scholarly journals E-Cigarettes are More Addictive than Traditional Cigarettes—A Study in Highly Educated Young People

Author(s):  
Jankowski ◽  
Krzystanek ◽  
Zejda ◽  
Majek ◽  
Lubanski ◽  
...  

E-cigarettes are often considered less addictive than traditional cigarettes. This study aimed to assess patterns of e-cigarette use and to compare nicotine dependence among cigarette and e-cigarette users in a group of highly educated young adults. From 3002 healthy adults, a representative group of 30 cigarette smokers, 30 exclusive e-cigarette users, and 30 dual users were recruited. A 25-item questionnaire was used to collect information related to the patterns and attitudes towards the use of cigarettes and e-cigarettes. The Fagerström test for nicotine dependence (FTND) and its adapted version for e-cigarettes were used to analyze nicotine dependence in each of the groups. The nicotine dependence levels measured with FTND were over two times higher among e-cigarette users (mean 3.5) compared to traditional tobacco smokers (mean 1.6; p<0.001). Similarly, among dual users, nicotine dependence levels were higher when using an e-cigarette (mean 4.7) compared to using traditional cigarettes (mean 3.2; p=0.03). Habits and behaviors associated with the use of e-cigarettes did not differ significantly (p>0.05) between exclusive e-cigarette users and dual users. The findings suggest that e-cigarettes may have a higher addictive potential than smoked cigarettes among young adults.

Author(s):  
Joan Hanafin ◽  
Salome Sunday ◽  
Luke Clancy

Abstract Aim Electronic cigarette (e-cigarette) use among Irish teenagers has risen significantly. In 2019, prevalence of current use (last 30 days) among 15–17-year-olds was 17.3%. We examine social determinants of adolescent e-cigarette current use. Subject and methods A stratified random sample of 50 schools in Ireland was surveyed in 2019, part of the European School Survey Project on Alcohol and other Drugs (ESPAD), with 3495 students aged 15, 16, and 17. Bivariate and multivariable logistic regression [providing adjusted odds ratios (AORs)] analyses were performed using Stata version 16. Results Current e-cigarette users were more likely to be male (AOR = 0.55, 95% CI:0.32–0.96, p < .01), younger (AOR = 0.34, 95% CI: 0.17–0.67, p = < .05), to participate in sport (AOR = 2.21, 95% CI: 1.05–4.65, p < .05), to have higher-educated parents (maternal higher education: AOR = 27.54, 95% CI: 1.50–505.77, p = < .05, paternal higher education: AOR = 2.44, 95% CI: 1.00–5.91, p < .05), and less likely to consider their families better off (AOR = 0.29, 95% CI: 0.13–0.65, p < .01), or to report familial support (AOR = 0.78, 95% CI: 0.64–0.95, p < .05). They were more likely to be cigarette smokers (AOR = 7.22, 95% CI: 3.97–13.12, p < .001), to report problem cannabis use (AOR = 3.12, 95% CI: 1.40–6.93, p < .01), to be ‘binge’ drinkers (AOR = 1.81, 95% CI : 1.00–3.32, p = .054), and to have friends who get drunk (AOR = 5.30, 95% CI: 1.34–20.86, p < .05). Conclusion Boys, smokers, binge drinkers, problem cannabis users, and sport-playing teenagers from higher-educated families, are at particular risk. As the number of young people using e-cigarettes continues to rise, including teenagers who have never smoked, improved regulation of e-cigarettes, similar to other tobacco-related products, is needed urgently to prevent this worrying new trend of initiation into nicotine addiction.


2018 ◽  
Vol 21 (11) ◽  
pp. 1556-1564 ◽  
Author(s):  
Meghan E Morean ◽  
Suchitra Krishnan-Sarin ◽  
Steve Sussman ◽  
Jonathan Foulds ◽  
Howard Fishbein ◽  
...  

Abstract Introduction Psychometrically sound measures of e-cigarette dependence are lacking. Methods We modified the PROMIS Item Bank v1.0—Smoking: Nicotine Dependence for All Smokers for use with e-cigarettes and evaluated the psychometrics of the 22-, 8-, and 4-item adapted versions, referred to as The E-cigarette dependence scale (EDS). Adults (1009) who reported using e-cigarettes at least weekly completed an anonymous survey in summer 2016 (50.2% male, 77.1% White, mean age 35.81 [10.71], 66.4% daily e-cigarette users, 72.6% current cigarette smokers). Psychometric analyses included confirmatory factor analysis, internal consistency, measurement invariance, examination of mean-level differences, convergent validity, and test-criterion relationships with e-cigarette use outcomes. Results All EDS versions had confirmable, internally consistent latent structures that were scalar invariant by sex, race, e-cigarette use (nondaily/daily), e-liquid nicotine content (no/yes), and current cigarette smoking status (no/yes). Daily e-cigarette users, nicotine e-liquid users, and cigarette smokers reported being more dependent on e-cigarettes than their counterparts. All EDS versions correlated strongly with one another, evidenced convergent validity with the Penn State E-cigarette Dependence Index and time to first e-cigarette use in the morning, and evidenced test-criterion relationships with vaping frequency, e-liquid nicotine concentration, and e-cigarette quit attempts. Similar results were observed when analyses were conducted within subsamples of exclusive e-cigarette users and duals-users of cigarettes and e-cigarettes. Conclusions Each EDS version evidenced strong psychometric properties for assessing e-cigarette dependence in adults who either use e-cigarette exclusively or who are dual-users of cigarettes and e-cigarettes. However, results indicated little benefit of the longer versions over the 4-item EDS, which provides an efficient assessment of e-cigarette dependence. Implications The availability of the novel, psychometrically sound EDS can further research on a wide range of questions related to e-cigarette use and dependence. In addition, the overlap between the EDS and the original PROMIS that was developed for assessing nicotine dependence to cigarettes provides consistency within the field.


2021 ◽  
pp. tobaccocontrol-2021-056479
Author(s):  
Julia C Chen-Sankey ◽  
Afton Kechter ◽  
Jessica Barrington-Trimis ◽  
Rob McConnell ◽  
Evan A Krueger ◽  
...  

IntroductionModified risk tobacco product (MRTP) claims for heated tobacco products (HTPs) that convey reduced exposure compared with conventional cigarettes may promote product initiation and transition among young people. We assessed the effects of a hypothetical MRTP claim for HTPs on young adults’ intention and perceptions of using HTPs and whether these effects differed by their current cigarette and e-cigarette use.MethodsWe embedded a randomised between-subjects experiment into a web-based survey administered among a cohort of 2354 Southern California young adults (aged 20–23) in 2020. Participants viewed depictions of HTPs with an MRTP claim (n=1190) or no claim (n=1164). HTP use intention and HTP-related harm and use perceptions relative to cigarettes and e-cigarettes were assessed.ResultsOverall, participants who viewed versus did not view the claim did not differ in HTP use intention (28.5% vs 28.7%) but were more likely to perceive HTPs as less harmful than cigarettes (11.4% vs 7.0%; p<0.001). The experimental effect on HTP use intention did not differ among past 30-day cigarette smokers versus non-smokers (interaction adjusted OR (AOR)=0.78, 95% CI 0.36 to 1.76) but differed among past 30-day e-cigarette users versus non-users (interaction AOR=1.67, 95% CI 1.02 to 2.68).DiscussionThe hypothetical MRTP claim may lower young adults’ HTP harm perceptions compared with cigarettes but may not change HTP use intention overall or differentially for cigarette smokers. The larger effect on HTP use intention among e-cigarette users than non-users raises the question of whether MRTP claims may promote HTP use or HTP and e-cigarette dual use among young e-cigarette users.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kelsey A. Simpson ◽  
Afton Kechter ◽  
Sara J. Schiff ◽  
Jessica L. Braymiller ◽  
Naosuke Yamaguchi ◽  
...  

Abstract Background While rates of e-cigarette use (‘vaping’) continue to potentiate concern, there is limited data on common symptoms of e-cigarette dependence among young adults who vape. This study sought to critically explore how young adults experience, manifest, and conceptualize vaping dependence symptoms in their everyday lives. Methods Between June 2018 and 2019, in-depth qualitative interviews were conducted with 62 young adults who use e-cigarettes (aged 18–25) and live in Southern California. We explored participants’ product preferences, daily e-cigarette use patterns, vaping history, withdrawal experiences, and quit attempts or periods of cessation. We used a thematic analysis approach to interpret the transcripts. Results Young adults discussed nine dimensions of vaping dependence that were organized into two categories: 1) general nicotine dependence symptoms, and 2) unique dependence symptoms related to vaping. Nicotine dependence symptoms included cravings and urgency to use, increased use to achieve desired effects, and unsuccessful quit attempts and withdrawal. Symptoms unique to vaping dependence included greater nicotine consumption due to accessibility and lack of restrictions, habitual vaping, inability to track vaping frequency, immediate gratification and comfort, social acceptability and norms, and awareness of vaping dependency. Conclusions In addition to nicotine dependence symptoms that have been characterized for other tobacco products, young adult e-cigarette users described unique symptoms of vaping dependence that necessitate the need for more refined measures. All dimensions of vaping dependence should be considered in discussions of policies as well as treatment and education efforts intended to protect young people from e-cigarette dependence.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
R Nakkash ◽  
M Tleis ◽  
T Asfar ◽  
W Maziak

Abstract Introduction E-cigarette use is becoming popular among youth worldwide and represents an emerging threat to public health. No previous study has looked into the prevalence of e-cigarettes use in the Eastern Mediterranean region. We report here on the prevalence of e-cigarette use in a cohort of 496 school and university students from Lebanon (62% males; 17 - 23 years) and differences in perceived harm between e-cigarette smokers and nonsmokers. We used data from Wave 8 of an ongoing cohort study that started in 2015 investigating the development of nicotine dependence symptoms in waterpipe smokers compared to cigarettes in Grades 8 and 9. Methods In 2019, we added questions to examine e-cigarette use patterns, risk perceptions, dependence, and susceptibility for future use among this population. Results were described and compared by gender status, e-cigarette users vs. non-users and other modes of tobacco use. Results Overall, 14.5 % reported ever use of e-cigarette and 8 % reported current use (use in the last month). Most ever e-cigarette users were cigarette smokers (32.8%), waterpipe smokers (34.3%), or dual smokers (10.45%). Compared to ever users, non-users were more likely to perceive e-cigarettes as more harmful (42% vs. 27% respectively, p= .007) and more addictive (41 % vs. 36% respectively, p= .013) than conventional cigarettes. Among current users, 28 % used e-cigarettes within 5 minutes of waking up. Among non-users, males were more open than female to try e-cigarettes if offered by a close friend (28.8% vs. 17.1%). Conclusions Our study suggests significant nicotine dependence among current users. Qualitative studies are needed to better understand why youth are drawn to this new emerging tobacco product. Our preliminary results point to the need to monitor e-cigarette use nationally by introducing questions on e-cigarette use in national school wide surveys such as Global Youth Tobacco Survey or the Global School Health Survey. Key messages E-cigarette use is spreading among youth in Lebanon. Results reveal significant nicotine dependence among youth in Lebanon users of e-cigarette.


2021 ◽  
pp. e1-e9
Author(s):  
Jennifer M. Kreslake ◽  
Bethany J. Simard ◽  
Katie M. O’Connor ◽  
Minal Patel ◽  
Donna M. Vallone ◽  
...  

Objectives. To determine whether the COVID-19 pandemic affected e-cigarette use among young people in the United States. Methods. Data came from a weekly cross-sectional online survey of youths and young adults (aged 15–24 years). Logistic regression analyses measured odds of past-30-day e-cigarette use (n = 5752) following widespread stay-at-home directives (March 14–June 29, 2020), compared with the pre‒COVID-19 period (January 1–March 13, 2020). Logistic regression among a subsample of current e-cigarette users (n = 779) examined factors associated with reduced use following stay-at-home orders. Results. Odds of current e-cigarette use were significantly lower during the COVID-19 pandemic compared with the pre‒COVID-19 period among youths aged 15 to 17 years (odds ratio [OR] = 0.72; 95% confidence interval [CI] = 0.54, 0.96) and young adults aged 18 to 20 years (OR = 0.65; 95% CI = 0.52, 0.81). E-cigarette users with reduced access to retail environments had higher odds of reporting reduced e-cigarette use (OR = 1.51; 95% CI = 1.07, 2.14). Conclusions. COVID-19 stay-at-home directives present barriers to e-cigarette access and are associated with a decline in e-cigarette use among young people. Public Health Implications. Findings support the urgent implementation of interventions that reduce underage access to e-cigarettes to accelerate a downward trajectory of youth and young adult e-cigarette use. (Am J Public Health. Published online ahead of print April 15, 2021: e1–e9. https://doi.org/10.2105/AJPH.2021.306210 )


2019 ◽  
Vol 55 (4) ◽  
pp. 670-688 ◽  
Author(s):  
Jenny Chesters ◽  
Johanna Wyn

The increasingly complex relationship between educational qualifications and employment is an integral, yet little-explored dimension of the labour market developments that have come to be referred to as the ‘gig economy’. This article explores the changing meaning and relevance of education through an analysis of young people’s employment outcomes in terms of employment status, having a job in their field of study and job satisfaction. It shows that while higher levels of education do provide some protection from unemployment, the relationship is murky. A relatively large proportion of highly educated young adults are experiencing underemployment and precarious work. Young women are less engaged in the labour market. Furthermore, those with secure jobs do not necessarily find them meaningful and those with meaningful jobs are not necessarily in secure employment. For many young people, using their educational qualifications to find security in work is a bit like ‘chasing rainbows’.


2018 ◽  
Vol 51 (5) ◽  
pp. 1800278 ◽  
Author(s):  
Thomas W. Ferkol ◽  
Harold J. Farber ◽  
Stefania La Grutta ◽  
Frank T. Leone ◽  
Henry M. Marshall ◽  
...  

Children and adolescents are highly susceptible to nicotine addiction, which affects their brain development, even in those who smoke infrequently. Young people who become addicted to nicotine are at greater risk of becoming lifelong tobacco consumers. The use of nicotine-delivering electronic cigarettes has risen dramatically among youths worldwide. In addition to physical dependence, adolescents are susceptible to social and environmental influences to use electronic cigarettes. The product design, flavours, marketing, and perception of safety and acceptability have increased the appeal of electronic cigarettes to young people, thus leading to new generations addicted to nicotine. Moreover, there is growing evidence that electronic cigarettes in children and adolescents serve as a gateway to cigarette smoking. There can be no argument for harm reduction in children. To protect this vulnerable population from electronic cigarettes and other nicotine delivery devices, we recommend that electronic cigarettes be regulated as tobacco products and included in smoke-free policies. Sale of electronic cigarettes should be barred to youths worldwide. Flavouring should be prohibited in electronic cigarettes, and advertising accessible by youths and young adults be banned. Finally, we recommend greater research on the health effects of electronic cigarettes and surveillance of use across different countries.


2021 ◽  
Author(s):  
Joan Hanafin ◽  
Salome Sunday ◽  
Luke Clancy

Abstract Aim: Electronic cigarette use among Irish teenagers has risen significantly. In 2019, prevalence of current use (last 30 days) among 15-17-year olds was 17.3%. We examine social determinants of adolescent e-cigarette current use. Subject and Methods: A stratified random sample of 50 schools in Ireland was surveyed in 2019, part of the European School Survey Project on Alcohol and other Drugs (ESPAD), with 3,495 students aged 15, 16 and 17. Bivariate and multivariable logistic regression (providing adjusted odds ratios (AORs)) analyses were performed using Stata version 16. Results: Current e-cigarette users were more likely to be male (AOR=0.55, 95% CI:0.32-0.96, p<.01), younger (AOR=0.34, 95% CI:0.17-0.67, p=<.05), to participate in sport (AOR=2.21, 95% CI:1.05-4.65, p<.05), to have higher-educated parents (maternal higher education: AOR=27.54, 95% CI:1.50-505.77, p=<.05, paternal higher education: AOR=2.44, 95% CI:1.00-5.91, p<.05), and less likely to consider their families better off (AOR=0.29, 95% CI:0.13-0.65, p<.01), or to report familial support (AOR=0.78, 95% CI:0.64-0.95, p<.05). They were more likely to be cigarette smokers (AOR=7.22, 95% CI:3.97-13.12, p<.001), to report problem cannabis use (AOR=3.12, 95% CI:1.40-6.93, p<.01), to be ‘binge’ drinkers (AOR=1.81, 95% CI:1.00-3.32, p=.054), and to have friends who get drunk (AOR=5.30, 95% CI:1.34-20.86, p<.05). Conclusion: Boys, smokers, binge drinkers, problem cannabis users, and sport-playing teenagers from higher-educated families, are at particular risk. As the number of young people using e-cigarettes continues to rise, including teenagers who have never smoked, improved regulation of e-cigarettes, similar to other tobacco-related products, is needed urgently to prevent this worrying new trend of initiation into nicotine addiction.


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