Secondhand E-Cigarette and Tobacco Smoke Exposure and Stages of E-Cigarette Use in US 6th-12th Graders
Abstract
INTRODUCTION: Studies examining the association of secondhand exposures with e-cigarette use behaviors have been limited by indirect or incomplete measures of exposure. This study reports the prevalence of secondhand e-cigarette and tobacco smoke exposure among US youth and examines how robust measures of secondhand exposure correlate with e-cigarette susceptibility, ever use, daily use, and quit attempts.
METHODS: A cross-sectional analysis of 21 946 US 6th-12th graders from the 2023 National Youth Tobacco Survey was conducted. Participants' past 30-day secondhand exposure status was classified as: no secondhand exposure, secondhand e-cigarette only, secondhand tobacco smoke only, or dual secondhand exposure. Multivariate, weighted logistic regression evaluated secondhand exposure status as a predictor of four binary e-cigarette use outcomes in separate models: susceptibility, ever use, daily use, and past 12-month serious quit attempt.
RESULTS: The estimated prevalence of past 30-day secondhand e-cigarette or tobacco smoke exposure was 64.2% (18.18 million). Secondhand exposure to e-cigarettes (adjusted odds ratio [AOR] 2.14 95% CI [1.54-2.98]), tobacco smoke (AOR 1.62 [1.32-2.00]), and dual exposure (AOR 2.44 [2.10-2.84]) were each associated with greater e-cigarette susceptibility. Secondhand e-cigarette (AOR: 2.45 [1.69-3.56]) and dual exposure (AOR: 1.55 [1.23-1.94]), but not secondhand tobacco smoke exposure, were positively associated with e-cigarette ever use. There…
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Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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