Links between young adults' reasons for trying electronic nicotine delivery systems (ENDS), smoking history, and...

Electronic nicotine delivery system (ENDS) use has become nearly as prevalent among young adults as cigarette use. Although a growing body of literature investigates the reasons young adults initiate ENDS use, little is known about how these reasons relate to subsequent nicotine use. Understanding how reasons for trying ENDS relate both to prior cigarette use and to subsequent patterns of cigarette and ENDS use may help to identify future higher- and lower-risk nicotine use.

Using data from a community longitudinal study, we examined lifetime cigarette use prior to age 23, reasons for trying ENDS reported at age 23, and cigarette and ENDS use at age 26 among 977 young adults who had tried ENDS by age 23.

Compared to those who had never or infrequently smoked cigarettes, current and former smokers were more likely to try ENDS to quit or cut down on cigarette use, to try a safer alternative to cigarettes, and/or out of curiosity. Participants who reported trying ENDS to quit cigarettes or to try a safer alternative (vs. those who didn't) were more likely to use cigarettes and ENDS 3 years later and use in higher quantities. Trying out of curiosity was associated with less cigarette and ENDS use, while trying for the available flavors was related to more ENDS but not cigarette use.

Young adults' reasons for trying ENDS indicate risk for future cigarette and ENDS use and could have clinical utility in identifying young adults who might benefit from preventive interventions.