College students' perceptions of risk and addictiveness of e-cigarettes and cigarettes.
As conventional cigarette use is declining, electronic cigarette ("e-cigarette") use is rising and is especially high among college students. Few studies examine dual use of e-cigarettes and cigarettes among this population. This study explores the relationship between dual and exclusive e-cigarette / cigarette use and perceptions of harm and addictiveness of both products.



This is a cross-sectional analysis of data from students attending 24 colleges in Texas (n=5,482). Multinomial logistic regression was employed to test the association between current e-cigarette / cigarette use and perceived harm and addictiveness of both products. Three tobacco groups were included: cigarette only users, e-cigarette only users, and dual users.



Dual users reported lower perceived harm of e-cigarettes most consistently (p<0.001, all comparisons). Perceived harm of cigarettes was significantly lower among cigarette only and dual users only, compared to non-users (p<0.001, all comparisons). Compared to non-users, all three groups reported significantly lower perceived addictiveness of e-cigarettes (p<0.001, all comparisons). The same finding was observed for perceived addictiveness of cigarettes, though findings were less consistent for the e-cigarette only group (p<0.02, all comparisons except one).



Findings demonstrate that among college students, perceptions of harm and addictiveness of e-cigarettes are lower than those for conventional cigarettes. For both products, perceptions of harm and addictiveness were lower among exclusive and dual users, compared to non-users.
a University of Texas Health Science Center at Houston , School of Public Health, Austin Regional Campus , Austin , Texas , USA.
Maria
M
Cooper
b Department of Kinesiology and Health Education , University of Texas at Austin , Austin , Texas , USA.
Alexandra
A
Loukas
a University of Texas Health Science Center at Houston , School of Public Health, Austin Regional Campus , Austin , Texas , USA.
Melissa B
MB
Harrell
a University of Texas Health Science Center at Houston , School of Public Health, Austin Regional Campus , Austin , Texas , USA.
Cheryl L
CL
Perry
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D066300:Electronic Nicotine Delivery Systems / Q000592:standards*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D010465:Perception; D012309:Risk-Taking; D012907:Smoking / Q000523:psychology*; D013334:Students / Q000523:psychology*; D019966:Substance-Related Disorders / Q000523:psychology*; D013781:Texas; D014495:Universities / Q000458:organization & administration
Alternative tobacco use; electronic cigarettes; tobacco use; young adults