E-cigarette Use Among High School and Middle School Adolescents in Connecticut.
BACKGROUND
There is limited evidence on electronic cigarette (e-cigarette) use among U.S. adolescents.


METHODS
Cross-sectional, anonymous surveys conducted in 4 high schools (HS; n = 3,614) and 2 middle schools (MS; n = 1,166) in Connecticut in November 2013 examined e-cigarette awareness, use patterns, susceptibility to future use, preferences, product components used (battery type, nicotine content, flavors), and sources of marketing and access.


RESULTS
High rates of awareness (MS: 84.3%; HS: 92.0%) and of lifetime (3.5% MS, 25.2 % HS) and current (1.5% MS, 12% HS) use of e-cigarettes was observed. Among those who had not tried e-cigarettes, 26.4% of MS and 31.7% of HS students reported being susceptible to future use. Males (OR = 1.70, p < .01), older students (OR = 1.39, p < .05), Caucasians (OR = 2.01, p < .001), ever cigarette smokers (OR = 13.04, p < .001), and current cigarette smokers (OR = 65.11, p < .001) were more likely to be lifetime e-cigarette users and to report greater future susceptibility (males: OR = 1.30; Caucasians: OR = 1.14; ever cigarette smokers; OR = 3.85; current cigarette smokers; OR = 9.81; ps < .01-.001). Among MS students who were lifetime e-cigarette users, 51.2% reported that e-cigarette was the first tobacco product they had tried. E-cigarettes that were rechargeable and had sweet flavors were most popular. Smokers preferred e-cigarettes to cigarettes. Current cigarette smokers were more likely to initiate with nicotine-containing e-cigarettes, and ever and never cigarette smokers to initiate with e-cigarettes without nicotine. Primary sources for e-cigarette advertisements were televisions and gas stations and, for acquiring e-cigarettes, were peers.


CONCLUSIONS
Longitudinal monitoring of e-cigarette use among adolescents and establishment of policies to limit access are imperatively needed.
Department of Psychiatry, Yale School of Medicine, New Haven, CT; Suchitra.krishnan-sarin@yale.edu.
Suchitra
S
Krishnan-Sarin
Department of Psychiatry, Yale School of Medicine, New Haven, CT;
Meghan E
ME
Morean
Department of Pediatrics, Yale School of Medicine, New Haven, CT.
Deepa R
DR
Camenga
Department of Psychiatry, Yale School of Medicine, New Haven, CT;
Dana A
DA
Cavallo
Department of Psychiatry, Yale School of Medicine, New Haven, CT;
Grace
G
Kong
D000293:Adolescent; D003237:Connecticut / Q000453:epidemiology; D003430:Cross-Sectional Studies; D066300:Electronic Nicotine Delivery Systems / Q000379:methods / Q000523:psychology*; D005260:Female; D005421:Flavoring Agents / Q000008:administration & dosage; D006801:Humans; D008297:Male; D040541:Marketing / Q000379:methods; D012574:Schools; D012907:Smoking / Q000453:epidemiology / Q000523:psychology*; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology*; D013334:Students / Q000523:psychology*; D014481:United States / Q000453:epidemiology
D005421:Flavoring Agents