Prevalence and Correlates of E-Cigarette Perceptions and Trial Among Early Adolescents in Mexico

Abstract

PURPOSE Assess the prevalence and correlates of e-cigarette perceptions and trial among adolescents in Mexico, where e-cigarettes are banned. METHODS Cross-sectional data were collected in 2015 from a representative sample of middle school students (n=10,146). Prevalence of e-cigarette awareness, relative harm, and trial were estimated, adjusting for sampling weights and school-level clustering. Multilevel logistic regression models adjusted for school-level clustering to assess correlates of e-cigarette awareness and trial. Finally, students who had tried only e-cigarettes were compared with students who had tried: 1) conventional cigarettes only; 2) both e-cigarettes and conventional cigarettes (dual triers); 3) neither cigarette type (never triers). RESULTS 51% of students had heard about e-cigarettes, 19% believed e-cigarettes were less harmful than conventional cigarettes, and 10% had tried them. Independent correlates of e-cigarette awareness and trial included established risk factors for smoking, as well as technophilia (i.e., use of more media technologies) and greater Internet tobacco advertising exposure. Exclusive e-cigarette triers (4%) had significantly higher technophilia, bedroom Internet access, and Internet tobacco advertising exposure compared to conventional cigarette triers (19%) and never triers (71%), but not compared to dual triers (6%), even though dual triers had significantly stronger conventional cigarette risk factors. CONCLUSIONS This study suggests that adolescent e-cigarette awareness and use is high in Mexico, in spite of its e-cigarette ban. A significant number of medium-risk youth have tried e-cigarettes only, suggesting that e-cigarettes could lead to more intensive substance use. Strategies to reduce e-cigarette use should consider reducing exposures to Internet marketing.

The relationships between sensation seeking and a spectrum of e-cigarette use behaviors: Cross-sectional and longitudinal analyses specific to Texas adolescents

“…Results from the present study are consistent with previous research that has investigated the association between sensation seeking and ever use of tobacco products in adolescents (Hampson et al, 2015; Hanewinkel & Isensee, 2015; Hanewinkel, Isensee, Sargent, & - Morgenstern, 2011; Primack et al, 2015; Thrasher et al, 2016; Wills et al, 2015); however, much of the previous research has been cross-sectional. Similar to the longitudinal study conducted by Hanewinkel and Isensee (2015), the present study found that higher sensation seeking was associated with increased odds of ever e-cigarette use over time.…”

“…To date, five studies have examined the association between sensation seeking and e-cigarette use behaviors, providing preliminary indication that high sensation seeking is associated with ever e-cigarette use in adolescents (Hampson, Andrews, Severson, & Barckley, 2015; Hanewinkel & Isensee, 2015; Primack et al, 2015; Thrasher et al, 2016; Wills et al, 2015). In a cross-sectional study of Hawaiian adolescents, Wills et al (2015) found that mean sensation seeking scores were significantly higher for 1) ever e-cigarette only users as compared to non-users, and 2) ever dual users of both e-cigarettes and conventional cigarette users as compared to e-cigarette only users.…”

Prevalence and predictors of e-cigarette trial among adolescents in Argentina

“…The correlates of trying e-cigarettes appear generally similar to those reported for cigarettes and can be divided into three mayor domains: sociodemographics (i.e., sex, age, parental education, type of school), personal risk (i.e., sensation seeking, prior cigarette use, other substance use) and network influences (i.e., friend smoking, household smoking and parenting style). Being male, having lower parental support, higher rebelliousness, peer tobacco use, and advertising exposures has been associated with trying an e-cigarette 3,8,[16][17][18][19][20] . Alcohol and other drugs use have also been associated 3,21 .…”

“…Alcohol and other drugs use have also been associated 3,21 . Beyond these more traditional risk factors for conventional cigarettes, the Mexican study indicated that trial of e-cigarettes was associated with more specific risk factors like greater utilization of electronic media devices (i.e., "technophilia"), bedroom Internet access, and Internet advertising exposures 8 . These risk factors may be particularly important in countries such as Argentina, that have banned e-cigarettes, as Internet can provide uncensored information including e-cigarette marketing.…”

“…These risk factors may be particularly important in countries such as Argentina, that have banned e-cigarettes, as Internet can provide uncensored information including e-cigarette marketing. 8,22 . The perception than e-cigarettes are less harmful than regular tobacco has also been associated with increased risk of trial 14,19 .…”