Although prevalence of youth e-cigarette use has increased dramatically, little is known about e-cigarette use among youth with asthma and how it differs by metropolitan status. This study assessed the prevalence of e-cigarette use among youth by asthma and metropolitan status and examined the associations between e-cigarette use, susceptibility to cigarette smoking, and asthma attack.

High school student participants from the 2012 Florida Youth Tobacco Survey were included (N=36,085). Information on demographics, asthma status, ever and past 30–day use of e-cigarettes, cigarette smoking susceptibility, and having asthma attacks in the past 12 months were collected. Data were weighted to be representative of Florida high school students. Analyses were conducted in 2015.

Overall, prevalence of ever and past 30–day e-cigarette use among students who reported having asthma were 10.4% and 5.3%, respectively, higher than those without asthma (7.2% and 2.5%, respectively, p<0.01). Among students with asthma, e-cigarette use was more common among those in non-metropolitan and rural counties than those in metropolitan counties (p<0.05). Ever and past 30–day e-cigarette use was associated with cigarette smoking susceptibility among participants with asthma and those who never tried cigarettes (n=2,410; ever use, AOR=3.96, 95% CI=1.49, 10.56; past 30–day use, AOR=422.10, 95% CI=50.29, >999.99). Past 30–day e-cigarette use was associated with having an asthma attack in the past 12 months among participants with asthma (n=5,865, p<0.01).

E-cigarette use is more common among Florida high school youth with asthma and is associated with susceptibility to cigarette smoking.