Within-person associations of escalated electronic nicotine delivery systems use with cigarette, alcohol, marijuana and drug use behaviors among US young adults.

Introduction:
This text summarizes a research study on the within-person associations of escalated electronic nicotine delivery systems (ENDS) use with other substance use behaviors among US young adults. The study aims to examine the changes in escalated ENDS use over a 6-year period and its associations with individual and combined substance use.

Key Points:

* The study used a longitudinal cohort design with US young adults aged 18-24 years.
* Escalated ENDS use was computed by subtracting the number of days of ENDS use within the past 30 days at wave w−1 from that at wave wand coded as 1 = escalated if the value was greater than zero (otherwise, coded as 0 = not escalated).
* The study found that escalated ENDS use was associated with increased odds of using each substance (binge drinking, marijuana use, marijuana vaping, prescription and illicit drugs) and different combinations of polysubstance use between cigarette smoking, binge drinking and marijuana use.
* Sweet/fruit flavor use was associated with increased likelihood of reporting co-use of cigarettes and marijuana.
* The prevalence of young adults using electronic nicotine delivery systems appeared to have increased steadily between 2013 and 2019, although the rate of increase may have started to accelerate in recent years.
* among established electronic nicotine delivery systems users, sweet/fruit flavor appears to be associated with increased risk of co-using cigarettes and marijuana.

Main Message:
The study suggests that escalated electronic nicotine delivery systems use and time-lagged established electronic nicotine delivery systems use appear to be prospectively associated with individual and combined substance use, particularly between cigarettes, alcohol and marijuana. Therefore, preventing young people from using ENDS products is crucial to discourage them from co-using other substances. additionally, regulation of sweet/fruit ENDS flavors may help thwart young people from escalating ENDS use and therefore using each and multiple substances.

han Dh, Elam KK, quinn PD, huang C, Seo DC. Within-person associations of escalated electronic nicotine delivery systems use with cigarette, alcohol, marijuana and drug use behaviors among US young adults. addiction (abingdon, England). 2023;118(3):509-519. doi:10.1111/add.16082