Journal
DRUG AND ALCOHOL DEPENDENCE
Volume 186, Issue -, Pages 257-263Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.drugalcdep.2017.11.027
Keywords
Electronic cigarettes; Tobacco use; Cigarette smoking; College students; Risk perceptions
Categories
Funding
- National Cancer Institute at the National Institutes of Health [1 P50 CA180906-01]
- Food and Drug Administration, Center for Tobacco Products (CTP)
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Background: Recent data suggest that lower perceived risks of e-cigarettes are associated with e-cigarette use in young adults; however, the temporality of this relationship is not well-understood. We explore how perceptions of harmfulness and addictiveness of e-cigarettes influence e-cigarette initiation, and specifically whether this association varies by cigarette smoking status, in a longitudinal study of tobacco use on college campuses. Methods: Data are from a 5-wave 24-college study in Texas. Only students who reported never using e-cigarettes at wave 1 were included (n = 2565). Multilevel discrete-time hazard models, accounting for school clustering, were used. The dependent variable, ever e-cigarette use, was assessed at each wave. Both time-varying (e cigarette perceptions of harmfulness and addictiveness, age, use of cigarettes, use of other tobacco products, and use of other substances) and time-invariant demographic covariates were included. Two-way interactions between each e-cigarette perception variable and current conventional cigarette use were tested to determine if the hypothesized relationship differed among smokers and non-smokers. Results: 21% of all never e-cigarette users at baseline had initiated e-cigarette ever use by wave 5. Significant two-way interactions qualified the relationship between risk perceptions and e-cigarette initiation. Specifically, perceptions of a lower degree of harmfulness (OR = 1.13, p =.047) and addictiveness (OR = 1.34,p < .001) of e-cigarettes predicted initiation among non-smokers, but not among current smokers. Conclusion: Perceiving a lower degree of risk of e-cigarettes contributes to subsequent e-cigarette initiation among non-smokers, but not among current smokers. Findings: have implications for prevention campaigns focusing on the potential harm of e-cigarettes for nonsmoking college students.
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