SRU public health professor studies why adolescents quit using e-cigarettes


Cigarettes and a vape pen

The perception of harms associated with the use of e-cigarettes, compared to smoking cigarettes, has a correlation to the quitting behaviors of adolescents, according to research by a Slippery Rock University public health professor.

May 11, 2022

SLIPPERY ROCK, Pa. — Researchers continue to study the short-term effects of a public health concern that became dire after a 2019 outbreak, which could have serious long-term health risks. This might sound like COVID-19, but it's actually the use of e-cigarettes, also known as vaping. Nikhil Ahuja, a Slippery Rock University assistant professor of public health and social work, has been studying tobacco control for more than seven years, particularly the use of e-cigarettes, which contain nicotine and have become a problem among youths.

"E-cigarettes have become a huge issue in the U.S. and especially among adolescents," Ahuja said. "There still needs to be more research in terms of assessing the long-term health effects, because these are newer products that are often changing, but definitely the short-term research has suggested that it is harmful and leads to nicotine addiction."

There are debates and insufficient evidence, according to Ahuja, that these types of products can be used as a tool for cessation from smoking tobacco, especially for adults, but the use of e-cigarettes has proven to be harmful to adolescents, aged 12-17. In 2019, there was an outbreak of "e-cigarette, or vaping, product-use associated lung injury," known as EVALI, which resulted in more than 2,500 hospitalizations in the U.S. and 68 deaths. According to Ahuja's research, in 2020, nearly 20% of U.S. high school students reported using an e-cigarette during the past 30 days.



"It's really important to focus on understanding the health risks among adolescents because we don't want to normalize tobacco-use behaviors again, especially with all the tobacco (control) work that has been done for decades," Ahuja said. "Since the EVALI outbreak, we are seeing a lot of studies coming out to help understand whether adolescents want to quit these products. That's something I really want to understand, because once we understand the different factors affecting quitting behavior, we can develop e-cigarette cessation interventions, especially focused on the young, adolescent population."

Last month, Ahuja presented his contribution to the research of e-cigarette use, a paper titled "Factors Associated with E‐cigarette Quitting Behavior among Adolescents in the United States," at the Society of Behavioral Medicine's annual meeting in Baltimore.

Ahuja examined survey data from the Population Assessment of Tobacco and Health, a national longitudinal study of tobacco use administered by the National Institutes of Health and the Food and Drug Administration. He used a socio-ecological model and studied differences in the PATH data, compared data from different years, to identify both individual and interpersonal factors related to adolescents who quit using e-cigarettes, which from 2017-18 surveys was 52%.

"Adolescents are underestimating the risk associated with e-cigarette use, and from an individual level, those who quit using e-cigarettes were not as likely to consider them to be less harmful (than smoking cigarettes) compared to non-quitters," Ahuja said. "And then with the interpersonal factors, I found that when someone else in their family, or an important person in their life, was using e-cigarettes, they were also less likely to be quitters. This suggests that the family environment is really important, and we have seen in (other) tobacco research that the behaviors adopted by parents are most likely to influence the adolescent's behaviors as well."

Ahuja said that his research reinforces the importance of education, interventions and policies targeting adolescents to quit using e-cigarettes, similar to what was successfully done to prevent young people from smoking cigarettes as more evidence emerged about their health risks.

"We need to develop school-based and community-based interventions and policies to correct the harm perceptions at the individual level among adolescents," Ahuja said. "We need to make sure that they are considering e-cigarettes to be as harmful as traditional cigarettes and discourage e-cigarette use among those who have never used e-cigarettes, as well as current users, for them to quit."

More information about Ahuja and public health programs at SRU are available on the department's webpage.

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