Reasons for E-cigarette Use, Vaping Patterns, and Cessation Behaviors among U.S. Adolescents


 
 
 This study sought to examine reasons for youth e-cigarette use in association with vaping patterns and cessation behaviors.
 
 
 
 A national representative sample of current (past 30-day) e-cigarette users in grades 6-12 was analyzed using the National Youth Tobacco Survey, conducted from January to March 2020. An exploratory oblique factor analysis using a rotated pattern matrix to select salient variable-factor relationships yielded four subscales related to reasons for youth e-cigarette use. Multivariate logistic regressions were performed to assess the associations of each subscale with vaping patterns (frequent e-cigarette use, dual use of e-cigarettes and other tobacco products) and vaping cessation behaviors (intention to quit vaping and past-year quit attempts).
 
 
 
 The 2020 NYTS sampled 180 schools with 1,769 current e-cigarette users. Four main reasons for vaping were identified through factor analysis, including 1) replacing cigarettes, 2) product characteristics (e.g., flavors, concealability, and vape tricks), 3) family/friend use, and 4) curiosity. Curiosity was associated with lower odds of frequent e-cigarette use (AOR= 0.5, p<.0001) and dual use of e-cigarettes and other tobacco products (AOR=0.6, p=.01) but higher odds of intention to quit (AOR=1.2, p=.26) and past year quit attempts (AOR=1.5, p=.01). Vaping due to product characteristics was associated with higher odds of frequent e-cigarette use (AOR=1.7, p<.0001) and lower odds of intention to quit (AOR=0.3, p<.0001) and past year quit attempts (AOR=0.9, p=.01).
 
 
 
 Adolescents vape for various reasons that follow distinct patterns and user characteristics. Overall, interventions tailored to address heterogeneous reasons for vaping may help optimize reduction in youth e-cigarette use.
 
 
 
 E-cigarettes have surpassed cigarettes and become the most commonly used tobacco product by U.S. youths. Adolescents choose to vape for different reasons. This study examined reasons for youth e-cigarette use and their associations with vaping patterns and cessation behaviors. The product characteristics factor (e.g., flavors, concealability, and vape tricks) was associated with more frequent e-cig use and lower odds of cessation behaviors, suggesting a need for flavor bans and product design regulation.
