Youth who initiate tobacco use with e-cigarettes only differ from those who start with cigarettes only or both products concomitantly

Abstract

Background Few studies have compared the psychosocial risk profiles for youth who begin using tobacco with e-cigarettes only, cigarettes only, or both of these products. Methods More than 40 known psychosocial risk factors for youth tobacco use, including intra-personal (e.g., sensation seeking), inter-personal (e.g., peer influence), and environmental (e.g., tobacco marketing) factors were compared between those who started with e-cigarettes only (n=156, N=14550), cigarettes only (n=59, N=7325), or both of these products (n=35, N=3510). Psychosocial risk factors were measured at baseline (2014-15) and tobacco use behaviors at 6, 12, and 18 month follow-ups (2015-16) in a population-based sample (n) of 3,116 students in 4 large urban areas of Texas that generalizes back to 353,552 students (N) who were in the 6 th , 8 th , and 10 th grades and had never used tobacco at baseline. Results Youth who started with cigarettes only or both, compared to youth who started with e-cigarettes only, were more likely to have a family member that used cigarettes or e-cigarettes (p< 0.01) and be past 30-day marijuana users (p=0.01) at baseline. Youth who started with e-cigarettes only, compared with the others, reported a higher positive affect (p=0.01) and lower negative affect at baseline (p=0.01) and were more likely to have positive outcome expectations about tobacco use (e.g., it helps me concentrate; p=0.05) and be past 30-day alcohol users (p=0.05) at baseline. Youth who started with both products, compared to one exclusively, were more likely to have engaged with tobacco-related content on digital media (e.g., posted pictures, blogged) (p< 0.05) and less likely to report seeing displays for cigarettes at retail point-of-sale (p< 0.01) at baseline. No other differences in known risk factors (e.g., sensation seeking) were observed. Conclusions Psychosocial risk profiles do vary significantly by starter tobacco products. Implications for intervention will be discussed.

Keywords

• WCTOH