E-cigarette use perceptions that differentiate e-cigarette susceptibility and use among high school students

Background: E-cigarette use among adolescents is increasingly popular and a growing public health concern. Objectives: To examine how individual e-cigarette use perceptions differ between adolescents based on e-cigarette use status and susceptibility to future use of e-cigarettes. Methods: Data were collected using surveys administered across eight Connecticut high schools (grades 9–12), Spring 2015. N = 2592 students (Mage = 16.01, SD = 1.28, Female = 51.7%) reported e-cigarette use and susceptibility and were categorized into non-susceptible never-users (57.8%), susceptible never-users (16.9%) and ever-users (25.4%). Youth also responded to 12 e-cigarette use perceptions describing perceived benefits and risks of e-cigarette use. Results: A multinomial logistic regression model was used. Eight use perceptions were related to susceptibility or use of e-cigarettes. The benefit-related use perception “feel relaxed” was the only item associated with greater odds of being both susceptible (vs. non-susceptible, p <.001) and an ever-user (vs. susceptible; p <.05). Two other benefit-related use perceptions were related to higher odds of being susceptible to e-cigarette use (“control your weight”; AOR = 1.82, p <.05; “look cool”; AOR = 3.13, p <.05). Results also identified key risk-related use perceptions that related to lower odds of either being susceptible to e-cigarette use (“have a heart attack”; AOR =.43, p <.001) or of ever-use (“have bad breath”; AOR =.28, p <.001; “get lung cancer”; AOR =.58, p <.05). Conclusion: E-cigarette use perceptions among youth differ by e-cigarette use and susceptibility status. Findings could help identify youth who are vulnerable to e-cigarette use and inform prevention, for example by developing counter-messaging for benefit perceptions associated with susceptibility and ever-use.