E-Cigarette-Only and Dual Use among Adolescents in Ireland: Emerging Behaviours with Different Risk Profiles

Abstract

E-cigarette-only use and dual-use are emerging behaviours among adolescent nicotine product users which have not yet been sufficiently explored. This study examines the prevalence of, and the factors associated with, nicotine product use in adolescence. The study is a cross-sectional analysis of the 2018 Planet Youth survey completed by 15–16 year olds in the West of Ireland in 2018. The outcome of interest was current nicotine product use, defined as use at least once in the past 30 days. A main effects multinomial logistic regression model was used to examine the association between potential risk and protective factors and nicotine product use. Among 4422 adolescents 22.1% were current nicotine product users, consisting of 5.1% e-cigarette only users, 7.7% conventional cigarette only users, and 9.3% dual-users. For risk factors, the odds of association were weaker for e-cigarette only use compared to conventional cigarette and dual use. Participating in team sport four times/week or more significantly reduced the odds of conventional cigarette and dual use but had no association with e-cigarette only use (Cig: adjusted odds ratio (AOR) 0.63, 95% confidence interval (CI) 0.44–0.90; Dual-use: AOR 0.63, 95% CI 0.43–0.93). Similarly, having higher value for conventional social norms reduced the odds of conventional cigarette and dual use but not e-cigarette only use. This is the first study to show, among a generalisable sample, that dual-use is the most prevalent behaviour among adolescent nicotine product users in Ireland. Risk factor profiles differ across categories of use and prevention initiatives must be cognisant of this.

Friends and family matter Most: a trend analysis of increasing e-cigarette use among Irish teenagers and socio-demographic, personal, peer and familial associations

“…This leads us to speculate, for example, that boys may be targeted through gaming platforms and that girls’ rapidly increasing e-cigarette use may be related to their greater social media use. The scope within these parallel gendered domains for targeted marketing of e-cigarettes by industry merits further research and we also support calls for regulatory action to prohibit sponsored e-cigarette content on social media platforms used by youth [ 40 , 41 ].…”

“…Gender being an incomplete explanation of the observed differences in teenage e-cigarette use, we draw attention to intersectionality [ 44 ] as a promising framework to achieve new understandings of teenage tobacco use. Although intersectionality has been examined in relation to adult smoking cessation (e.g., [ 45 , 46 ]), there is little or no research to date on teenage tobacco use (and consequent health inequalities) that captures the complexity of “multiple aspects of identity” [ 41 ], employing analyses at the intersections of, for example, categories of gender, race, class/SES, disability, sexuality, and religion. More complex conceptual analyses are needed to generate new insights into this emergent and increasing problem of new tobacco product use by young people.…”

Trend analyses suggest gender-focused, peer-aware, and parent-targeted interventions could reduce teenage e-cigarette use

“…We know that heavier exposure to advertisements and e-cigarette content in social media posts is associated with a greater risk for e-cigarette use among adolescents, and even brief exposure to e-cigarette content on social media has been found to be associated with greater intention to use and more positive attitudes toward e-cigarettes (38). The scope within these parallel gendered domains for targeted marketing of e-cigarettes by industry merits further research and we also support calls for regulatory action to prohibit sponsored e-cigarette content on social media platforms used by youth (38,39).…”

Association between electronic nicotine delivery systems and electronic non-nicotine delivery systems with initiation of tobacco use in individuals aged < 20 years. A systematic review and meta-analysis

“…These findings are of concern as other cross-sectional studies have reported that children and adolescents who use ENDS and/or ENNDS have different psychological profiles to current smokers, and would have otherwise have been at low risk of smoking. [ 58 – 61 ] As such, there is an urgent need for governments internationally to take action to regulate the availability and marketing of ENDS/ENNDS products to children and adolescents.…”