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Do EK, et al. Reasons for E-cigarette Use and Their Associations With Frequency, Dependence, and Quit Intentions: Findings From a Youth and Young Adult Sample. American Journal of Preventive Medicine. Jul 2025. Volume 69, Issue 1, 107629 https://www.ajpmonline.org/article/S0749-3797(25)00107-2/fulltext

“The purpose of this study was to examine associations between reasons for e-cigarette use and e-cigarette use frequency, dependence, and quit intentions.

Data were obtained from the Truth Longitudinal Cohort, a national probability-based online survey of U.S. youth and young adults (aged 15–24 years, collected from October 2022 to December 2023. The analytic sample (N=815) included participants who reported current e-cigarette use and their most important reason for e-cigarette use (selected from a list of responses, regrouped into categories), use frequency (number of days used in the past 30 days), dependence (E-cigarette Dependence Scale), and quit intentions (any versus none). Linear and logistic regression models were applied to aggregated cross-sectional data, adjusted for age, gender identity, race and ethnicity, perceived financial situation, past 30-day use of other combustible tobacco products, and e-cigarette device type.

The most endorsed reason for using e-cigarettes was coping with mental health challenges (39.6%), followed by sensation seeking (20.4%), lower perceived harms (14.7%), social status/acceptability (10.9%), ease of use/access (10.1%), and peer/family influence (4.3%). All reasons for e-cigarette use were associated with e-cigarette use frequency and dependence. Using e-cigarettes as a means of coping with mental health challenges and social status/acceptability were also associated with greater odds of expressing any quit intentions.”

TRC Research Commentary

MacMonegle A, et al. The Impact of “The Real Cost” on E-cigarette Initiation among U.S. Youth. American Journal of Preventive Medicine. 14 Mar 2025.

https://www.ajpmonline.org/article/S0749-3797(25)00071-6/fulltext

“This study examined the effect of exposure to “The Real Cost” Youth E-cigarette Prevention Campaign on e-cigarette initiation among U.S. youth aged 11–18.

Data were analyzed from the first two waves of a longitudinal evaluation of the campaign, conducted between August and December 2023 (baseline) and June and September 2024 (follow-up), with analyses completed in 2025. The study included youth who reported never having tried an e-cigarette at baseline and completed the follow-up survey (n = 3,408). An exposure index (range: 0–16) was generated using respondents’ self-reported frequency of exposure to each of four campaign advertisements (0 = never; 4 = very often). The impact of exposure on e-cigarette initiation was examined at follow-up using a discrete-time survival analysis logistic regression model, controlling for potential confounding variables. The estimated number of youth prevented from initiating e-cigarette use was extrapolated to the national youth population.

To determine the e-cigarette prevention campaign’s impact, researchers measured campaign awareness, beliefs about the harms of e-cigarette use, and beliefs about the negative consequences of vaping nicotine.

The odds of reporting e-cigarette initiation at follow-up decreased as exposure to campaign advertisements increased. For every unit increase in the exposure index, there was a 6% reduction in the probability of initiation. The campaign prevented an estimated 444,252 (95% CI: 73,639–814,866) U.S. youth aged 11–18 from initiating e-cigarette use between 2023 and 2024.

Youth with higher exposure to “The Real Cost” E-cigarette Prevention Campaign ads were less likely to initiate e-cigarette use during the study period. These findings indicate that the campaign has contributed to recent declines in e-cigarette use among U.S. youth.”

Comment: Media campaigns that show the mental and physical consequences of e-cigarette use have a greater impact on youth prevention. Explained immediate adverse harms have more impact than long-term consequences, such as sustained nicotine addiction. Stephen Hamann