BACKGROUND AND OBJECTIVE: Flavored electronic cigarettes (e-cigarettes) are not prohibited in the United States, and e-cigarette flavors proliferate on the market. This study sought to examine flavored e-cigarette use and its association with smoking among youth.
METHODS: Estimates of flavored e-cigarette use from the 2014 National Youth Tobacco Survey were investigated. A logistic regression model was used to assess whether flavored e-cigarette use was associated with (1) intention to initiate cigarette use among never-smoking youth (n = 16 471), (2) intention to quit tobacco use among current-smoking youth (n = 1338), and (3) perception of tobacco's danger among all respondents (n = 21 491).
RESULTS: A total of 2017 respondents reported using e-cigarettes in the last 30 days, of whom 1228 (60.9%) reported using flavored e-cigarettes. Among never-smoking youth, 55.6% (288) of current e-cigarette users reported using flavored e-cigarettes. Among current smokers, 68.4% (495) of current e-cigarette users reported using flavored e-cigarettes. Compared with not using e-cigarettes in the past 30 days, using flavored e-cigarettes was associated with higher odds of intention to initiate cigarette use among never-smoking youth (adjusted odds ratio [aOR] = 5.7; P < .0001), lower odds of intention to quit tobacco use among current-smoking youth (aOR = 0.6; P = .006), and a lower prevalence of perception of tobacco's danger among all respondents (aOR = 0.5; P < .0001).
CONCLUSIONS: Flavored e-cigarette use is associated with increased risks of smoking among youth. Comprehensive tobacco control and prevention strategies that address flavored e-cigarette products are critically needed to reduce tobacco use among youth.
Adolescent; Adolescent Behavior; Age Factors; Cross-Sectional Studies; Electronic Nicotine Delivery Systems; Female; Flavoring Agents; Humans; Logistic Models; Male; Predictive Value of Tests; Prevalence; Retrospective Studies; Risk Assessment; Sex Factors; Smoking; United States
Ecigarettes; Teenagers; Vaping
Dai H, Hao J. Flavored Electronic Cigarette Use and Smoking Among Youth. Pediatrics. 2016;138(6):e20162513. doi:10.1542/peds.2016-2513