Adolescent E-Cigarette Onset and Escalation: Associations With Internalizing and Externalizing Symptoms.

Area of Science:

• Adolescent Health
• Behavioral Science
• Public Health

Background:

• Internalizing (anxiety, depression) and externalizing (impulsivity, sensation seeking, substance use) symptoms are common in adolescents.
• E-cigarette use (vaping) is a growing public health concern among youth.

Purpose of the Study:

• To determine if internalizing and/or externalizing symptoms predict the onset and escalation of 30-day e-cigarette use over 30 months in adolescents.
• To identify distinct adolescent profiles at risk for e-cigarette use.

Main Methods:

• A longitudinal study involving 1,808 adolescents surveyed every six months for 30 months.
• Latent growth curve modeling was used to analyze the relationships between symptoms and e-cigarette use patterns.

Main Results:

• Externalizing symptoms were associated with initial 30-day e-cigarette use.
• Depression was linked to increased e-cigarette use escalation, while anxiety was linked to decreased escalation.
• Past cigarette smoking slowed the onset of 30-day e-cigarette use.

Conclusions:

• Two adolescent groups at risk for e-cigarette use were identified: early onset (higher-risk profile) and later onset (initially lower-risk profile).
• Prevention efforts should be tailored based on the timing and specific symptom profiles associated with e-cigarette use onset and escalation.