Understanding patterns of use and perceptions of harm and addictiveness for the e-cigarette with a focus on youth and young adults in Texas
This study used qualitative and quantitative methods to explore patterns of use and perceptions of harm and addictiveness for the electronic cigarette (or “e-cigarette”). For Paper 1, 50 qualitative interviews were conducted among current e-cigarette users to elucidate certain behavioral and motivational aspects of “real world” use. A particular focus was placed on comparing young adults (19-29 years old) to adults (30-61 years old). Several prominent themes emerged from the key informant interviews. These included product type preferences, flavorings, subjective effects, patterns of use, quantification of use, and motivations for use, among others. These findings provide a deeper understanding of e-cigarette use among young adults and adults, with relevance for future FDA communication campaigns, regulation, and surveillance efforts. For paper 2, secondary data analysis was conducted on baseline data collected in a rapid response surveillance system of Texas middle and high school students’ tobacco use behaviors (n=3,006). This paper used logistic regression to explore the relationship between perceptions of harm and addictiveness and e-cigarette use, including flavored and non-flavored products. The hypothesis was that youth who used e-cigarettes were more likely to perceive them as less harmful and addictive than youth who did not use them. Findings suggest that low harm perceptions of e-cigarettes was associated with past 30 day e-cigarette use in youth (p<0.001); these findings were consistent for boys and girls across all strata of race/ethnicity. In addition, the results suggest that youth e-cigarette users are more likely to report flavored e-cigarettes are less harmful than non-flavored e-cigarettes (p<0.001); this finding was especially strong for females but did not differ by race/ethnicity. Finally, while low perceived addictiveness was not significantly associated with current e-cigarette use, more than half of the respondents reported that e-cigarettes are “not at all” addictive. This finding is especially troubling, given that nicotine is a highly addictive substance whose effects on the developing brain remain unknown. Findings from this paper can be used to inform future FDA communication campaigns, as well as regulatory action specific to flavorings in e-cigarettes. These findings are preliminary, as the entire baseline sample was not available at the time of this analysis; these analyses will be re-run prior to submitting this manuscript for publication. Paper 3 explored the relationship between e-cigarette use and perceptions of harm and addictiveness among a population of college students in Texas (n=5,207). Secondary data analysis was performed using baseline survey data, and multinomial logistic regression was employed. The hypothesis was that individuals who have used e-cigarettes and/or cigarettes perceive e-cigarettes as less harmful and addictive than individuals who have not used either product. In general, lower perceptions of harm and addictiveness were associated with current e-cigarette and/or cigarette use. These findings were consistent for both young adult men and women, as well as across all strata of race/ethnicity. Results from this paper can help to inform future FDA communication campaigns.
Public health|Behavioral Sciences|Epidemiology
Cooper, Maria R, "Understanding patterns of use and perceptions of harm and addictiveness for the e-cigarette with a focus on youth and young adults in Texas" (2015). Texas Medical Center Dissertations (via ProQuest). AAI3737112.