Associations of childhood executive control with adolescent cigarette and E-cigarette use: Tests of moderation by poverty level

Background: Adolescent cigarette smoking has continued to decline, whereas electronic cigarette (e-cigarette) use has increased dramatically among youth. Nicotine use in any form, even at low levels, during adolescence can have adverse consequences, particularly for low-income individuals. To elucidate potential early intervention targets, this study examined childhood executive control (EC), a set of cognitive processes for directing attention and behavior, in relation to adolescent cigarette and e-cigarette onset, testing for differential prediction by poverty level. Method: Participants were 313 children (51% female, 64% European American) recruited in a small city in the Midwestern United States beginning in 2006 and then followed into adolescence between ages 14 and 16 years. EC was measured in the laboratory with performance-based tasks when children were age 5 years, 3 months. Self-reports of cigarette onset and e-cigarette onset were obtained in adolescence (Mage = 15.65 years). Overall, 24% of the sample was at or below the poverty line. Results: Cigarette onset was higher in the poverty group (17%) than in the non-poverty (8%) group, but ecigarette onset did not differ by poverty level (36% poverty versus 38% non-poverty). Multiple group structural equation modeling revealed a statistically significant group difference such that EC ability was a significant negative predictor of e-cigarette onset for poverty but not for non-poverty youth. A similar group difference was evident as a trend for cigarette onset. Conclusions: Because EC has been shown to be modifiable, early interventions to improve EC for children living in poverty might help prevent adolescent e-cigarette onset.

Automated summary

The study found that children from low-income families are more likely to start smoking, but there is no significant difference in the percentage of e-cigarette use between poverty and non-poverty families. Furthermore, executive control ability has a significant negative predictive effect on the initial use of e-cigarettes for low-income adolescents.