Summary
Introduction:
This text is a summary of a study examining the impact of flavoring and nicotine in the initial e-cigarette exposure on subsequent e-cigarette use among adolescents. The study offers new evidence for a prospective relationship between e-cigarette flavoring, e-cigarette nicotine content, and an adolescent’s e-cigarette use trajectory.
Key Points:
* The study used a two-part Latent Growth Curve Model (LGCM) to evaluate the association between the presence of flavoring and nicotine in the first e-cigarette used, and progression to current e-cigarette use as well as escalation in use across the following 18 months.
* A linear trend fit the data for the average level of change in the number of days that e-cigarettes were used.
* Having a greater number of peers and household members who use e-cigarettes was associated with current e-cigarette use at baseline.
* Using standardized coefficients, flavoring was associated with a 1.09 standard deviation increase in the rate of progression to current e-cigarette use compared to no flavoring.
* Females had a slower rate of progression to current e-cigarette users across the 18 month follow-up than males.
* Higher levels of sensation-seeking at baseline was associated with progression to current e-cigarette use across the following 18 months.
* Higher scores translated to a .47 standard deviation increase in the rate of progression from baseline.
* Initial use of an e-cigarette with nicotine versus without nicotine was associated with using e-cigarettes on a greater number of days at baseline.
Main Message:
The study highlights the importance of policies to prevent e-cigarette use among youth and underscores the risk that flavor and nicotine pose for progression beyond initial use. The popularity of pod-based e-cigarettes, such as Juul, and the potential for adolescents who initiate e-cigarette use with nicotine free e-liquid to transition to e-liquid with nicotine, suggest that further research is needed to delineate further synergistic effects of nicotine and flavoring on e-cigarette uptake.
Citation
Audrain-McGovern J, Rodriguez D, Pianin S, Alexander E. Initial e-cigarette flavoring and nicotine exposure and e-cigarette uptake among adolescents. Drug and alcohol dependence. 2019;202:149-155. doi:10.1016/j.drugalcdep.2019.04.037
