The E-cigarette Social Environment, E-cigarette Use, and Susceptibility to Cigarette Smoking. Academic Article uri icon


  • PURPOSE: One concern regarding the recent increase in adolescent e-cigarette use is the possibility that electronic (e-) cigarettes may be used by those who might not otherwise have used cigarettes, and that dual use, or transition to cigarette use alone, may follow. METHODS: Questionnaire data were obtained in 2014 from 11th/12th grade students attending schools in 12 communities included in the Southern California Children's Health Study. We evaluated the cross-sectional association between e-cigarette use, the social environment (family and friends' use and approval of e-cigarettes and cigarettes), and susceptibility to future cigarette use among never cigarette smokers (N= 1,694), using previously validated measures based on reported absence of a definitive commitment not to smoke. RESULTS: Among adolescents who had never used cigarettes, 31.8% of past e-cigarette users and 34.6% of current (past 30-day) e-cigarette users indicated susceptibility to cigarette use, compared with 21.0% of never e-cigarette users. The odds of indicating susceptibility to cigarette use were two times higher for current e-cigarette users compared with never users (odds ratio= 1.97; 95% confidence interval: 1.21-3.22). A social environment favorable to e-cigarettes (friends' use of and positive attitudes toward the use of e-cigarettes) was also associated with greater likelihood of susceptibility to cigarette use, independent of an individual's e-cigarette use. CONCLUSIONS: E-cigarette use in adolescence, and a pro-e-cigarette social environment, may put adolescents at risk for future use of cigarettes. E-cigarettes may contribute to subsequent cigarette use via nicotine addiction or social normalization of smoking behaviors.

published proceedings

  • J Adolesc Health

altmetric score

  • 11.35

author list (cited authors)

  • Barrington-Trimis, J. L., Berhane, K., Unger, J. B., Cruz, T. B., Urman, R., Chou, C. P., ... McConnell, R.

citation count

  • 96

complete list of authors

  • Barrington-Trimis, Jessica L||Berhane, Kiros||Unger, Jennifer B||Cruz, Tess Boley||Urman, Robert||Chou, Chih Ping||Howland, Steve||Wang, Kejia||Pentz, Mary Ann||Gilreath, Tamika D||Huh, Jimi||Leventhal, Adam M||Samet, Jonathan M||McConnell, Rob

publication date

  • January 2016