Harm perceptions of secondhand e-cigarette aerosol among youth in the United States

E-cigarette use among youth remains a public health concern. Although extant literature has examined the perceived harms of cigarette use and secondhand smoke, perceptions of harms associated with secondhand ecigarette aerosol (SHA) are not well understood. Therefore, we used data from the 2020 U.S. National Youth Tobacco Survey (n = 13,292) in which participants indicated whether SHA caused no harm, little harm, some harm, or a lot of harm. We dichotomized SHA harm perceptions as harmless vs harmful. We included sociodemographics (i.e., age, sex, race/ethnicity, sexual orientation, urbanicity), e-cigarette use characteristics, and SHA exposure as covariates and estimated associations between SHA harm perceptions and each covariate using adjusted logistic regression. Most youth perceived SHA as harmful (87.9 %) compared to harmless (12.1 %). Older youth (vs younger youth) had higher odds of perceiving SHA as harmless, whereas male (vs female) youth had 49 % higher odds (95 % CI: 1.29-1.72) of perceiving SHA as harmless. As the number of days of e-cigarette use in the past 30 days increased (vs non-users), odds of perceiving SHA as harmless increased. Youth exposed to SHA (vs no exposure) in the past 30 days had 35 % higher odds of perceiving SHA as harmless (95 % CI: 1.16-1.57). To conclude, youth SHA harm perceptions varied overall and by sociodemographic characteristics, ecigarette use, and SHA exposure. Educational campaigns to inform youth of the health risks associated with ecigarettes and SHA are needed to reduce overall nicotine intake and disparities in nicotine exposure.

Automated summary

The use of e-cigarettes among youth is still a major public health concern. This study aimed to understand the perceptions of harms associated with secondhand e-cigarette aerosol (SHA). Results showed that most youth perceived SHA as harmful. Older youth and male youth were more likely to perceive SHA as harmless. The odds of perceiving SHA as harmless increased with the number of days of e-cigarette use in the past 30 days and with SHA exposure. These findings highlight the need for educational campaigns to inform youth about the health risks of e-cigarettes and SHA, in order to reduce overall nicotine intake and disparities in nicotine exposure.