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Disparities in E-Cigarette Harm and Addiction Perceptions Among Adolescents in the United States: a Systematic Review of the Literature

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Abstract

Background

Health disparities associated with e-cigarette use are increasingly apparent among US adolescents. Perceptions of e-cigarette harm and addiction play an important role in understanding adolescents’ e-cigarette use behavior. The objective of this systematic review is to examine racial/ethnic and socio-economic disparities in e-cigarette harm and addiction perceptions among US adolescents.

Methods

We searched five databases to identify cross-sectional or longitudinal studies that focused on adolescents (≤ 18 years of age) who were ever, current, or never e-cigarettes users; we then examined how race/ethnicity and/or socio-economic status (SES) impacted e-cigarette harm and/or addiction perceptions. Two co-authors independently identified relevant studies, extracted data, and assessed the risk of bias.

Results

Adhering to PRISMA guidelines, eight of 226 identified studies met the inclusion criteria. These eight studies examined either perceptions regarding absolute e-cigarette harm and/or addiction (i.e., assessing perception of only e-cigarette) or relative e-cigarette harm and/or addiction (i.e., comparative perceptions to traditional cigarettes) by race and ethnicity. Two of the eight studies assessed absolute harm and/or addiction perceptions of e-cigarettes by SES. Our results indicate that, compared to all other racial/ethnic groups, relative e-cigarette harm and addiction perceptions were lower among Non-Hispanic White adolescents; however, absolute e-cigarette harm perception was higher among these groups. No clear patterns of racial/ethnic differences in absolute e-cigarette addiction perceptions and SES differences in absolute e-cigarette harm perceptions were reported.

Conclusion

More research is needed to explicitly assess perceptions of e-cigarette harm and addiction among US adolescents by race/ethnicity and SES to develop subgroup appropriate public health messaging.

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Author information

Authors and Affiliations

  1. Department of Public Health, College of Health Professions, Slippery Rock University of Pennsylvania, Slippery Rock, PA, USA

    Nikhil A. Ahuja

  2. Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN, USA

    Satish K. Kedia & Sanjaya Regmi

  3. School of Communication Studies, Kent State University at Stark, North Canton, OH, USA

    Patrick J. Dillon

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  1. Nikhil A. Ahuja
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Contributions

All authors have read and approved the submitted version of the paper. The specific contributions were as follows: NA: conceptualization, literature search, data extraction, synthesis and analysis, writing—original draft, review and editing; SK: conceptualization, supervision, and writing—review and editing; SR: literature search, data extraction, synthesis, and analysis, writing—review and editing; PD: writing—review and editing.

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Correspondence to Nikhil A. Ahuja.

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Ahuja, N.A., Kedia, S.K., Regmi, S. et al. Disparities in E-Cigarette Harm and Addiction Perceptions Among Adolescents in the United States: a Systematic Review of the Literature. J. Racial and Ethnic Health Disparities 11, 696–709 (2024). https://doi.org/10.1007/s40615-023-01553-1

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