title: The Associations Between E-Cigarettes and Binge Drinking, Marijuana Use, and Energy Drinks Mixed With Alcohol.
abstract: OBJECTIVE
  Use of e-cigarettes by youth is proliferating worldwide, but little is known about the behavioral profile of youth e-cigarette users and the association of e-cigarette use with other health-risky behaviors. This study examines the associations between e-cigarette use and tobacco, marijuana, and alcohol use among a large sample of Canadian youth.
  
  
  METHODS
  Using Canadian data from 39,837 grade 9 to 12 students who participated in year 3 (2014-2015) of the COMPASS study, logistic regression models were used to examine how current use of e-cigarettes were associated with tobacco, marijuana, binge drinking, and energy drinks mixed with alcohol. Pearson's chi-square tests were used to examine subgroup differences by sex.
  
  
  RESULTS
  Overall, 9.75% of respondents were current e-cigarette users. Current cigarette smokers (odds ratio [OR] = 3.009), current marijuana users (OR = 5.549), and noncurrent marijuana users (OR = 3.653) were more likely to report using e-cigarettes than noncigarette smokers and nonmarijuana users. Gender differences among males and females showed higher risk of e-cigarette use among female current marijuana users (OR = 7.029) relative to males (OR = 4.931) and female current smokers (OR = 3.284) compared to males (OR = 2.862). Compared to nonbinge drinkers, weekly (OR = 3.253), monthly (OR = 3.113), and occasional (OR = 2.333) binge drinkers were more likely to use e-cigarettes. Similarly, students who consume energy drinks mixed with alcohol (OR = 1.650) were more likely to use e-cigarettes compared to students who do not consume them.
  
  
  CONCLUSIONS
  We identify that youth who binge drink or use marijuana have a greater increased risk for using e-cigarettes compared to cigarette smokers. These data suggest that efforts to prevent e-cigarette use should not only be discussed in the domain of tobacco control.
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada. Electronic address: smilicic@waterloo.ca.
authors.forename: Sandra
authors.initials: S
authors.lastname: Milicic
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: Scott T
authors.initials: ST
authors.lastname: Leatherdale
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D063425:Binge Drinking / Q000453:epidemiology*; D002170:Canada / Q000453:epidemiology; D015897:Comorbidity; D066300:Electronic Nicotine Delivery Systems / Q000706:statistics & numerical data*; D061215:Energy Drinks / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D000074609:Marijuana Use / Q000453:epidemiology*; D012737:Sex Factors; D000066608:Underage Drinking / Q000523:psychology / Q000706:statistics & numerical data*
keywords: Binge drinking; E-cigarettes; Energy drinks; Marijuana use; Risky behaviors; Tobacco use; Youth