Abstract
Introduction
A diverse class of products, “e-cigarettes” present surveillance and regulatory challenges because of nonstandard terminology used to describe subtypes, especially among young adults, where occasional e-cig use is most prevalent.
Methods
Young adults (n = 3364) in wave 9 (Spring 2016) of the Truth Initiative Young Adult Cohort were randomized to see two of five photos of common e-cig products (three varieties of first-generation e-cigs and one variety each of second- and third-generation e-cigs). Qualitative responses were coded into nine classifications: “e-cigarette, e-hookah, vape-related, mod, other or more than one kind of e-cig, marijuana-related, non-e-cig tobacco product, misidentified, and don’t know.” We characterized the sample and survey responses and conducted multivariable logistic regression to identify participant characteristics associated with correctly identifying the devices as e-cigs. Data were weighted to represent the young adult population in the United States in 2016.
Results
The majority of participants identified the pictured devices as some type of e-cig (57.7%–83.6%). The white first-generation e-cig, as well as the second- and third-generation e-cigs caused the greatest confusion, with a large proportion of individuals responding “don’t know” (12.2%–25.1%, depending on device) or misidentifying the e-cig as a non-nicotine product (3.4%–16.1%, depending on device) or non-e-cig tobacco product (1.4%–14.6%, depending on device).
Conclusions
Accurate surveillance and analyses of the effect of e-cigs on health behavior and outcomes depend on accurate data collection on users’ subtype of e-cig. Carefully chosen images in surveys may improve reporting of e-cig use in population studies.
Implications
Survey researchers using images to cue respondents, especially young adult respondents, should consider avoiding use of white or colorful first-generation e-cigs, which were commonly misidentified in this research, in preference for black or dark colored first-generation e-cigs, such as the blu brand e-cig. Given the sizable proportion of respondents who classified second- and third-generation e-cigs with terminology related to vaping, surveys specifically aimed at assessing use of these types of e-cigs should include the term “vape” when describing this subclass of devices.
Spanish normative studies in a young adult population (NEURONORMA young adults project): Guidelines for the span verbal, span visuo-spatial, Letter-Number Sequencing, Trail Making Test and Symbol Digit Modalities Test
