Abstract :
Keywords Adolescents; Middle school students; High school students; Tobacco use Highlights * Adolescents are vulnerable to e-cigarette experimentation and use. * Use is associated with cognitive susceptibility and low perceived harm risks. * These correlates of use are malleable targets for future prevention interventions. * E-cigarette prevention should focus on adolescents from underserved communities. Abstract Introduction The prevalence of e-cigarette use among US adolescents is increasing. However, there is limited research on the prevalence and correlates of e-cigarette use among adolescents in low income and under resourced communities. We report on their e-cigarette susceptibility and use behaviors, and perceived risks of harm and addiction. Methods Students in grades 7, 9, and 11 from a Title I school district in the northeastern US completed an online survey during a class period. Lifetime e-cigarette use and its correlates were tested in bivariate and logistic regression models. Results Most students were of Latino ethnicity (66%), and 36% identified as Black/African American. Overall, 55% of the full sample were considered 'susceptible' to e-cigarette use: 19% were lifetime e-cigarette users while 6% were lifetime smokers. Students in 11th grade were more likely (OR = 2.5) to have ever used e-cigarettes compared to students in 7th grade. Those that were more curious (OR = 11.8), intended to use e-cigarettes in the next 12 months (OR = 2.8), and would use the product if it was offered by a friend (OR = 2.4) had greater odds of lifetime e-cigarette use. By contrast, students who perceived at least moderate risks of health harm (OR = 0.44) were less likely to have used e-cigarettes. Conclusions Adolescents from marginalized communities are susceptible to and are using e-cigarettes. Prevention efforts targeting underserved areas may benefit from e-cigarette health education messages that reduce curiosity, interrupt social aspects of initiation, and emphasize health harms. Author Affiliation: (a) Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven St., NW, Suite 4100, Washington, DC 20007, United States (b) John Theurer Cancer Center, Hackensack Meridian Health, 40 Prospect Ave., Hackensack, NJ 07601, United States (c) Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd., Philadelphia, PA 19104, United States * Corresponding author at: Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven St., NW, Suite 4100, Washington, DC, 20007, United States. Article History: Received 2 April 2020; Revised 9 November 2020; Accepted 11 November 2020 Byline: Kenneth P. Tercyak [tercyakk@georgetown.edu] (a,*), Lilianna Phan (a), Katia Gallegos-Carrillo (b), Darren Mays (a), Janet Audrain-McGovern (c), Kathryn Rehberg (a), Yameng Li (a), Francisco Cartujano-Barrera (b), A. Paula Cupertino (a,b)