Original article
E-cigarette Use and Beliefs Among Urban Public High School Students in North Carolina

https://doi.org/10.1016/j.jadohealth.2015.03.018Get rights and content

Abstract

Purpose

The aim of this study was to examine the prevalence, attitudes, and risk factors associated with electronic cigarette (e-cigarette) use among high school students in tobacco growing state.

Methods

A 47-item e-cigarette questionnaire modeled after Monitoring the Future with additional information about demographics, adolescent and family nicotine use, and school and health care interventions was designed, piloted, and administered to public high school students (N = 3,298) in May 2013, in an urban county in North Carolina.

Results

Completers (2,769/3,298) were aged 16.4 years (standard deviation ± 1.4) with 48.9% males and 43.9% African-American, 38% white, and 4.6% Hispanics. The majority (77.3%) knew about e-cigarettes; 15.2% reported that they had tried an e-cigarette, and 60% reported that e-cigarettes were safe or had minimal health hazards. Only 5.4% reported that schools had offered information about e-cigarette use. One quarter (24.9%) reported ever cigarette smoking, and 13.3% reported ever using smokeless tobacco. E-cigarette use was positively associated with older age, tobacco use, male gender, Caucasian race, mother's e-cigarette use, biological parents' tobacco use, and lower academic performance, whereas negatively associated with having a mother who never used e-cigarettes, not knowing any e-cigarette users, and living with mother (p < .05).

Conclusions

E-cigarette use and awareness is evident among high school students in North Carolina. A high number of smokers and smokeless tobacco users are using e-cigarettes simultaneously, and many perceive e-cigarettes as healthy and with minimal health hazards. Also, there is limited school-based education about e-cigarettes.

Section snippets

Methods

This was a cross-sectional, nonexperimental study of all three high school students in an urban county in North Carolina. We developed a 47-item “High School Questionnaire” in which self-report of e-cigarette and other tobacco product use was modeled after MTF [17] (before e-cigarette questions were added) and attitudes and beliefs, demographic and background characteristics, family's tobacco use, information received in school about nicotine/tobacco products and nicotine effects, desire and

Sample characteristics

Respondents were on average age of 16.4 years (standard deviation = 1.4), and 51% were males, 44% were African-American, 38% white, and 8.2% Hispanic. Most respondents reported being in ninth grade (31%) followed by 10th grade (25.6%), 11th grade (22.8%), and 12th grade (20.6%). More than one-third (36.6%) reported having lived in a small city most of their lives, and 24.6% reported having lived in the country. Participants reported living with their biological mother (87%), biological father

Discussion

Most adolescents are aware of, and many are currently using, or have experimented with e-cigarettes. We found that e-cigarettes have been tried more than smokeless tobacco. Adolescents in our study reported higher lifetime use (15.2%) and past month use (7.4%) of e-cigarettes than that in the 2012 CDC NYTS data (10% and 2.8%, respectively). The usage rates have been found to be variable but high across different states: Connecticut (25.2% lifetime use and 12% current use of e-cigarettes among

Acknowledgments

This research was presented as a poster during the 60th annual meeting of the American Academy of Child and Adolescent Psychiatry in Orlando, Florida, USA (October 2013) and the 27th International Biometrics Conference in Florence, Italy (July 2014).

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    Conflicts of Interest: The authors have no conflicts of interest with any financial organization regarding the material discussed in the article.

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