Comparing Risk Factors for Past 30-day E-cigarette and Combustible Tobacco Use: A Longitudinal Analysis of the Texas Adolescent Tobacco and Marketing Surveillance Study (2014-2017).

Significance: Youth use of e-cigarettes is reaching 'epidemic proportions,' even as combustible tobacco use is declining. Comparison of risk factors that are uniquely associated with e-cigarette and combustible tobacco use among adolescents is warranted.
Methods: Six waves of data from the Texas Adolescent Tobacco and Marketing Surveillance (TATAMS) study (n=3907; N=461,069; 2014-2017) were used in this analysis. A random intercept logistic regression model was used to compare intrapersonal, interpersonal, and environmental risk factors for use of both products based on the Social Ecological Model.
Results: Risk factors that were significantly associated with both past 30-day use of e-cigarette and combustible tobacco products over time included past 30-day use of marijuana and alcohol, social acceptability of product use, having friends and family members who used the products, and male gender. Increasing age, worse academic performance, higher sensation seeking score, higher recall of social media promotion in the past 30 days, and lower positive affect score were associated with past 30-day use of combustible tobacco only. White race was associated with past-30 day use of e-cigarettes only.
Conclusion: Involving peers and parents in preventive interventions designed to reduce uptake of these products is paramount, as is the need to address other substance use, like alcohol and marijuana. Efforts should also be made to create a social climate that makes tobacco use (e-cigarettes and combustible products) less acceptable and desirable.