Perception of e-cigarette harm and its correlation with use among U.S. adolescents

Stephen M. Amrock, Joseph Zakhar, Sherry Zhou, Michael Weitzman

Research output: Contribution to journalArticle

Abstract

Introduction: U.S. adolescents increasingly use e-cigarettes. The perceived harm of e-cigarettes has not been described, nor has the correlation between harm perception and e-cigarette use been assessed. This study examines correlates of e-cigarette harm perception and use of e-cigarettes in a national survey. Methods: We used cross-sectional nationally representative data from the 2012 National Youth Tobacco Survey (n = 24,658). Cross-tabulations and multivariate ordered probit and logistic regression models were employed to assess relative harm perception and e-cigarette use. Results: Half of U.S. adolescents had heard of e-cigarettes. Of these, 13.2% (95% confidence interval [CI] = 11.7-14.9) and 4.0% (95% CI = 3.4-4.7) reported ever or currently using e-cigarettes, respectively. Of those aware of e-cigarettes, 34.2% (95% CI = 32.8-35.6) believed e-cigarettes were less harmful than cigarettes. Among those trying e-cigarettes, 71.8% (95% CI = 69.0-74.5) believed e-cigarettes were comparatively less harmful. Females and those ≥ 17 years old were more likely to perceive e-cigarettes as more harmful relative to cigarettes, while on average Whites, users of other tobacco products, and those with family members who used tobacco were more likely to perceive e-cigarettes as comparatively safer. Among cigarette-naive e-cigarette users, use of other tobacco products and perceived harm reduction by e-cigarettes were, respectively, on average associated with 1.6 and 4.1 percentage-point increases in e-cigarette use. Conclusions: Perception of e-cigarettes as less harmful than conventional cigarettes was associated with increased e-cigarette use, including among cigarette-naive e-cigarette users. These findings should prompt further scientific investigation and merit attention from regulators.

Original languageEnglish (US)
Pages (from-to)330-336
Number of pages7
JournalNicotine and Tobacco Research
Volume17
Issue number3
DOIs
StatePublished - Jan 1 2015

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Tobacco Products
Confidence Intervals
Tobacco
Logistic Models
Harm Reduction

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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Perception of e-cigarette harm and its correlation with use among U.S. adolescents. / Amrock, Stephen M.; Zakhar, Joseph; Zhou, Sherry; Weitzman, Michael.

In: Nicotine and Tobacco Research, Vol. 17, No. 3, 01.01.2015, p. 330-336.

Research output: Contribution to journalArticle

Amrock, Stephen M. ; Zakhar, Joseph ; Zhou, Sherry ; Weitzman, Michael. / Perception of e-cigarette harm and its correlation with use among U.S. adolescents. In: Nicotine and Tobacco Research. 2015 ; Vol. 17, No. 3. pp. 330-336.
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abstract = "Introduction: U.S. adolescents increasingly use e-cigarettes. The perceived harm of e-cigarettes has not been described, nor has the correlation between harm perception and e-cigarette use been assessed. This study examines correlates of e-cigarette harm perception and use of e-cigarettes in a national survey. Methods: We used cross-sectional nationally representative data from the 2012 National Youth Tobacco Survey (n = 24,658). Cross-tabulations and multivariate ordered probit and logistic regression models were employed to assess relative harm perception and e-cigarette use. Results: Half of U.S. adolescents had heard of e-cigarettes. Of these, 13.2{\%} (95{\%} confidence interval [CI] = 11.7-14.9) and 4.0{\%} (95{\%} CI = 3.4-4.7) reported ever or currently using e-cigarettes, respectively. Of those aware of e-cigarettes, 34.2{\%} (95{\%} CI = 32.8-35.6) believed e-cigarettes were less harmful than cigarettes. Among those trying e-cigarettes, 71.8{\%} (95{\%} CI = 69.0-74.5) believed e-cigarettes were comparatively less harmful. Females and those ≥ 17 years old were more likely to perceive e-cigarettes as more harmful relative to cigarettes, while on average Whites, users of other tobacco products, and those with family members who used tobacco were more likely to perceive e-cigarettes as comparatively safer. Among cigarette-naive e-cigarette users, use of other tobacco products and perceived harm reduction by e-cigarettes were, respectively, on average associated with 1.6 and 4.1 percentage-point increases in e-cigarette use. Conclusions: Perception of e-cigarettes as less harmful than conventional cigarettes was associated with increased e-cigarette use, including among cigarette-naive e-cigarette users. These findings should prompt further scientific investigation and merit attention from regulators.",
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