Frequency of E-cigarette Use, Health Status, and Risk and Protective Health Behaviors in Adolescents

Abstract

Objectives E-cigarettes (ECs) are increasingly popular among adolescents, who perceive them as “safer” than cigarettes. Although research has examined risk factors for adolescent EC use, little is known about how EC use correlates with health status and protective health behaviors. Methods 2,488 adolescents (mean age=17.31, SD=0.67; 46% male) completed a survey on EC and cigarette use, physical and mental health, physical activity, diet, sleep, and alcohol and other drug (AOD) use. Logistic regression compared EC-only users to dual EC/cigarette users, cigarette-only users, and non-users on these health factors. Among EC-only users, separate ordinary least squares regression models assessed the effects of health status/behavior variables on frequency of past-year EC use, controlling for demographics and smokeless tobacco use. Results User groups were similar on physical health and engagement in protective health behaviors (physical activity, sleep duration/quality, healthy diet), but EC-only users reported fewer mental health symptoms and less AOD use than dual or cigarette-only users. Among EC-only users, AOD use (all p < .0001) predicted more frequent EC use; healthy diet predicted less frequent use (p < .01). Conclusions EC-only use is associated with lower engagement in risky behaviors, but not better health status or higher engagement in protective health behaviors, compared to cigarette smoking. Dual EC/cigarette users may represent a particularly high risk group due to their greater AOD use and cigarette consumption. Among “intermediate risk” EC-only users, AOD use and unhealthy diet correlated with heavier use, and may be important targets for preventing escalation to more harmful tobacco use.

Co-occurrence of tobacco product use, substance use, and mental health problems among youth: Findings from wave 1 (2013–2014) of the population assessment of tobacco and health (PATH) study

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The Association of Sleep Duration and the Use of Electronic Cigarettes, NHANES, 2015-2016

“…Researchers recently concluded that dual use of electronic cigarettes with conventional tobacco is associated with decreased sleep quality in women [21]. Other researchers who examined sleep data on 2488 California adolescents found no significant difference in weekday sleep time duration between adolescents who used electronic cigarettes at a higher frequency and lower frequency, although adolescents who used electronic cigarettes slept significantly less on weekends compared with adolescents who did not use electronic cigarettes [22].…”

Heat-not-burn tobacco, electronic cigarettes, and combustible cigarette use among Japanese adolescents: a nationwide population survey 2017

“…Previous studies have suggested that smoking is associated with an unhealthy lifestyle [35,36]. Similarly, an association between health risk behaviour and e-cigarettes use has been reported [37]. However, to our knowledge, the relationship between new products and healthy behaviour among adolescents has not been sufficiently investigated.…”