Flavorings and Perceived Harm and Addictiveness of E-cigarettes among Youth

Given the increasing trend in use of electronic cigarettes ("e-cigarettes") among youth, it is crucial to understand how these products are perceived and how these perceptions are associated with their decision whether or not to use them.

This is a cross-sectional analysis of data from a rapid response surveillance system of 6th, 8th and 10th grade students' tobacco use behaviors (sample [n] = 3704 from a population of students [N] = 434,601). We used weighted logistic regression models to investigate the relationship between perceptions of harm and addictiveness and e-cigarette use, including the use of flavored and non-flavored e-cigarettes.

Compared to youth who did not use e-cigarettes, ever and current e-cigarette users had higher odds of reporting that e-cigarettes were "not at all harmful" to health and "not at all addictive." Ever and current e-cigarette users had higher odds of reporting that flavored e-cigarettes were "less harmful" than non-flavored e-cigarettes, compared to youth who did not use e-cigarettes.

These findings warrant attention given that nicotine is an addictive substance whose effects on the adolescent brain are potentially negative. Youth e-cigarette users perceived lower harm from flavored e-cigarettes, which is worrisome given emerging research documenting harmful constituents in certain e-cigarette flavorings.