title: The E-cigarette Social Environment, E-cigarette Use, and Susceptibility to Cigarette Smoking.
abstract: One concern regarding the recent increase in adolescent e-cigarette use is the possibility that electronic (e-) cigarettes may be used by those who might not otherwise have used cigarettes, and that dual use, or transition to cigarette use alone, may follow.
  
  
  
  Questionnaire data were obtained in 2014 from 11th/12th grade students attending schools in 12 communities included in the Southern California Children's Health Study. We evaluated the cross-sectional association between e-cigarette use, the social environment (family and friends' use and approval of e-cigarettes and cigarettes), and susceptibility to future cigarette use among never cigarette smokers (N = 1,694), using previously validated measures based on reported absence of a definitive commitment not to smoke.
  
  
  
  Among adolescents who had never used cigarettes, 31.8% of past e-cigarette users and 34.6% of current (past 30-day) e-cigarette users indicated susceptibility to cigarette use, compared with 21.0% of never e-cigarette users. The odds of indicating susceptibility to cigarette use were two times higher for current e-cigarette users compared with never users (odds ratio = 1.97; 95% confidence interval: 1.21-3.22). A social environment favorable to e-cigarettes (friends' use of and positive attitudes toward the use of e-cigarettes) was also associated with greater likelihood of susceptibility to cigarette use, independent of an individual's e-cigarette use.
  
  
  
  E-cigarette use in adolescence, and a pro-e-cigarette social environment, may put adolescents at risk for future use of cigarettes. E-cigarettes may contribute to subsequent cigarette use via nicotine addiction or social normalization of smoking behaviors.
authors.affiliation: Department of Preventive Medicine, University of Southern California, Los Angeles, California. Electronic address: jtrimis@usc.edu.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Barrington-Trimis
authors.affiliation: Department of Preventive Medicine, University of Southern California, Los Angeles, California.
authors.forename: Kiros
authors.initials: K
authors.lastname: Berhane
authors.affiliation: Department of Preventive Medicine, University of Southern California, Los Angeles, California.
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: Unger
authors.affiliation: Department of Preventive Medicine, University of Southern California, Los Angeles, California.
authors.forename: Tess Boley
authors.initials: TB
authors.lastname: Cruz
authors.affiliation: Department of Preventive Medicine, University of Southern California, Los Angeles, California.
authors.forename: Robert
authors.initials: R
authors.lastname: Urman
authors.affiliation: Department of Preventive Medicine, University of Southern California, Los Angeles, California.
authors.forename: Chih Ping
authors.initials: CP
authors.lastname: Chou
authors.affiliation: Department of Preventive Medicine, University of Southern California, Los Angeles, California.
authors.forename: Steve
authors.initials: S
authors.lastname: Howland
authors.affiliation: Department of Preventive Medicine, University of Southern California, Los Angeles, California.
authors.forename: Kejia
authors.initials: K
authors.lastname: Wang
authors.affiliation: Department of Preventive Medicine, University of Southern California, Los Angeles, California.
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Pentz
authors.affiliation: Department of Preventive Medicine, University of Southern California, Los Angeles, California; Department of Children, Youth, and Families, School of Social Work, University of Southern California, Los Angeles, California.
authors.forename: Tamika D
authors.initials: TD
authors.lastname: Gilreath
authors.affiliation: Department of Preventive Medicine, University of Southern California, Los Angeles, California.
authors.forename: Jimi
authors.initials: J
authors.lastname: Huh
authors.affiliation: Department of Preventive Medicine, University of Southern California, Los Angeles, California.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Leventhal
authors.affiliation: Department of Preventive Medicine, University of Southern California, Los Angeles, California.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Samet
authors.affiliation: Department of Preventive Medicine, University of Southern California, Los Angeles, California.
authors.forename: Rob
authors.initials: R
authors.lastname: McConnell
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D003430:Cross-Sectional Studies; D066300:Electronic Nicotine Delivery Systems; D005260:Female; D006801:Humans; D008297:Male; D000067074:Peer Influence; D012306:Risk; D012907:Smoking / Q000639:trends*; D012931:Social Environment; D013334:Students / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D062789:Tobacco Products / Q000706:statistics & numerical data; D014481:United States
keywords: Adolescents; E-cigarettes; Social environment; Susceptibility to smoking