A prospective longitudinal relation between elevated use of electronic devices and use of electronic nicotine delivery systems

Abstract Background In recent years, there has been a rapid increase in the use of both electronic nicotine delivery systems (ENDS) and electronic devices among U.S. youth. Informed by the Diffusion of Innovations Theory (DIT), it was hypothesized that elevated use of electronic devices (EUED) prospectively would predict ENDS use among youth. Methods Data were drawn from the Population Assessment of Tobacco and Health (PATH) Study, a longitudinal cohort study in a nationally representative sample. Participants who were 12–17 years old, and naive to both conventional cigarettes and ENDS at baseline (N = 11,325) were sampled. A total of 8723 respondents had matched data from Wave 1 to Wave 2 and 6051 respondents had matched data for all the three waves. Multivariable sequential logistic regressions were conducted to examine determinants of ENDS use in later waves using R version 3.5.2. Results Among youth who were naive to both ENDS and conventional cigarettes at baseline, those with EUED were more likely to initiate ENDS use in later years than those without EUED even after controlling for exposure to ENDS advertisements and other well-established covariates of ENDS use. Daily (adjusted odds ratio [AOR] ranges from 2.76 to 3.56) and weekly (AOR ranges from 2.16 to 2.65) social networking service (SNS) users were more likely to initiate ENDS use than non-users of SNS in the adjusted models. Conclusions The findings support the hypothesis that EUED prospectively predicts ENDS use among youth. The use of DIT framework helps understand the link between EUED and ENDS use.