Does exposure to cigarette brands increase the likelihood of adolescent e-cigarette use? A cross-sectional study

Abstract

Objective: To examine the relationship between tobacco cigarette brand recognition and e-cigarette use in adolescents. Design: Cross-sectional observational study Setting: High schools in Scotland Participants: Questionnaires were administered to pupils in Secondary 2 (S2 mean age: 14.0 years) and Secondary 4 (S4 mean age: 15.9 years) across 4 communities in Scotland. An 86% response rate with a total sample of 1404 pupils was achieved. Main outcome measures: Self-reported previous use of e-cigarettes and self-reported intention to try e-cigarettes in the next six months. Results: 75% (1029/1377) of respondents had heard of e-cigarettes (69.5% S2, 81.1% S4) and of these 17.3% (10.6% S2, 24.3% S4 n=1020) had ever tried an e-cigarette. 6.8% (3.7% S2, 10.0% S4 n=1019) reported that they intended to try an e-cigarette in the next 6 months. Recognition of more cigarette brands was associated with greater probability of previous e-cigarette use (OR 1.20 99% CI 1.05 to 1.38) as was having a best friend who smoked (OR 3.17 99% CI 1.42 to 7.09). Intention to try e-cigarettes was related to higher cigarette brand recognition (OR 1.41 99% CI 1.07 to 1.87), hanging around in the street or park more than once a week (OR 3.78 99% CI 1.93 to 7.39) and living in areas of high tobacco retail density (OR 1.20 99% CI 1.08 to 1.34). Never having smoked was a protective factor for both future intention to try and past e-cigarette use (OR 0.07 99% CI 0.02 to 0.25 and OR 0.10 99% CI 0.07 to 0.16 respectively) Conclusions: Higher cigarette brand recognition was associated with increased probability of previous use and of intention to use e-cigarettes. The impact of tobacco control measures such as restricting point of sale displays on the uptake of e-cigarettes in young people should be evaluated. Strengths and limitations E-cigarette use among young people is increasing and the nature and determinants of this process are of great interest to health professionals. This is the first study to look at environmental determinants of e-cigarette uptake in adolescents. The study has a high response rate (86%). Sample is not nationally representative but the logistic regression models have been adjusted to account for the demographic profile of participants.