Background: Using electronic nicotine delivery systems (e.g., e-cigarette) or vaping may have negative health effects from the aerosol and product constituents. Though the products are relatively new in the US, the use of e-cigarettes has rapidly increased, especially in younger adults. In this study, we examined age differences in use patterns, reasons for use, health knowledge, e-cigarette perceptions, and quit intentions among current e-cigarette users.
Methods: The sample was 1,494 current e-cigarette users ages 18-64, drawn from a national adult vaping survey conducted in 2016. Intention to quit was categorized into 3 groups: very likely, moderate, and less likely. Descriptive and multivariate analyses were used.
Results: The sample included participants in the following age groups: 18-24 (17%), 25-34 (38%), 35-44 (23%), and 45-64 (25%). Main reasons for e-cigarette initiation were as a cigarette alternative, perceived as healthier, and attraction to flavors. Only 4% of the participants reported using e-cigarettes on recommendation from a healthcare professional(s); 66% did not hear/see/read about the health effects of e-cigarettes in the past 3 months. Compared to older groups, the 18-24 age group was less likely to use e-cigarettes as an alternative to cigarettes (33% vs. 40-49%) or on a healthcare professional’s recommendation (2.3% vs. 6.8%), but more likely to vape for reasons such as flavors (44% vs. 20-33%) or friends’ use (18% vs. 4%). The 18-24 age group was also more likely than the oldest age group to use flavored e-liquid other than tobacco flavor (67% vs. 53%), have heard/seen/read information about vaping health effects (41.4% vs. 27%), and believe that vaping has no health benefits (26.1% vs. 16%).(All P-values for the above comparisons <.05). With adjustment for sex, race/ethnicity, and education levels, compared to the oldest group, the odds of being very likely to quit e-cigarette use versus less likely to quit in the 18-24 age group were 37% lower (95% CI: 0.41-0.98).
Conclusions: There were significant age differences in use motivation, usage patterns, receipt of health information, perceived risks, and quit intentions. Public health efforts should increase the accessibility of information on e-cigarette use risks. Different health messaging and communication strategy approaches may be required for varying age groups.