Prevalence and Mental Health Correlates of Electronic Cigarette Use Among Pediatric Primary Care Patients

Electronic cigarettes (e-cigarettes) are the most used tobacco product among US adolescents. Information about the prevalence of use in a pediatric primary care population has been limited. Youth aged 12 to 17 attending a well-child visit completed screening for past year e-cigarette, cigarette, cannabis, and alcohol use, as well as depression and anxiety symptoms. We examined e-cigarette-use prevalence, frequency, and relationship to demographics, mental health symptoms, and other substance use. Among 9740 patients, 8.2% reported past-year e-cigarette use. Males (7.2%) were less likely than females (9.2%) to use e-cigarettes, while more frequent use was associated with more frequent cannabis, alcohol, and cigarette use, as well as elevated depression and anxiety symptoms. Sex differences support a recent trend toward young females using e-cigarettes at higher rates than males. Polysubstance use was common, highlighting the importance of regular screening for all substances and feasible interventions for this setting.