Reasons to use e-cigarettes among adults and youth in the Population assessment of Tobacco and health (PaTh) study.

Introduction:
This article examines the reasons why adults and youth use e-cigarettes, and how these reasons are associated with user characteristics. The study uses data from the Population assessment of Tobacco and health (PaTh) study to determine the underlying themes of reasons to use e-cigarettes and to examine the associations between these reasons and user characteristics, separately for youth and adults. The findings of this study can inform regulatory efforts to prevent e-cigarette initiation and promote cessation.

Key Points:

* The study used exploratory factor analysis (EFa) to identify two factors, "alternatives to cigarettes" and "larger social environment", which best describe the observed patterns motivating e-cigarette use among youth and adults.
* adult current established e-cigarette users were associated with both factors, while former established users were associated with the "alternative to cigarettes" factor.
* among youth, those who used e-cigarettes earlier today were associated with both reasons to use factors, while those who used e-cigarettes any day in the past 30 days but not in the past 7 days were not associated with either factor.
* Several adult socio-demographic characteristics were associated with one but not the other factor, or both but in opposite directions.
* The study found minimal differences between factors when comparing adults and youth, but two variables loaded on different factors between adults and youth.
* The "alternative to cigarettes" factor encompasses not just goal-directed use, but also perceptions about where the product could be used, how acceptable use is, and how use might affect health.
* The "larger social environment" factor includes peer influences, social norms, media, advertising, and socializing influences, which are part of a larger, latent organizing factor.
* The findings can help inform regulatory efforts to prevent e-cigarette initiation and promote cessation, by tailoring tobacco prevention and control programs to specific user populations.

Main Message:
The study found that reasons to use e-cigarettes are associated with patterns of e-cigarette use among youth and adults. The two identified factors, "alternatives to cigarettes" and "larger social environment", could support a comprehensive approach to addressing rising e-cigarette use among youth and adults. Understanding the reasons why people use e-cigarettes can help inform regulatory efforts to prevent e-cigarette initiation and promote cessation, by tailoring tobacco prevention and control programs to specific user populations. The findings highlight the need for further research to support the development of evidence-based regulatory measures that effectively address the complex and evolving reasons for e-cigarette use.

Nicksic NE, Snell LM, Barnes aJ. Reasons to use e-cigarettes among adults and youth in the Population assessment of Tobacco and health (PaTh) study. addictive Behaviors. 2019;93:93-99. doi:10.1016/j.addbeh.2019.01.037