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J Adolesc Health. 2019 Jun;64(6):770-775. doi: 10.1016/j.jadohealth.2019.02.019.

Adolescents' E-Cigarette Use: Increases in Frequency, Dependence, and Nicotine Exposure Over 12 Months.

Author information

1
Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California.
2
Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, California.
3
University of California, Berkeley, Berkeley, California.
4
Division of Adolescent & Young Adult Medicine, University of California, San Francisco, San Francisco, California. Electronic address: mark.rubinstein@ucsf.edu.

Abstract

PURPOSE:

This study examined changes in e-cigarette and dual-use frequency, levels of nicotine exposure and e-cigarette dependence, and device and e-liquid preferences over 12 months.

METHODS:

Adolescents (N = 173, aged 13-18 years) who reported past-month e-cigarette use and at least 10 lifetime uses were recruited from the San Francisco Bay Area. The sample was 75.1% male, 54.9% non-Hispanic White, mean age 16.6 years (standard deviation = 1.2); 26.6% reported past-month cigarette smoking at baseline (i.e., dual use). At baseline, 6-month, and 12-month follow-up, participants provided saliva samples for cotinine testing and self-reported e-cigarette use frequency, dependence, past-month smoking, product preference, and flavor preference.

RESULTS:

Most (80.3%) were still using e-cigarettes at 12 months, and daily use increased from 14.5% to 29.8%. Model testing indicated an overall increase from baseline to 12 months in frequency of e-cigarette use (F(2, 166) = 5.69, p = .004), dependence (F(2, 164) = 5.49, p = .005), and cotinine levels (F(2, 103) = 4.40, p = .038). Among those reporting only e-cigarette use at baseline, 28.8% reported combustible cigarette use during follow-up. Among those reporting dual use at baseline, 57.1% were still dual using at 12 months, 31.4% reported e-cigarette use only, and none abstained from both products. Higher nicotine delivering e-cigarette devices (i.e., Juul, mods) became more popular over time, whereas flavor preferences (i.e., fruit, mint/menthol, and candy) remained stable.

CONCLUSIONS:

Adolescents' e-cigarette use persisted over a 12-month period with significant increases in frequency of use, nicotine exposure, and e-cigarette dependence. Transitions from single to dual and dual to single nicotine product use were observed in approximately one in three users over the study period.

KEYWORDS:

Addiction; Adolescent; Cigarettes; Dependence; E-cigarette; ENDS; Nicotine

PMID:
31122507
PMCID:
PMC6538303
[Available on 2020-06-01]
DOI:
10.1016/j.jadohealth.2019.02.019

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