Effect of harm perception on ENDS initiation among US adolescents and young adults: Longitudinal findings from the population assessment of tobacco and health (PaTh) study, 2013-2018.

Introduction:
This text discusses a study on the impact of harm perception on electronic nicotine delivery systems (ENDS) initiation among US adolescents and young adults. The study uses data from the Population assessment of Tobacco and health (PaTh) Study conducted from 2013 to 2018. The study aims to examine the effect of harm perception on ENDS initiation among a US nationally representative sample of adolescents and young adults over a five-year period.

Key Points:

* The study focuses on ENDS initiation among adolescents (12-17 years) and young adults (18-24 years) who never used ENDS at baseline.
* harm perception was assessed as a time-dependent variable and categorized as relative and absolute harm perception.
* Relative harm perception (RhP) was assessed by asking whether ENDS are less harmful, about the same, or more harmful than cigarettes.
* absolute harm perception (ahP) was assessed by asking how much people harm themselves when they use ENDS.
* The Cox proportional hazards regression models were used to assess the relationship between harm perception and ENDS initiation.
* Covariates of interest included demographics, tobacco-related reasons for use and attitudes, health status, risk behaviors, media, smoke-free home rules, parents' education, and peer/family influence.
* The study found that perceiving ENDS as reduced or low-harm products significantly predicted ENDS initiation among adolescents and young adults.

Main Message:
The study highlights the importance of ENDS harm perception and the central role of risk communication strategies that need to target those young people who are at particular risk of unwarranted ENDS use. The findings suggest that tailored interventions through risk communication strategies can benefit from ENDS as smoking cessation tools without encouraging tobacco-naïve young generations' ENDS uptakes. The study also underscores the need for appropriate programs, such as health communication, to increase self-efficacy among young people to discard the influence of peers or family members on smoking behavior uptakes.

Li W, Osibogun O, Gautam P, Li T, Cano MÁ, Maziak W. Effect of harm perception on ENDS initiation among US adolescents and young adults: Longitudinal findings from the population assessment of tobacco and health (PaTh) study, 2013-2018. Drug and alcohol dependence. 2023;244:109784. doi:10.1016/j.drugalcdep.2023.109784