E-Cigarettes: Emerging Public Health Issue or Isolated Concern?

While little research exists, a growing number of public health officials are concerned about the potential short- and long-term health impact of electronic(e)-cigarette use, especially when it comes to adolescents and young adults. Though limited, studies suggest that 10%-20% of high-school-aged youth report recent e-cigarette use, with higher rates reported by males. Less is known about young adults’ use of e-cigarettes and how this behavior may relate to the use of other harmful substances. Thus, the purpose of this study is to examine 1) the prevalence of e-cigarette use among a sample of young adults, 2) the association of e-cigarette use to traditional cigarettes, alcohol, marijuana, and other drugs, and 3) motivations for e-cigarette use.

Participants included 653 young adults (mean age = 20) originally recruited in high school who responded to the following question: since your last survey (about 1 year ago), “did you use electronic cigarettes (e-cigs, vapors)”. Participants who reported e-cigarette use were then asked about their motivations for use and presented with several possible options. Participants also reported on their past year use of cigarettes, alcohol, marijuana, prescription drugs, cocaine, amphetamines, hallucinogens, ecstasy, over-the-counter drugs, and inhalants. The young adults self-identified their racial/ethnic background as Hispanic (37.2%), White (33.4%), or African American (29.4%).

Past year prevalence of e-cigarette use was 28.3%, with males (36.1%) reporting significantly higher use than females (23.2%), χ²(1) = 12.88, p < .001. Hispanic (31.6%) and Caucasian (38.9%) young adults reported a higher past year prevalence of e-cigarette use than their African American (11.9%) counterparts, χ²(2) = 38.83, p < .001. E-cigarette use was significantly and positively related to every substance use variable. Motivations for e-cigarette use included: the taste is better than regular cigarettes (55.7%), using as a substitute for smoking in places where smoking is prohibited (36.2%), to avoid smelling like tobacco smoke (31.9%), to help cut down the number of cigarettes smoked (23.8%), to help quit smoking entirely (23.8%), to save money (18.9%), and to avoid exposing others to second-hand smoke (17.3%).

Findings suggest that e-cigarette use is common, especially among males, and Hispanic and Caucasian young adults. While the health impact of e-cigarette use is largely unknown, this study shows a clear relationship between e-cigarette use and other known harmful substances. Implications for substance use prevention and intervention programs will be discussed, as well as motivations for use of e-cigarettes.