ECPN Student Poster Contestant: E-Cigarette and Alcohol Use in Hispanic Adolescents: The Moderating Role of Parent-Adolescent Communication and Parent Smoking Status.

Introduction: E-cigarettes were the most used tobacco product among U.S. middle and high school students in 2017. We explore the prevalence of e-cigarette use and its relationship to alcohol use; which have both been known to have a “gateway effect” among adolescents. Furthermore, we explore how this relationship may be moderated by parental perceptions of parent-adolescent communication and parental cigarette smoking status.

Methods: This cross-sectional study uses data from an ongoing randomized clinical trial evaluating the relative effectiveness of an online adaptation of an evidence-based intervention in preventing substance use, HIV sexual risk behaviors, chlamydia and gonorrhea. The study sample consisted of 300 Hispanic adolescents between 12-16 years of age (mean age=13.90; SD=1.33; 51% female), and their caregivers (mean age=43.08; SD=6.43; 93% female). Measures analyzed for adolescents included lifetime e-cigarette use and lifetime alcohol use. Parent measures analyzed included lifetime cigarette use status and parent-adolescent communication (Mean=75.85, SD=9.86). A series of logistic regression models examined the association between lifetime e-cigarette use and lifetime alcohol use, as well as the moderator role of parent-adolescent communication and parent cigarette use.

Results: 10.3% of adolescents reported lifetime use of e-cigarettes, and 65% of this group were exclusive e-cigarette users. In bivariate analysis, lifetime e-cigarette use was significantly associated with lifetime alcohol use (OR=6.31, 95% CI=2.57, 15.48). Parent-adolescent communication and parent cigarette smoking status were found to moderate the association between lifetime e-cigarette use and lifetime alcohol use. For parents who reported low levels of parent-adolescent communication (below mean), adolescents who reported lifetime e-cigarette use were more likely to report lifetime alcohol use (OR=13.63, 95% CI=3.25, 57.08), relative to adolescents whose parents reported high levels of parent-adolescent communication (above mean; OR=2.89, 95% CI=.69, 12.15). For parents who smoked cigarettes, adolescents who reported lifetime e-cigarette use were more likely to report lifetime alcohol use (OR=15.00, 95% CI=3.52, 63.89), relative to adolescents with non-smoking parents (OR=3.34, 95% CI=.96, 11.63).

Conclusions: Given the association between lifetime e-cigarette use and lifetime alcohol use, longitudinal data are needed to examine the temporality of initiation with these substances; determining if e-cigarettes act as a gateway for other illicit substances. With the moderating role of parent perceptions of parent-adolescent communication and smoking status, interventions can target parents who perceive low levels of parent-adolescent communication and use cigarettes. Such interventions, and examination of longitude data, can be effective in reducing exposure to nicotine and alcohol in adolescents.