Adolescents who might not normally smoke still could be at risk of being recruited to use e-cigarettes, a study in the journal Pediatrics said.
The study, released Dec. 15, was based on a survey of 1,941 high school students in Hawaii in 2013. The survey looked at e-cigarette use and cigarette use, alcohol and marijuana use, psychosocial risk and protective variables such as parental support, academic involvement, smoking expectancies, peer smoking and sensation seeking. Both youths who used e-cigarettes and regular cigarettes and those who used e-cigarettes only were more likely to perceive e-cigarettes as healthier, according to the study. Teenagers who only used e-cigarettes were intermediate in levels of risk and protective factors between nonusers and those who used both cigarettes and e-cigarettes, the study said. For researchers, this posed a question about whether such cigarettes recruit low-risk youth to tobacco product use.
Results of the study showed 96% of survey participants knew about e-cigarettes, with 67% of them considering e-cigarettes to be healthier than cigarettes. Results also showed that 29% of the youth surveyed had used e-cigarettes, while 18% had used them in the last month. Fifteen percent of the teens had used conventional cigarettes, 47% had used alcohol and 18% had used marijuana, according to the study.
Researchers noted that cigarette smoking rates in Hawaii tend to be lower than in other parts of the country because of higher taxation and strict sales enforcement.
There is a debate about whether e-cigarettes will benefit public health, the researchers wrote. However, there is little knowledge about how e-cigarette users and dual users differ from other adolescents on a range of variables.
E-cigarettes are battery-operated devices made to look like conventional tobacco cigarettes and work by an atomizer heating liquid containing nicotine, turning it into a vapor that can be inhaled, according to the Mayo Clinic. Although makers of e-cigarettes claim the product is a safe alternative to a regular cigarette, the Food and Drug Administration has questioned its safety, according to the Mayo Clinic. The clinic recommends saying no to e-cigarettes until more is known about their potential risks.
The prevalence of e-cigarette use among high schoolers in Hawaii was higher than rates reported in previous studies. Researchers said higher taxes on traditional cigarettes could make e-cigarettes more appealing in that state. Another reason noted is that vendors offer flavors of e-cigarettes, such as mango and pineapple, which are popular with local youth, Adolescents in Hawaii also are exposed to aggressive marketing for e-cigarettes, the study stated.
This study reports a U.S. adolescent sample with one of the largest prevalence rates of e-cigarette only use in the existing literature, the researchers wrote. Dual use also had a substantial prevalence. The fact that e-cigarette only users were intermediate in risk status between nonusers and dual users raises the possibility that e-cigarettes are recruiting medium-risk adolescents, who otherwise would be less susceptible to tobacco product use.