Internalizing and externalizing problems on the age of e-cigarette initiation in youth: Findings from the Population assessment of Tobacco and health (PaTh), 2013-2017.

Introduction:
This text provides an analysis of the relationship between internalizing and externalizing problems and the age of initiation of e-cigarette use among U.S. youth. The study uses data from the Population assessment of Tobacco and health (PaTh) study from 2013-2017. The analysis adjusts for covariates such as sex, race/ethnicity, parent level of education, previous use of other tobacco products, and previous substance use.

Key Points:

* The study used data from the Population assessment of Tobacco and health (PaTh) study from 2013-2017.
* The analysis focused on the relationship between internalizing and externalizing problems and the age of initiation of e-cigarette use among U.S. youth.
* The study controlled for covariates such as sex, race/ethnicity, parent level of education, previous use of other tobacco products, and previous substance use.
* Youth with high internalizing and high externalizing problems had increased risk of an earlier age of ever e-cigarette initiation and first reporting past 30-day e-cigarette use.
* Externalizing problems resulted in the highest risk for e-cigarette initiation compared to internalizing problems.
* Waiting to intervene until youth reach 17-18 years of age may result in increases in e-cigarette incidence that could have been prevented.
* Comprehensive communication and prevention and intervention programs should assess youth for mental health problems and e-cigarette use to provide support for risky behaviors before they lead to more harmful outcomes.

Main Message:
The study finds that both internalizing and externalizing problems are associated with earlier ages of e-cigarette initiation among U.S. youth. Externalizing problems, in particular, may represent a strong risk factor for e-cigarette initiation. Comprehensive communication and prevention and intervention programs should assess youth for mental health problems and e-cigarette use to provide support for risky behaviors before they lead to more harmful outcomes. Waiting to intervene until youth reach 17-18 years of age may result in increases in e-cigarette incidence that could have been prevented.

Pérez a, Bluestein Ma, Kuk aE, Chen B, harrell MB. Internalizing and externalizing problems on the age of e-cigarette initiation in youth: Findings from the Population assessment of Tobacco and health (PaTh), 2013-2017. Preventive medicine. 2022;161:107111. doi:10.1016/j.ypmed.2022.107111