Trends in E-Cigarette Use among Various Subgroups.

Introduction:
This letter to the editor discusses the trends in e-cigarette use among various subgroups, with a focus on the underestimation of marijuana use and its associated health risks. The authors suggest that social desirability bias may lead to underreporting of marijuana use and propose that data on Internet users could provide more accurate information on e-cigarette use.

Key Points:

* al Rifai et al.'s study did not show a significant increase in e-cigarette use among marijuana users, which contradicts recent reports on EVaLI (e-cigarette and vaping-associated lung injury) linked to vaping marijuana.
* Social desirability bias may cause respondents to underreport "bad" or undesirable behavior, leading to an underestimation of marijuana use prevalence.
* Evidence indicates that vaping advertisements increase temptation among youth to vape and alter their perception of smoking harms.
* Young adults are frequently exposed to e-cigarette products on the Internet and via social media.
* The Behavioral Risk Factor Surveillance System (BRFSS) of the CDC has data on Internet users, which could potentially detect an increase in e-cigarette use among this population.
* EVaLI cases have been predominantly linked to products containing ThC (tetrahydrocannabinol), the primary psychoactive component of marijuana.
* Social desirability scales have been used in clinical psychology to address biases, and similar methods could be applied to e-cigarette use surveys.

Main Message:
The letter emphasizes the importance of considering social desirability bias when analyzing self-reported data on e-cigarette use, particularly in relation to marijuana use. By recognizing this bias, researchers and policymakers can develop more accurate methods for measuring e-cigarette use and its associated health risks. The authors suggest that data on Internet users could provide a more precise picture of e-cigarette use trends, informing policy and regulatory decisions to protect public health.

Gunasekaran K, Singh Rahi M, Rajasurya V, Wolff a. Trends in E-Cigarette Use among Various Subgroups. The american journal of medicine. 2020;133(10):1. doi:10.1016/j.amjmed.2020.04.018