Emerging, Hot Topic: The E-Cigarette Epidemic on Campus: Current Trends in Students’ Misperceptions, Perceptions, and Behaviors

Introduction:

The rapid growth of the electronic smoking device industry is of significant concern. Recently, tobacco giant Altria purchased a 35% stake in electronic smoking device JUUL for 12.8 billion, valuing JUUL labs at 38 billion dollars. The US Surgeon General concluded “E-cigarette use poses a significant – and avoidable – health risk to young people.” Risks include addiction, long term harm to brain development and respiratory health, and potential progression to traditional smoking. While there has been progress in reducing cigarette smoking, e-cigarettes are now the most commonly used tobacco product among young people. The U.S. Surgeon General has declared electronic smoking device use among young people an epidemic.

Methods:

Undergraduate students enrolled at a West Coast university in the U.S. completed a questionnaire examining the following variables for conventional and electronic smoking devices (n=219); (a) age of smoking initiation, (b) perceptions of harm, (c) perceptions of addictiveness, (d) smoking intentions, (e) prior and current (last 30 days) use, and (f) feelings about addiction. Students also completed a sensation-seeking scale. Quantitative data were analyzed using SPSS and open-ended data were examined for trends.

Results:

A large percentage (65%) of this sample reported trying electronic smoking devices (ESD). The age of ESD initiation ranged from 12-21 years, with an average age of 16. Sensation-seeking was positively correlated with ESD use (r=.36, p <.001). A substantial percent of the sample (48%) reported using an ESD in the last 30 days, compared to 10% having smoked conventional cigarettes. There were differences in perceived harm and addictiveness. On a 5-point Likert scale, students perceived electronic cigarettes to be less harmful (3.89) than conventional cigarettes (4.75), p <.001 and perceived them to be less addictive (4.44 vs. 4.63), p <.001. However, in open-ended comments some students reported they were struggling with addiction and wished they had not started.

Conclusion:

E-cigarettes, a rapidly evolving product, were initially touted as a smoking cessation device. However, students in this study were typically underage when initiating e-cigarettes. Almost half had used an e-cigarette within 30 days. New types of ESD's may be re-normalizing smoking behavior. Students need clear information about nicotine's addictiveness, and the risks of early exposure. Those high in sensation-seeking may benefit from targeted prevention. Public health efforts for educating about new nicotine-containing products are needed, as is continued research on the best ways to communicate risks and inform policy to address this epidemic.