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Exploring Associations between Susceptibility to the Use of Electronic Nicotine Delivery Systems and E-Cigarette Use among School-Going Adolescents in Rural Appalachia

Author

Listed:
  • Hadii M. Mamudu

    (Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA)

  • Christen Nwabueze

    (Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA)

  • Florence M. Weierbach

    (Department of Graduate Studies, College of Nursing, East Tennessee State University, Johnson City, TN 37614, USA)

  • Joshua Yang

    (Department of Public Health, California State University, Fullerton, CA 92831, USA)

  • Antwan Jones

    (Department of Epidemiology, Milken School of Public Health, and Department of Sociology, The George Washington University, Washington, DC 20052, USA)

  • Michelle McNabb

    (Northeast Regional Office, Tennessee Department of Health, Johnson City, TN 37604, USA)

  • Esther Adeniran

    (Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA)

  • Ying Liu

    (Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA)

  • Liang Wang

    (Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA)

  • Cynthia J. Blair

    (Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA)

  • Adeola Awujoola

    (Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA)

  • David L. Wood

    (James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37604, USA)

Abstract

Electronic nicotine delivery systems (ENDS) use, including e-cigarettes, has surpassed the use of conventional tobacco products. Emerging research suggests that susceptibility to e-cigarette use is associated with actual use among adolescents. However, few studies exist involving adolescents in high-risk, rural, socioeconomically distressed environments. This study examines susceptibility to and subsequent usage in school-going adolescents in a rural distressed county in Appalachian Tennessee using data from an online survey ( N = 399). Relying on bivariate analyses and logistic regression, this study finds that while 30.6% of adolescents are ever e-cigarette users, 15.5% are current users. Approximately one in three adolescents are susceptible to e-cigarettes use, and susceptibility is associated with lower odds of being a current e-cigarette user (OR = 0.03; CI: 0.01–0.12; p < 0.00). The age of tobacco use initiation was significantly associated with decreased current use of e-cigarettes (OR = 0.89; CI: 0.83–0.0.97; p < 0.01). Overall, the results of this exploratory study suggest the need for larger studies to identify unique and generalizable factors that predispose adolescents in this high-risk rural, socioeconomically disadvantaged region to ENDS use. Nevertheless, this study offers insight into e-cigarette usage among U.S adolescents in rural, socioeconomically disadvantaged environments and provides a foundation for a closer examination of this vulnerable population.

Suggested Citation

  • Hadii M. Mamudu & Christen Nwabueze & Florence M. Weierbach & Joshua Yang & Antwan Jones & Michelle McNabb & Esther Adeniran & Ying Liu & Liang Wang & Cynthia J. Blair & Adeola Awujoola & David L. Woo, 2020. "Exploring Associations between Susceptibility to the Use of Electronic Nicotine Delivery Systems and E-Cigarette Use among School-Going Adolescents in Rural Appalachia," IJERPH, MDPI, vol. 17(14), pages 1-14, July.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:14:p:5133-:d:385248
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    References listed on IDEAS

    as
    1. Carl V. Phillips, 2015. "Gateway Effects: Why the Cited Evidence Does Not Support Their Existence for Low-Risk Tobacco Products (and What Evidence Would)," IJERPH, MDPI, vol. 12(5), pages 1-26, May.
    2. Altman, D.G. & Levine, D.W. & Coeytaux, R. & Slade, J. & Jaffe, R., 1996. "Tobacco promotion and susceptibility to tobacco use among adolescents aged 12 through 17 years in a nationally representative sample," American Journal of Public Health, American Public Health Association, vol. 86(11), pages 1590-1593.
    3. Dorota Kaleta & Mirosław Niedzin & Agnieszka Jankowska & Kinga Polańska, 2019. "Predictors of E-Cigarette Use Susceptibility—A Study of Young People from a Socio-Economically Disadvantaged Rural Area in Poland," IJERPH, MDPI, vol. 16(20), pages 1-11, October.
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