Perception of e-cigarette harm and its correlation with use among US adolescents

SM Amrock, J Zakhar, S Zhou… - Nicotine & Tobacco …, 2015 - academic.oup.com
SM Amrock, J Zakhar, S Zhou, M Weitzman
Nicotine & Tobacco Research, 2015academic.oup.com
Introduction: US 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 …
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.
Oxford University Press