The association between alcohol, marijuana, illegal drug use and current use of E-cigarette among youth and young adults in Canada: results from Canadian Tobacco, Alcohol and Drugs Survey 2017

Abstract

Background: E-cigarettes have grown in popularity around the world since 2003. Although marketed as a smoking cessation tool, e-cigarettes can lead to tobacco cigarette smoking in youth. In Canada, among all age groups, youth and young adults have the highest prevalence of e-cigarette use. The objective of this study was to assess the factors associated with e-cigarette use among youth and young adults in Canada, and to specifically examine the association between alcohol, marijuana and illicit drug use. Methods: Data from the 2017 Canadian Tobacco, Alcohol and Drugs Survey were used. The sample was restricted to those aged 15-24 years (n = 10,322), and main outcome defined as 'E-cigarette use in the past 30-days'. Multivariable logistic regression was performed to assess the association between the main outcome and substance use variables (illicit drug, marijuana and alcohol use), tobacco exposure variables, and demographic and healthrelated factors. Results: 6.2% Canadians aged 15-24 reported using e-cigarettes in the past 30-days, while 23.9% reported having ever tried e-cigarettes. Twenty-three percent of the past 30-day users reported using e-cigarettes every day and 72.5% of the past 30-day users reported having nicotine in their last e-cigarette. Additionally, youth aged 15-17 were 4.95 times more likely to be e-cigarette users as compared to those aged 22-24 (OR: 4.95, 95% CI: 3.1-7.9). Moreover, e-cigarette use was significantly associated with marijuana use (OR:4.17, 95% CI: 2.6-6.7) and alcohol use (OR: 5.08, 95% CI: 2.9-9.0), and approached significance with illicit drug use (OR: 1.68, 95% CI: 1.0-2.9). Furthermore, being a current smoker (OR: 2.93, 95% CI: 1.8-4.7) and male (OR: 2.28, 95% CI: 1.5-3.4) was significantly associated with the outcome. Conclusion: This study is nationally representative and provides insight into e-cigarette use among youth and young adults aged 15-24 years. Given that e-cigarettes can be used as illicit drug delivery systems, more studies are needed to understand how Canadian youth and young adults are using e-cigarettes. Stricter restrictions on public e-cigarette smoking, and awareness campaigns informing youth of risks of e-cigarette smoking should be implemented.

Prevalence of Electronic Cigarette Use and Its Determinants among 13-to-15-Year-Old Students in Greece: Results from the 2013 Global Youth Tobacco Survey (GYTS)

“…Future research could take into account e-cigarettes that do not contain nicotine and e-cigarettes that contain other addictive substances, since e-cigarettes can also be used as illicit drug delivery systems [45]. Future studies could also attempt to determine the frequency of use among current users of e-cigarettes and study potential misconceptions about the safety of e-cigarettes among the general public and adolescents in particular [46,47].…”

Dual Substance Use of Electronic Cigarettes and Alcohol

“…EC users have an increased risk of alcohol misuse (Figure 1), such as binge drinking or chronic use, when compared with non-EC users (Lanza and Teeter, 2018;Mehra et al, 2019). While the literature is replete for this trend with the use of traditional cigarettes and alcohol consumption, a similar public health issue may exist for EC use and requires future study.…”

Trends and Characteristics in Marijuana Use Among Public School Students — King County, Washington, 2004–2016

“…Statewide data from 2016 also show similar higher prevalence of household, peer and individual factors associated with youth substance use among grade 10 marijuana users than nonusers (https://www.askhys.net/library/2016/RecentMarijaunaUseGr10.pdf). Findings from a 2017 survey of Canadian residents aged 15–24 years found that marijuana users were significantly more likely to be past 30-day e-cigarette users, compared with nonusers ( 8 ). Polysubstance use and driving after using marijuana or riding in a car driven by someone who had used marijuana recently are public health issues that are important to monitor.…”