Youth Use, Risky Behaviours & Adverse Childhood Experiences (ACEs)


Adolescent Males' Awareness of and Willingness to Try Electronic Cigarettes

Jessica K. Pepper, Paul L. Reiter, Annie-Laurie McRee, Linda D. Cameron, Melissa B. Gilkey, Noel T. Brewer
Published online: 1 Feb 2013

Only two participants (< 1%) had previously tried e-cigarettes. 

Among those who had not tried e-cigarettes, most (67%) had heard of them. Awareness was higher among older and non-Hispanic adolescents. 

Nearly 1 in 5 (18%) participants were willing to try either a plain or flavoured e-cigarette, but willingness to try plain versus flavoured varieties did not differ. 

Smokers were more willing to try any e-cigarette than non-smokers (74% vs. 13%; OR 10.25, 95% CI 2.88, 36.46). 

Non-smokers who had more negative beliefs about the typical smoker were less willing to try e-cigarettes (OR .58, 95% CI .43, .79).


Parent, peer, and executive function relationships to early adolescent e-cigarette use: A substance use pathway?

Mary Ann Pentz, HeeSung Shin, Nathaniel Riggs, Jennifer B. Unger, Katherine L. Collison, Chih-Ping Chou
Published online: 1 Nov 2014

Lifetime use prevalence was 11.0% for e-cigarettes, 6.8% for cigarettes, and 38.1% for alcohol. Free lunch and age were marginally related to e-cigarette use (p<.10). Parent e-cigarette ownership was associated with the use of all substances, while peer use was associated with gateway drug use (p’s<.05-.001). EF (Executive Function) deficits were associated with the use of all substances five times more likely than others to use e-cigarettes and over twice as likely to use gateway drugs.

E-cigarette and gateway drug use may have common underlying risk factors in early adolescence, including parent and peer modelling of substance use, as well as EF deficits. Future research is needed to examine longitudinal relationships of demographics, parent and peer modelling, and EF deficits to e-cigarette use in larger samples, trajectories of e-cigarette use compared to use of other substances, and the potential of EF skills training programs to prevent e-cigarette use.


Associations between e-cigarette access and smoking and drinking behaviours in teenagers

Karen Hughes, Mark A Bellis, Katherine A Hardcastle, Philip McHale, Andrew Bennett, Robin Ireland, Kate Pike
Published online: 31 Mar 2015

Results:One in five participants reported having accessed e-cigarettes (19.2%). Prevalence was highest among smokers (rising to 75.8% in those smoking >5 per day), although 15.8% of teenagers that had accessed e-cigarettes had never smoked conventional cigarettes (v.13.6% being ex-smokers). E-cigarette access was independently associated with male gender, having parents/guardians that smoke and students’ alcohol use. Compared with non-drinkers, teenagers that drank alcohol at least weekly and binge drank were more likely to have accessed e-cigarettes (adjusted odds ratio [AOR] 1.89, P < 0.001), with this association particularly strong among never-smokers (AOR 4.59, P < 0.001). Among drinkers, e-cigarette access was related to: drinking to get drunk, alcohol-related violence, consumption of spirits; self-purchase of alcohol from shops or supermarkets; and accessing alcohol by recruiting adult proxy purchasers outside shops.”


E-Cigarette Uptake Amongst UK Youth: Experimentation, but Little or No Regular Use in Nonsmokers

Linda Bauld, Anne Marie MacKintosh, Allison Ford, Ann McNeill
Published online: 1 Jan 2016

What do these data tell us? They suggest that at the moment, regular use of e-cigarettes is almost entirely concentrated in young people who already smoke. As studies in other countries have also shown, never smokers are trying these devices (which may or may not contain nicotine—the surveys did not ask this). However, in the United Kingdom at least the data suggests that they are not progressing to habitual use.

Survey on the use of electronic cigarettes and tobacco among children in middle and high school

N Stenger, E Chailleux
Published online: 1 Jan 2016

RESULTS: Among the students, 56% had tried an electronic cigarette at least once (boys: 59.9%, girls: 49.3%; ranging from 31.3% for the 8th grade students to 66.1% for the 12th grades). However, only 3.4% reported that they used electronic cigarettes every day. Initiation of e-cigarette use in these teenagers was principally due to use by friends or triggered by curiosity and they usually choose fruit or sweet flavours initially. The majority could not give the concentration of nicotine in e-cigarettes that they used. Moreover, 61.5% of the students had ever tried tobacco and 22.3% were daily smokers. Our study found a strong link between vaping and smoking. 80% of the students who had ever tried conventional cigarettes (94% for the daily smokers) had also tried an electronic cigarette, versus 16% of the students who have never smoked. Few students (6.2%) used electronic cigarettes without smoking tobacco too. Usually, they have tried tobacco before trying an electronic cigarette. Only tobacco smokers seem to smoke electronic cigarettes with nicotine.

CONCLUSION: Although our study shows that teenagers frequently try electronic cigarettes, it does not prove, for the moment, that vaping itself usually leads to nicotine addiction. However, as most of the teenagers are unable to tell if the electronic cigarette they are testing contains nicotine, it raises the possibility that they could be vulnerable to manipulation by the tobacco industry.

Nicotine concentration of e-cigarettes used by adolescents

Meghan E.Morean, Grace Kong, Dana A. Cavallo, Deepa R. Camenga, Suchitra Krishnan-Sarin
Published online: 1 Oct 2016

Adolescents reported using nicotine-free e-liquid (28.5%), nicotine e-liquid (37.4%), or not knowing their e-liquid nicotine concentration (34.1%). 

Nicotine users comprised more smokers and heavier e-cigarette users compared to nicotine-free e-liquid users and those who did not know their nicotine concentration. 


The 2018 American Teen Vaping Epidemic, Recalculated

Brad Rodu
Published online: 16 May 2019

For comparison, I conducted the same analysis on the 2017 NYTS, which yielded 26,660 underage teens who vaped 20-30 days in the past month but never used other products. That was less than 0.2% of all high school students.

It is true that frequent vaping among underage high school teens increased substantially from 26,660 in 2017 to 95,316 in 2018. These numbers translate into an increase from less than 0.2 to 0.6% of all high school students.

In summary, the oft-cited teen vaping epidemic involves not three million youths, but rather 95,000 underage teens who vaped frequently but never used other tobacco products – or 0.6% of the nation’s 14.8 million high school students.

Epidemic of youth nicotine addiction? What does the National Youth Tobacco Survey reveal about high school e-cigarette use in the USA? (Preprint)

Robert West, Jamie Brown
Published online: 2 Oct 2019

Conclusions: Data from the NYTS do not support claims of a new epidemic of nicotine addiction stemming from use of e-cigarettes, nor concerns that declines in youth tobacco addiction stand to be reversed after years of progress. Among current e-cigarette users who had never tried tobacco products, responses consistently pointed to minimal dependence.


Up in Smoke: Exploring the Relationship between Bullying Victimization and E-Cigarette Use in Sexual Minority Youths

Courtney R. Doxbeck
Published online: 28 Jul 2020

Conclusions/Importance: These findings suggest that sexual minority students who report cyberbullying victimization may use cigarette and e-cigarette products more than their non-cyberbullied peers. 

Changes from 2017 to 2018 in e-cigarette use and in ever marijuana use with e-cigarettes among US adolescents: analysis of the National Youth Tobacco Survey

Konstantinos Farsalinos, Anastasia Barbouni, Raymond Niaura
Published online: 28 Jul 2020

Frequent and daily e-cigarette use was by far lower in never-smokers compared with ever-smokers.

Vaping and fidget-spinners’: A qualitative, longitudinal study of e-cigarettes in adolescence

Rikke Tokle
Published online: Aug 2020

Vaping in the study represented a time-limited trend rather than a steady user pattern.

Drivers out of vaping were changes in peer-group perceptions, diminished novelty and lack of addiction as the youth vaped non-nicotine-containing e-liquids.

In this study I have found evidence that e-cigarettes or vaping devices can represent fashionable experimentation rather than steady user patterns.