• Jessica L Barrington-Trimis, Kiros Berhane, Jennifer B Unger, Tess Boley Cruz, Jimi Huh, Adam M Leventhal, Robert Urman, Kejia Wang, Steve Howland, Tamika D Gilreath, Chih-Ping Chou, Mary Ann Pentz, and Rob McConnell.
• Department of Preventive Medicine and jtrimis@usc.edu.
• Pediatrics. 2015 Aug 1;136(2):308-17.

BackgroundUse of electronic cigarettes (e-cigarettes) among adolescents has increased since their introduction into the US market in 2007. Little is known about the role of e-cigarette psychosocial factors on risk of e-cigarette or cigarette use in adolescence.MethodsInformation on e-cigarette and cigarette psychosocial factors (use and attitudes about use in the home and among friends) was collected from 11th- and 12th-grade participants in the Southern California Children's Health Study during the spring of 2014.ResultsOf 2084 participants, 499 (24.0%) had used an e-cigarette, including 200 (9.6%) current users (past 30 days); 390 participants (18.7%) had smoked a combustible cigarette, and 119 (5.7%) were current cigarette smokers. Cigarette and e-cigarette use were correlated. Nevertheless, 40.5% (n = 81) of current e-cigarette users had never smoked a cigarette. Psychosocial factors (home use of each product, friends' use of and positive attitudes toward e-cigarettes and cigarettes) and participant perception of the harm of e-cigarettes were strongly positively associated both with e-cigarette and cigarette use. Most youth who reported e-cigarette use had friends who used e-cigarettes, and almost half of current users reported that they did not believe there were health risks associated with e-cigarette use.ConclusionsLongitudinal studies of adolescents are needed to determine whether the strong association of e-cigarette psychosocial factors with both e-cigarette and cigarette use will lead to increased cigarette use or dual use of cigarettes and e-cigarettes, or whether e-cigarettes will serve as a gateway to cigarette use.Copyright © 2015 by the American Academy of Pediatrics.

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