Research paper
Prevalence and predictors of e-cigarette trial among adolescents in Argentina
Paola Morello 1  
,  
Adriana Perez 1, 2,  
Lorena Peña 1,  
Paula Lozano 3,  
James Sargent 4,  
 
 
More details
Hide details
1
Centro de Estudios de Estado y Sociedad (CEDES), Argentina
2
Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Argentina
3
Department of Health Promotion, Education, and Behavior University of South Carolina, Columbia, USA
4
Department of Pediatrics, Geisel School of Medicine at Dartmouth, USA
Publish date: 2016-12-01
Submission date: 2016-09-05
Final revision date: 2016-11-11
Acceptance date: 2016-11-11
 
Tob. Prev. Cessation 2016;2(December):80
KEYWORDS:
TOPICS:
ABSTRACT:
Introduction:
Over the last few years, the increasing use of electronic cigarettes has become a new public health problem. Since 2011, Argentina has had a complete ban on marketing and sale of e-cigarettes. However, e-cigarettes are marketed online and can be easily bought in stores. We conducted a longitudinal study to evaluate the determinants of e-cigarette trial among Argentinean early adolescents.

Methods:
A school-based longitudinal study was conducted in 2014-15, in 3 large cities in Argentina. Among students who reported never smoking an e-cigarette at baseline, we assessed demographics, media use, sensation seeking, smoking behavior, network member smoking, use of other substances, and perception of e-cigarette risk as potential risk factors for e-cigarette trial at follow up (mean between-wave interval 17.1 months) using multilevel logistic regression models with random intercepts for schools.

Results:
E-cigarette trial prevalence increased from baseline (1.8%; n=57) to follow up (7.1%; n=139). Independent predictors of e-cigarette use at follow up included: higher sensation seeking (OR: 1.49 95% CI 1.21-1.84); being a current smoker (OR: 2.58 95% CI 1.38-4.83); having close friends that smoke cigarettes (OR: 1.93 95% CI 1.25-2.99) and being highly exposed to tobacco product ads online (OR: 1.87 95% CI 1.04-3.36). Attending a public school was the only protective factor (OR: 0.40 95% CI 0.22-0.73).

Conclusions:
In Argentina, illicit trial of e-cigarettes among early adolescents is low but appears to be rapidly increasing. Identifying students at risk could help identify policies and programs to prevent increasing use in this population.

CORRESPONDING AUTHOR:
Paola Morello   
Centro de Estudios de Estado y Sociedad (CEDES), Argentina, Sánchez de Bustamante 27, 1173 buenos aires, Argentina
 
REFERENCES (37):
1. WHO report on the global tobacco epidemic, 2015: raising taxes on tobacco. World Health Organization, Geneva. 2015 Available at: http://www.who.int/tobacco/global_report/2015/report/en/ (accessed April 2016).
2. Gravely S, Fong GT, Cummings KM, et al. Awareness, trial, and current use of electronic cigarettes in 10 countries: Findings from the ITC project. Int J Environ Res Public Health 2014;11(11):11691-704. doi: 10.3390/ijerph111111691.
3. White J, Li J, Newcombe R, et al. Tripling use of electronic cigarettes among New Zealand adolescents between 2012 and 2014. J Adolesc Health 2015;56(5):522-528. doi: 10.1016/j.jadohealth.2015.01.022.
4. Babineau K, Taylor K, Clancy L. Electronic Cigarette Use among Irish Youth: A Cross Sectional Study of Prevalence and Associated Factors. Plos One 2015;10(5):e0126419. doi: 0.1371/journal.pone.0126419.
5. Singh T, Arrazola RA, Corey CG, et al. Tobacco Use Among Middle and High School Students — United States, 2011–2015. MMWR Morb Mortal Wkly Rep 2016;65:361–367. doi: http://dx.doi.org/10.15585/mmwr.mm6514a1.
6. Goniewicz ML, Leigh NJ, Gawron M, et al. Dual use of electronic and tobacco cigarettes among adolescents: a cross-sectional study in Poland. Int J Public Health. 2016;61(2):189-97. doi: 10.1007/s00038-015-0756-x.
7. Land S, Parascandola M, et al. Tobacco use transitions in the United States: The National Longitudinal Study of Adolescent Health. Prev Med. 2015;81:251-7. doi: 10.1016/j.ypmed.2015.08.026.
8. Thrasher JF, Abad-Vivero EN, Barrientos-Gutíerrez I, et al. Prevalence and Correlates of E-Cigarette Perceptions and Trial Among Early Adolescents in Mexico. J Adolesc Health. 2016;58(3):358-65. doi: 10.1016/j.jadohealth.2015.11.008.
9. Bunnell RE, Agaku IT, Arrazola RA, et al. Intentions to smoke cigarettes among never-smoking US middle and high school electronic cigarette users: National Youth Tobacco Survey, 2011-2013. Nicotine Tob Res. 2015;17(2): 228-235. doi: 10.1093/ntr/ntu166.
10. Wills TA, Sargent JD, Knight R, et al. E-cigarette use and willingness to smoke: a sample of adolescent non-smokers. Tob Control. 2016;25(e1):e52-9. doi: 10.1136/tobaccocontrol-2015-052349.
11. Primack BA, Soneji S, Stoolmiller M, et al. Progression to Traditional Cigarette Smoking After Electronic Cigarette Use Among US Adolescents and Young Adults. JAMA Pediatr 2015;169(11):1018-23. doi: 10.1001/jamapediatrics.2015.1742.
12. Leventhal AM, Strong DR, Kirkpatrick MG, et al. Association of Electronic Cigarette Use With Initiation of Combustible Tobacco Product Smoking in Early Adolescence. JAMA. 2015;314(7):700-7. doi: 10.1001/jama.2015.8950.
13. Chatterjee K, Alzghoul B, Innabi A, Meena N. Is vaping a gateway to smoking: a review of the longitudinal studies. Int J Adolesc Med Health. 2016. pii: /j/ijamh.ahead-of-print/ijamh-2016-0033/ijamh-2016-0033.xml. doi: 10.1515/ijamh-2016-0033.
14. Choi K, Forster JL Beliefs and experimentation with electronic cigarettes: a prospective analysis among young adults. Am J Prev Med 2014;46:175–8. doi: 10.1016/j.amepre.2013.10.007.
15. Hanewinkel R, Isensee B Risk factors for e-cigarette, conventional cigarette, and dual use in German adolescents: a cohort study. Prev Med 2015;74:59–62. doi: 10.1016/j.ypmed.2015.03.006.
16. Pokhrel P, Fagan P, Kehl L, et al. Receptivity to e-cigarette marketing, harm perceptions, and e-cigarette use. Am J Health Behav. 2015;39(1):121-31. doi: 10.5993/AJHB.39.1.13.
17. Kinnunen JM, Ollila H, El-Amin SE-T, et al. Awareness and determinants of electronic cigarette use among Finnish adolescents in 2013: a population-based study. Tob Control 2014:1-8. doi: 10.1136/tobaccocontrol-2013-051512.
18. Ambrose BK, Rostron BL, Johnson et al. Perceptions of the Relative Harm of Cigarettes and E-cigarettes Among U.S. Youth. Am J Prev Med 2014;47:S53-S60. doi: 10.1016/j.amepre.2014.04.016
19. Wills TA, Knight R, Sargent JD, et al. Longitudinal study of e-cigarette use and onset of cigarette smoking among high school students in Hawaii. Tob Control. 2016 Jan 25. pii: tobaccocontrol-2015-052705. doi: 10.1136/tobaccocontrol-2015-052705.
20. Kong G, Morean ME, Cavallo DA, et al. Reasons for electronic cigarette experimentation and discontinuation among adolescents and young adults. Nicotine Tob Res 2015;17(7):847-54. doi: 10.1093/ntr/ntu257.
21. Dautzenberg B, Birkui P, Noël M, Dorsett J,et. al E-Cigarette: A New Tobacco Product for Schoolchildren in Paris. Open Journal of Respiratory Diseases, 2013, 3, 21-24. doi: 10.4236/ojrd.2013.31004
22. Huang GC, Unger JB, Soto D, et al. Peer Influences: The Impact of Online and Offline Friendship Networks on Adolescent Smoking and Alcohol Use. J Adoles Health., 2014;54(5):508-14. doi: 10.1016/j.jadohealth.2013.07.001
23. WHO Electronic nicotine delivery systems.2014. FCTC/CO.
24. ANMAT Disposición 3226/2011. Available at: http://www.msal.gob.ar/tabaco/index.php/institucional/legislacion (accessed April 2016).
25. Melamed M. La zona gris del cigarrillo electrónico: está prohibido, pero igual se vende en el país. Diario La Nación. Available at: http://www.lanacion.com.ar/1887558-vaping-la-zona-gris-del-cigarrillo-electronico (accessed April 2016).
26. Ministerio de Salud de la Nación. Encuesta Mundial de Tabaquismo en jóvenes (EMTJ). Argentina: 2012. Available at: http://www.msal.gov.ar/ent/index.php/vigilancia/publicaciones/encuestas-poblacionales (accessed July 2016).
27. Mejia R, Perez A, Pena L, Morello P, et al. Parental Restriction of Mature-rated Media and Its Association With Substance Use Among Argentinean Adolescents. Acad Pediatr. 2016;16(3):282-9. doi: 10.1016/j.acap.2015.11.004.
28. Galanti MR, Siliquini R, Cuomo L, et al. & EU-Dap Study Group. Testing anonymous link procedures for follow-up of adolescents in a school-based trial: the EU-DAP pilot study. 2007.Prev Med;44(2), 174-17.
29. Alderete E, Kaplan C P, Gregorich SE, et al. Smoking behavior and ethnicity in Jujuy, Argentina: evidence from a low-income youth sample. 2009. Subst Use Misuse;44(5), 632-646. doi: 10.1080/10826080902809717.
30. Thrasher J F, Jackson C, Arillo-Santillán E, Sargent JD. Exposure to smoking imagery in popular films and adolescent smoking in Mexico. 2008. Am J Prev Med;35(2):95-102. doi: 10.1016/j.amepre.2008.03.036.
31. Sargent J D, Beach M L, Adachi-Mejia A M et al. Exposure to movie smoking: its relation to smoking initiation among US adolescents. 2005. Pediatrics, 116(5), 1183-91. doi: 10.1542/peds.2005-0714.
32. Stephenson MT, Hoyle RH, Palmgreen P, Slater MD. Brief measures of sensation seeking for screening and large-scale surveys. 2003. Drug Alcohol depend;72(3):279-286.
33. Jackson C, Henriksen l, FosheeVA. The Authoritative Parenting Index: predicting health risk behaviors among children and adolescents. Health Educ Behav. 1998; 258(3):319-337. doi: 10.1177/109019819802500307
34. Goniewicz ML, Gawron M, Nadolska J, et al. Rise in electronic cigarette use among adolescents in Poland. J Adolesc Health 2014;55:713–15. doi: 10.1016/j.jadohealth.2014.07.015.
35. Hanson MD, Chen E. Socioeconomic status and health behaviors in adolescence: a review of the literature. Journal of behavioral medicine 2007;30(3):263-85. doi: 10.1007/s10865-007-9098-3
36. Choi K, Forster J. Characteristics associated with awareness, perceptions, and use of electronic nicotine delivery systems among young US Midwestern adults. Am J Public Health. 2013;103(3):556–61. doi: 10.1016/j.amepre.2013.10.007.
37. Wills TA, Knight R, Williams R, et al. Risk factors for exclusive e-cigarette use and dual e-cigarette and tobacco use in adolescents. Pediatrics 2015;135:e43–51. doi: 10.1542/peds.2014-0760.
eISSN:2459-3087