Dataset Information

Associations Between Family and Peer E-Cigarette Use With Adolescent Tobacco and Marijuana Usage: A Longitudinal Path Analytic Approach.

ABSTRACT:

Introduction

Research indicates a link between adolescent e-cigarette use and combustible tobacco cigarette (CTC) initiation, and recent studies suggest their connection with marijuana uptake. Our 3-year longitudinal cohort study investigated the implications of adolescent, peer, and family e-cigarette use with adolescents' expectations and willingness to initiate CTC use, and subsequent CTC and marijuana use.

Aims and methods

Relationships were examined in a secondary analysis of a 3-year longitudinal cohort subsample involving adolescents enrolled in alternative California high schools (N = 1025). Analyses examined responses over three yearly observations. Family, peer, and respondents' e-cigarette use, respondents' positive cigarette expectancies and willingness to use CTCs were assessed in the study's first year (T1). CTC use in the survey's second year (T2) and marijuana use in the third year (T3) were assessed via path analysis.

Results

Respondents reporting at least one family member or peer using e-cigarettes were more likely to use e-cigarettes at T1 than those whose peers/family members did not. They reported more positive expectancies about CTCs and greater willingness to initiate use. These variables predicted CTC use at T2, which directly anticipated marijuana use in the survey's third year (T3), as did adolescents' use of e-cigarettes at T1. All model relations were statistically significant.

Conclusions

Analysis demonstrated the strong association of family members' and peers' behaviors with adolescent e-cigarette use, and the temporal precedence of e-cigarette use with subsequent CTC and marijuana uptake. The predictive implications of e-cigarettes for other dangerous substance use should be examined in future prevention campaigns.

Implications

The presented study expands upon existing literature connecting adolescent e-cigarette use and later CTC and marijuana use. The findings indicate the significant implications of exposure to e-cigarette use by parents and peers and demonstrate in a longitudinal 4-year panel survey the direct and indirect predictive implications of e-cigarette use for CTC and marijuana uptake. The research illustrates the utility of programs and campaigns that target peer and family groups to maximize impacts on adolescent willingness to try CTCs, positive expectancies, and possible onset of CTC and marijuana use.

SUBMITTER: Coleman M

PROVIDER: S-EPMC8628870 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:IntroductionSociodemographic differences in electronic cigarette use among cigarette smokers have not been previously characterized in the US adult population.MethodsWe analyzed longitudinal data from Waves 1 and 2 of the nationally representative Population Assessment of Tobacco and Health (PATH) study. Differences by income (based on federal poverty level (FPL)) and race/ethnicity in e-cigarette uptake at Wave 2 among cigarette smokers who were e-cigarette nonusers at Wave 1 were assessed using binomial and multinomial logistic regression. We differentiated e-cigarette users who quit cigarettes (exclusive users) from those who did not quit cigarettes (dual users). E-cigarette-related attitudes/beliefs were evaluated to understand potential contributions to sociodemographic differences in e-cigarette uptake and use patterns.ResultsAmong 6592 smokers who were e-cigarette nonusers at Wave 1, 13.5% began using e-cigarettes at Wave 2, of whom 91.3% were dual users. Compared with non-Hispanic Whites, non-Hispanic Black, and Hispanics were less likely to become exclusive e-cigarette users (OR [Blacks] = 0.27, 95% CI = 0.09 to 0.77; OR [Hispanics] = 0.26, 95% CI = 0.09 to 0.70). Low-income smokers were less likely than higher-income smokers to become exclusive e-cigarette users (OR [<100% FPL vs. ?200% FPL] = 0.48, 95% CI = 0.27 to 0.89). Black, Hispanic, and low-income smokers were more likely to believe e-cigarettes are more harmful than cigarettes and to have positive tobacco-related social norms.ConclusionsBlack, Hispanic, and low-income smokers were less likely than White and higher-income smokers to begin using e-cigarettes in the context of quitting cigarettes. Differences in e-cigarette uptake may be partly explained by perceived harm or social norms of e-cigarettes.ImplicationsResults of this study show that the exclusive use of e-cigarettes is more prevalent in higher-income and White smokers. Our data suggest that higher-income and White smokers may be more likely to use e-cigarettes as a means to quit combustible cigarettes compared with low-income and racial/ethnic minority smokers. These findings suggest that sociodemographic differences in e-cigarette uptake and use patterns may contribute to widening disparities in cigarette smoking.