Harm Reduction or Harm Introduction? Prevalence and Correlates of E-Cigarette Use Among French Adolescents

Electronic cigarettes are marketed as a tool to give up or reduce cigarette smoking, and their use has risen sharply in recent years. There is concern that use is increasing particularly among adolescents and that they are not being used as a cessation tool but as a novel experience in their own right.

The present research assessed prevalence and sociodemographic correlates of e-cigarette use and standard cigarette use and also explored the extent to which e-cigarettes appear to be used as a cessation tool. This was assessed using a questionnaire administered to 1,486 French adolescents aged 16 years.

Prevalence of e-cigarette experimentation was high (54%) and comparable to that for standard cigarettes (55%). Furthermore, 20% of those who had experimented with e-cigarettes had never tried standard cigarettes, and among regular smokers of standard cigarettes, intentions to quit were not associated with e-cigarette usage frequency. Experimentation with both e-cigarettes and standard cigarettes was significantly predicted by higher age, higher socioeconomic status, and parental smoking of standard cigarettes (in particular the father). Being male marginally predicted e-cigarette use, whereas being female significantly predicted standard cigarette use.

These findings give cause for concern: e-cigarette usage experimentation is extremely high, and is not associated with attempts to quit smoking standard cigarettes. Rather, it is exposing adolescents to a highly addictive drug (nicotine) and may pave the way for a future cigarette habit.