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Gender Differences in U.S. Adolescent E-Cigarette Use

Current Addiction Reports volume 4, pages 422–430 (2017)Cite this article

Abstract

Purpose of Review

This study aims to review the recent (2012–2017) available gender difference data on e-cigarette use among adolescents.

Recent Findings

E-cigarettes are the most commonly used tobacco product among adolescents, and recent study findings showed that e-cigarette use can lead to cigarette smoking. However, gender differences in e-cigarette use among adolescents are relatively unknown.

Summary

We used the search terms “adolescents” and “e-cigarettes” on PubMed and identified 652 articles. Of these, 16 articles (2.5%) examined gender differences in adolescent e-cigarette use. Boys appear to have greater use of e-cigarettes, but girls may be at increased risk if e-cigarettes are targeted to them, as it has been for cigarettes. Data on gender differences are limited, and future research should continue to examine gender differences in e-cigarette use. Trends in use rates could evolve with new regulations and innovations in e-cigarette marketing and product features.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. • Jamal A, Gentzke A, Hu SS, Cullen KA, Apelberg BJ, Homa DM, et al. Tobacco use among middle and high school students—United States, 2011–2016. MMWR. 2017;66(23):597–603. Provides the most recent national rates of e-cigarette use among youth.

    PubMed  Google Scholar 

  2. Nitzkin JL. The case in favor of E-cigarettes for tobacco harm reduction. Int J Environ Res Public Health. 2014;11(6):6459–71.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Kong G, Krishnan-Sarin S. A call to end the growing epidemic of adolescent e-cigarette use. Drug Alcohol Depend. 2017;174:215–21.

    Article  Google Scholar 

  4. • Soneji S, Barrington-Trimis JL, Wills TA, Leventhal AM, Unger JB, Gibson LA, et al. Association between initial use of e-cigarettes and subsequent cigarette smoking among adolescents and young adults a systematic review and meta-analysis. 2017. Most recent review of the association between e-cigarette and cigarette use among youth.

  5. • USDHHS. E-Cigarette Use Among Youth and Young Adults. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. 2016. US Surgeon General report of e-cigarette use among youth.

  6. Johnston LD, O’Malley PM, Miech RA, Bachman JG, Schulenberg JE. Monitoring the future national survey results on drug use, 1975–2015: overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, The University of Michigan; 2016.

    Google Scholar 

  7. Barrington-Trimis JL, Berhane K, Unger JB, Cruz TB, Huh J, Leventhal AM, et al. Psychosocial factors associated with adolescent electronic cigarette and cigarette use. Pediatr. 2015;136(2):308–17.

    Article  Google Scholar 

  8. Krishnan-Sarin S, Morean ME, Camenga DR, Cavallo DA, Kong G. E-cigarette use among high school and middle school students. Nic Tob Res. 2015;17:810–8.

    Article  Google Scholar 

  9. Leventhal AM, Strong DR, Kirkpatrick MG, Unger JB, Sussman S, Riggs NR, et al. Association of electronic cigarette use with initiation of combustible tobacco product smoking in early adolescence. JAMA. 2015;314(7):700–7.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  10. Wills TA, Knight R, Williams RJ, Pagano I, Sargent JD. Risk factors for exclusive e-cigarette use and dual e-cigarette use and tobacco use in adolescents. Pediatr. 2014;135(1):43–51.

    Article  Google Scholar 

  11. Perkins KA, Donny EC, Caggiula AR. Sex differences in nicotine effects and self-administration: review of human and animal evidence. Nic Tob Res. 1999;1:301–15.

    CAS  Article  Google Scholar 

  12. Warren CW, Jones NR, Eriksen MP, Asma S. Patterns of global tobacco use in young people and implications for future chronic disease burden in adults. Lancet. 2006;367:749–53.

    CAS  Article  PubMed  Google Scholar 

  13. Greaves L. Sifting the evidence: gender and tobacco control. Geneva; 2007.

  14. Barbeau EM, Leavy-Sperounis A, Balbach ED. Smoking, social class, and gender: what can public health learn from the tobacco industry about disparities in smoking? Tob Control. 2004;13(2):115.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  15. Amos A, Haglund M. From social taboo to “torch of freedom”: the marketing of cigarettes to women. Tob Control. 2000;9(1):3.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  16. Wakefield M, Morley C, Horan JK, Cummings KM. The cigarette pack as image: new evidence from tobacco industry documents. Tob Control. 2002;11(suppl 1):i73.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Doxey J, Hammond D. Deadly in pink: the impact of cigarette packaging among young women. Tob Control. 2011;20(5):353–60.

    Article  PubMed  Google Scholar 

  18. USDHHS. Women and smoking: a report of the surgeon general. MMWR Morb Mortal Wkly Rep. 2002;51:1–30.

    Google Scholar 

  19. USDHHS. The Health Consequences of Smoking for Women. A report of the Surgeon General. Washington D.C.: U.S. Department of Health and Human Services, Public Health Service, Office of the Assistant Secretary for Health, Office on Smoking and Health; 1980.

  20. Benowitz NL, Lessov-Schlaggar CN, Swan GE, Jacob P III. Female sex and oral contraceptive use accelerate nicotine metabolism. Clinical Pharmacology & Therapeutics. 2006;79:480–8.

    CAS  Article  Google Scholar 

  21. Piper ME, Cook JW, Schlam TR, Jorenby DE, Smith SS, Bolt DM, et al. Gender, race, and education differences in abstinence rates among participants in two randomized smoking cessation trials. Nic Tob Res. 2010;12(6):647–57.

    Article  Google Scholar 

  22. Scharf D, Shiffman S. Are there gender differences in smoking cessation, with and without bupropion? Pooled- and meta-analyses of clinical trials of bupropion SR. Addiction. 2004;99(11):1462–9.

    Article  PubMed  Google Scholar 

  23. Cepeda-Benito A, Reynoso JT, Erath S. Meta-analysis of the efficacy of nicotine replacement therapy for smoking cessation: differences between men and women. Jounal of Consulting and Clinical Psychology. 2004;74:712–22.

    Article  Google Scholar 

  24. Perkins KA. Acute responses to nicotine and smoking: implications for prevention and treatment of smoking in lower SES women. Drug Alcohol Depend. 2009;104:S79–86.

    CAS  Article  PubMed  Google Scholar 

  25. Sofuoglu M, Mooney M. Subjective responses to intravenous nicotine: greater sensitivity in women than men. Exp Clin Psychopharmacol. 2009;17(2):63–9.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  26. Hu M, Davies M, Kandel DB. Epidemiology and correlates of daily smoking and nicotine dependence among young adults in the United States. Am J Public Health. 2006;96(2):299–308.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Thompson AB, Tebes JK, McKee SA. Gender differences in age of smoking initiation and its association with health. Addiction research & theory. 2015;23(5):413–20.

    Article  Google Scholar 

  28. Bright BC, Soulakova JN. Evidence of telescoping in regular smoking onset age. Nic Tob Res. 2014;16(6):717–24.

    Article  Google Scholar 

  29. Fulkerson JA, French SA. Cigarette smoking for weight loss or control among adolescents: gender and racial/ethnic differences. J Adolesc Health. 2003;32(4):306–13.

    Article  PubMed  Google Scholar 

  30. Vidrine JI, Anderson CB, Pollak KI, Wetter DW. Gender differences in adolescent smoking: mediator and moderator effects of self-generated expected smoking outcomes. Am J Health Promot. 2006;20(6):383–7.

    Article  PubMed  Google Scholar 

  31. Smith PH, Bessette AJ, Weinberger AH, Sheffer CE, McKee SA. Sex/gender differences in smoking cessation: a review. Prev Med. 2016;92(Supplement C):135–40.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Bohadana A, Nilsson F, Rasmussen T, Martinet Y. Gender differences in quit rates following smoking cessation with combination nicotine therapy: influence of baseline smoking behavior. Nicotine Tob Res. 2003;5(1):111–6.

    Article  PubMed  Google Scholar 

  33. Pisinger C, Jorgensen T. Weight concerns and smoking in a general population: the Inter99 study. Prev Med. 2007;44(4):283–9.

    Article  PubMed  Google Scholar 

  34. Perkins KA, Giedgowd GE, Karelitz JL, Conklin CA, Lerman C. Smoking in response to negative mood in men versus women as a function of distress tolerance. Nic Tob Res. 2012;14(12):1418–25.

    Article  Google Scholar 

  35. Zang EA, Wynder EL. Differences in lung cancer risk between men and women: examination of the evidence. JNCI: Journal of the National Cancer Institute. 1996;88(3–4):183–92.

    CAS  Article  PubMed  Google Scholar 

  36. Siegfried JM. Women and lung cancer: does oestrogen play a role? Lancet Oncol. 2001;2(8):506–13.

    CAS  Article  PubMed  Google Scholar 

  37. Langhammer A, Johnsen R, Gulsvik A, Holmen TL, Bjermer L. Sex differences in lung vulnerability to tobacco smoking. Eur Respir J. 2003;23:1017–23.

    Article  Google Scholar 

  38. Gold DR, Wang X, Wypij D, Speizer FE, Ware JH, Dockery DW. Effects of cigarette smoking on lung function in adolescent boys and girls. N Engl J Med. 1996;335:931–7.

    CAS  Article  PubMed  Google Scholar 

  39. Holmen TL, Barrett-Connor E, Clausen J, Langhammer A, Holmen J, Bjermer L. Gender differences in the impact of adolescent smoking on lung function and respiratory symptoms. The Nord-Trøndelag health study, Norway, 1995–1997. Respir Med. 2002;96(10):796–804.

    CAS  Article  PubMed  Google Scholar 

  40. Singh T, Arrazola RA, Corey CG. Tobacco use among middle and high school students—United States, 2011–2015. MMWR. 2016;65:361–7.

    PubMed  Google Scholar 

  41. Camenga DR, Kong G, Cavallo DA, Liss AK, Hyland A, Delmerico J, et al. Alternate tobacco product and drug use among adolescents who use electronic cigarettes, cigarettes only, and never smokers. J Adolesc Health. 2014;55(4):588–91.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Lippert AM. Do adolescent smokers use e-cigarettes to help them quit? The sociodemographic correlates and cessation motivations of U.S. adolescent e-cigarette use. Am J Health Promot. 2015;29(6):374–9.

    Article  PubMed  Google Scholar 

  43. Dutra LM, Glantz SA. Electronic cigarettes and conventional cigarette use among us adolescents: a cross-sectional study. JAMA Pediatr. 2014;168(7):610–7.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Cardenas VM, Breen PJ, Compadre CM, Delongchamp RR, Barone CP, Phillips MM, et al. The smoking habits of the family influence the uptake of e-cigarettes in US children. Ann Epidemiol. 2015;25(1):60–2.

    Article  PubMed  Google Scholar 

  45. Barnett TE, Soule EK, Forrest JR, Porter L, Tomar SL. Adolescent electronic cigarette use: associations with conventional cigarette and hookah smoking. Am J Prev Med. 2015;49(2):199–206.

    Article  PubMed  Google Scholar 

  46. Corsi DJ, Lippert AM. An examination of the shift in school-level clustering of US adolescent electronic cigarette use and its multilevel correlates, 2011–2013. Health Place. 2016;38:30–8.

  47. Huang L, Kowitt SD, Sutfin EL, Patel T, Ranney LM, Goldstein AO. Electronic cigarette use among high school students and its association with cigarette use and smoking cessation, North Carolina youth tobacco surveys, 2011 and 2013. Prev Chronic Dis. 2016;13:150564.

    Article  Google Scholar 

  48. Alcalá HE, Albert SL, Ortega AN. E-cigarette use and disparities by race, citizenship status and language among adolescents. Addict Behav. 2016;57:30–4.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Barrington-Trimis JL, Urman R, Berhane K, Unger JB, Cruz TB, Pentz MA, et al. E-cigarettes and future cigarette use. Pediatr. 2016;138(1). https://doi.org/10.1542/peds.2016-0379.

  50. Cooper M, Case KR, Loukas A. E-cigarette use among Texas youth: results from the 2014 Texas youth tobacco survey. Addict Behav. 2015;50:173–7.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Gilreath TD, Leventhal A, Barrington-Trimis JL, Unger JB, Cruz TB, Berhane K, et al. Patterns of alternative tobacco product use: emergence of hookah and e-cigarettes as preferred products amongst youth. J Adolesc Health. 2016;58(2):181–5.

    Article  PubMed  Google Scholar 

  52. Porter L, Duke J, Hennon M, Dekevich D, Crankshaw E, Homsi G, et al. Electronic cigarette and traditional cigarette use among middle and high school students in Florida, 2011–2014. PLoS One. 2015;10:e0124385.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Westling E, Rusby JC, Crowley R, Light JM. Electronic cigarette use by youth: prevalence, correlates, and use trajectories from middle to high school. J Adolesc Health. 2017;60:660–6.

  54. Giovacchini CX, Pacek L, McClernon FJ, Que LG. Use and perceived risk of electronic cigarettes among North Carolina middle and high school students. N C Med J. 2017;78(1):7–13.

    PubMed  Google Scholar 

  55. Jamal A, King BA, Neff LJ, Whitmill J, Babb SD, Graffunder CM. Current cigarette smoking among adults—United States, 2005–2015. MMWR Morb Mortal Wkly Rep. 2016;65:1205–11.

    Article  PubMed  Google Scholar 

  56. Andrade MD, Hastings G, Angus K. Promotion of electronic cigarettes: tobacco marketing reinvented? Brit Med J. 2013;347

  57. Grana RA, Ling PM. “Smoking revolution”: a content analysis of electronic cigarette retail websites. Am J Prev Med. 2014;46:395–403.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Kong G, Morean ME, Cavallo DA, Camenga DR, Krishnan-Sarin S. Sources of electronic cigarette acquisition among adolescents in Connecticut. Tob Regul Sci. 2017;3(1):10–6.

    Article  PubMed  Google Scholar 

  59. Smith EA, Thomson K, Offen N, Malone RE. “If you know you exist, it’s just marketing poison”: meanings of tobacco industry targeting in the lesbian, gay, bisexual, and transgender community. Am J Public Health. 2008;98(6):996–1003.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Lee JGL, Henriksen L, Rose SW, Moreland-Russell S, Ribisl KM. A systematic review of neighborhood disparities in point-of-sale tobacco marketing. Am J Public Health. 2015;105(9):e8–e18.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Lee JGL, Landrine H, Torres E, Gregory KR. Inequities in tobacco retailer sales to minors by neighbourhood racial/ethnic composition, poverty and segregation, USA, 2015. Tob Control. 2016;25:e142–5.

  62. Zhu S, Sun JY, Bonnevie E, Cummins SE, Gamst A, Yin L, et al. Four hundred and sixty brands of e-cigarettes and counting: implications for product regulation. Tob Control. 2014;23(suppl 3):iii3–9.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Barrington-Trimis JL, Gibson LA, Halpern-Felsher B, Harrell MB, Kong G, Krishnan-Sarin S, et al. Type of e-cigarette device used among adolescents and young adults: findings from a pooled analysis of 8 studies of 2,166 vapers. Nic Tob Res. 2017. https://doi.org/10.1093/ntr/ntx069.

  64. Morean ME, Kong G, Cavallo DA, Camenga DR, Krishnan-Sarin S. Nicotine concentration of e-cigarettes used by adolescents. Drug Alcohol Depend. 2016;167:224–7.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

This study was supported in part by the National Institutes of Health (NIH) and Food and Drug Administration (FDA) grant P50DA036151, awarded to the Yale Tobacco Center of Regulatory Science (TCORS). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the FDA.

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  1. Yale School of Medicine, 34 Park Street, Room S-211, New Haven, CT, 06519, USA

    Grace Kong, Karissa E. Kuguru & Suchitra Krishnan-Sarin

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  1. Grace Kong
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  2. Karissa E. Kuguru
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  3. Suchitra Krishnan-Sarin
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Correspondence to Grace Kong.

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G.K., K.E.K., and S.K.-S. declare they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Women and Addictions

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Kong, G., Kuguru, K.E. & Krishnan-Sarin, S. Gender Differences in U.S. Adolescent E-Cigarette Use. Curr Addict Rep 4, 422–430 (2017). https://doi.org/10.1007/s40429-017-0176-5

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Keywords

  • E-cigarette
  • Youth
  • Adolescents
  • Gender