Prevalence of Electronic Cigarette Dependence among Youth and Its association With Future Use.

Introduction:
This article presents the findings of a prospective cohort study examining the prevalence and symptom presentation of electronic cigarette (e-cigarette) dependence and its association with future e-cigarette use among past-year e-cigarette users aged 16 to 18 in Southern California. The study also aims to compare e-cigarette dependence with combustible cigarette dependence, prevalence of e-cigarette dependence symptoms in subgroups at elevated risk, and associations between baseline e-cigarette dependence and subsequent vaping patterns.

Key Points:

* The study found that e-cigarette dependence was less prevalent and severe than combustible cigarette dependence but had similar symptom profiles.
* E-cigarette dependence was positively associated with vaping continuation, frequency, and intensity 6 months later.
* Prevalence of e-cigarette dependence symptoms was higher in subgroups at elevated risk, including youth who recently vaped, vaped nicotine, or also smoked.
* Symptoms of e-cigarette dependence were associated with increased risk of future vaping.
* The study controlled for potential confounding influences through the use of propensity score covariates.
* The follow-up period was limited to 6 months, leaving unclear the long-term association of e-cigarette dependence with future use.
* all measures were self-reported and did not include clinical diagnosis of nicotine dependence.

Main Message:
The study suggests that e-cigarette dependence among youth may be an expression of tobacco use disorder associated with use escalation. The findings highlight the importance of considering e-cigarette dependence as a potential health consequence of e-cigarette use in regulatory decision-making. adolescents are particularly vulnerable to nicotine exposure, and dependence symptoms associated with nicotine exposure via e-cigarettes are associated with greater risk of future vaping escalation. Therefore, dependence is an important health effect of e-cigarette use that should be considered in federal regulatory decisions that weigh the relative harms and benefits of e-cigarettes.

Vogel Ea, Cho J, McConnell RS, Barrington-Trimis JL, Leventhal aM. Prevalence of Electronic Cigarette Dependence among Youth and Its association With Future Use. JaMa network open. 2020;3(2):1. doi:10.1001/jamanetworkopen.2019.21513