Nicotine Vaping and Co-occurring Substance Use Among Adolescents in the United States from 2017–2019

Abstract

Background: The use of electronic cigarettes (or “vaping”) among adolescents remains a public health concern given exposure to harmful substances, plus potential association with cannabis and alcohol. Understanding vaping as it intersects with combustible cigarette use and other substance use can inform nicotine prevention efforts. Methods: Data were drawn from 51,872 US adolescents (grades 8, 10, 12, years: 2017–2019) from Monitoring the Future. Multinomial logistic regression analyses assessed links of past 30-day nicotine use (none, smoking-only, vaping-only, and any smoking plus vaping) with both past 30-day cannabis use and past two-week binge drinking. Results: Nicotine use patterns were strongly associated with greater likelihood of cannabis use and binge drinking, particularly for the highest levels of each. For instance, those who smoked and vaped nicotine had 36.53 [95% CI:16.16, 82.60] times higher odds of having 10+ past 2-week binge drinking instances compared to non-users of nicotine. Discussion: Given the strong associations between nicotine use and both cannabis use and binge drinking, there is a need for sustained interventions, advertising and promotion restrictions, and national public education efforts to reduce adolescent nicotine vaping, efforts that acknowledge co-occurring use.

Keywords:

• Vaping
• adolescent
• nicotine
• trends
• substance use

Declaration of interest

The authors report there are no competing interests to declare.

Data availability statement

MTF data are available in publicly accessible format.

Additional information

Funding

These analyses are funded by NIDA grant R01DA048853 (PI: Keyes) and with support from the Columbia Center for Injury Science and Prevention (NCIPC grant R49-CE003094). Additionally, Dr. Martins reports funding from NIDA grant R01DA037866, and Dr. Hasin reports funding from NIDA grant R01DA048860.