesota. Modified random-digit
Results
Among all participants included in the analysis (n=1379), the average age was 24.1 years (SD=1.7); 48.4% of the sample was male, 90.3% was non-Hispanic white, 63.7% enrolled in or graduated from a 4-year college. Regarding smoking status at baseline, 17.8 were current smokers, 12.8% were former smokers, and 69.4% were nonsmokers. At 1-year follow-up, 7.4% (n=102) of the sample (who had never used e-cigarettes at baseline) reported ever using e-cigarettes: 21.6% (n=53) among baseline current
Discussion
E-cigarettes have received attention from the U.S. population since their introduction in 2007. The study showed that, among baseline nonsmokers, 2.9% of baseline nonsmokers in this U.S. regional sample of young adults reported ever using e-cigarettes at follow-up, suggesting an interest in e-cigarettes among nonsmoking young adults, a group that is still experimenting with tobacco.6 This study also suggested that about 12% of former young adult smokers at baseline were re-introduced to
Acknowledgments
This work was supported by the National Cancer Institute at the National Institutes of Health (R01 CA86191: Jean Forster, principal investigator).
No financial disclosures were reported by the authors of this paper.
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