Underage E-Cigarette Purchasing and Vaping Progression Among Young Adults |
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| Institution: | 1. Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota;2. School of Nursing, University of Minnesota, Minneapolis, Minnesota;3. Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota;1. University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX, United States;2. Population Research Center, University of Texas at Austin, Austin, TX, United States;3. TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States;4. Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States;1. Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, United States;2. Rutgers School of Public Health, Rutgers University, Piscataway, NJ, United States;3. Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States;4. Indiana University Bloomington School of Public Health, Bloomington, IN, United States;5. Pacific Institute for Research & Evaluation, Louisville, KY, United States;6. Behavioral Health and Health Policy, Westat, Rockville, MD, United States;1. Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania;2. Division of Epidemiology and Community Health, The University of Minnesota, Minneapolis, Minnesota;3. The Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania;4. Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania;1. Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland;2. Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland;3. Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;1. Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA, USA;2. Division of Oral Epidemiology and Dental Public Health, School of Dentistry, University of California San Francisco, San Francisco, CA, USA |
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| Abstract: | PurposeDespite laws prohibiting sale of e-cigarettes to individuals aged less than 21 years, many underage young adults purchase e-cigarettes from retail stores, which may increase likelihood of continued use due to a greater access to vaping products and exposure to point-of-sale marketing.MethodsData are from a prospective cohort of young adults aged 18–20 years in Los Angeles who had ever used e-cigarettes at baseline (N = 1,029). We evaluated the association of underage e-cigarette purchasing behavior (owned and purchased vs. owned but never purchased vs. never owned an e-cigarette) with subsequent vaping frequency, intensity, and dependence symptoms one year later, adjusting for vaping behaviors prior to baseline; additional models evaluated whether associations differed by purchase location or product type.ResultsAt baseline, 332 (32%) had purchased e-cigarettes while underage, 227 (22%) owned but never purchased e-cigarettes themselves, and 470 (46%) never owned an e-cigarette. Compared to never owning e-cigarettes, those who had purchased their own e-cigarettes vaped more days in the past month (rate ratio RR] = 2.97; 95% confidence interval CI]: 2.15–4.09), had more vaping episodes per day (RR: 2.58; 95% CI: 2.12–3.14), vaped more puffs per vaping episode (RR: 1.90; 95% CI: 1.61–2.23), and had greater odds of dependence (odds ratio: 3.68; 95% CI: 2.51–5.40); elevated estimates were also observed for those who owned but never purchased e-cigarettes (vs. never owned). Vaping dependence was greatest among participants who purchased JUULs or other pod-mods.DiscussionParticipants who purchased e-cigarettes underage subsequently vaped more intensely and had greater vaping dependence. Regulations that reduce underage retail access to e-cigarettes may help prevent vaping progression among those most at risk of dependence. |
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| Keywords: | E-cigarettes Vaping Young adults Retailers |
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