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In Event: Special Poster Session 05 with Continental Breakfast Reception
In Poster Session: PS 05 - Policy Section
Introduction. E-cigarettes are the most popular tobacco product among youth, but current prevalence estimates may underestimate actual rates of use. Most studies assess e-cigarette use with a variant of the question: “Have you ever used an e-cigarette, even once or twice?” Typically, only participants who indicate lifetime use are asked subsequent questions about e-cigarette use, meaning that all additional information collected about e-cigarette use hinges on an affirmative answer to the initial question. However, it is possible that there is confusion about what exactly constitutes e-cigarette use and that some participants who actually use e-cigarettes incorrectly indicate non-use. Confusion may result from the fact that a multitude of products fall under the umbrella term “e-cigarettes,” different names are used to refer to e-cigarettes (e.g., vapes, electronic vaping devices), and different terminology is used to refer to e-cigarette use (e.g., “vaping,” “JUULing”). In this study, we compared rates of endorsing e-cigarette use when adolescents were asked about lifetime e-cigarette use in two different ways to examine the impact of terminology on prevalence estimates.
Methods. In May-June 2018, 1960 students from 2 Connecticut high schools completed a computerized, school-based survey on tablets provided by the study staff. Participants first reported on lifetime use of an e-cigarette via the question: “Have you ever tried an e-cigarette, even one or two puffs?” (accompanied by a picture of exemplar e-cigarette devices). Participants then reported on lifetime use of five specific types of e-cigarette devices: Disposables, Cig-a-Likes, or E-hookahs; Vape pens or Egos; JUULs; pod systems other than JUULs like PHIX or Suorin; and Advanced Personal Vaporizers/Mods. Adolescents were asked about lifetime use of each product separately (no/yes) and were provided with example pictures of each device type and a brief description. Descriptive statistics were run for lifetime e-cigarette use (based on the question “Have you ever tried an e-cigarette?”), lifetime use of each product, and lifetime e-cigarette use calculated based on the endorsement of lifetime use of one or more of the specific e-cigarette products.
Results. 35.8% of students endorsed lifetime “e-cigarette” use, while 51.3% endorsed lifetime use of 1 specific e-cigarette product. When rates of individual product use were assessed, JUULs were the most commonly used product (44.0%), followed by Vape-pens/Egos (28.5%), pod systems other than JUULs (26.5%), Mods or APVs (25.2%), and Disposables, Cig-a-likes, or E-hookahs (12.4%). Importantly, 31.5% of adolescents who endorsed lifetime product use did not endorse lifetime “e-cigarette” use.
Conclusions. The study findings suggest that asking about e-cigarette use, broadly defined, leads to an underestimation of actual use compared to assessing lifetime use of a range of different products that are classified as e-cigarettes. Conversely, the findings indicate that assessing the use of specific e-cigarette products may yield more accurate, albeit higher, rates of use. If these findings are replicated in a nationally representative sample, regulatory efforts requiring all e-cigarette products to be clearly labeled as “e-cigarettes” may help to reduce confusion.
Meghan Morean, Oberlin College and Yale School of Medicine
Deepa Camenga, Yale School of Medicine
Krysten Bold, Yale School of Medicine
Grace Kong, Yale School of Medicine
Asti Jackson, Yale School of Medicine
Patricia Simon, Yale School of Medicine
Dana Cavallo, Yale School of Medicine
Suchitra Krishnan-Sarin, Yale School of Medicine