Purpose
Youth e-cigarette use is associated with increased risk of COVID-19-related health outcomes. However, in the absence of public information campaigns about such health risk as well as e-cigarettes still on the market, youth will likely continue using e-cigarettes. We examined youth perceptions of the health harms of e-cigarettes in relation to COVID-19 and the impact on e-cigarette use.
Methods
We conducted a national cross-sectional survey of adolescents and young adults (AYAs) aged 13-24 years old in May 2020 (n=4,351; 65% female; 50:50 e-cigarette ever-users/never-users) to assess e-cigarette use. Participants were asked about perceptions of COVID-19 risk, respiratory problems, and severe lung disease given e-cigarette use.
Results
Over one-third (37.1%) of ever-users and 22.4% of never-users believed that e-cigarette use did not increase the risk of COVID-19 because it affects the lungs. Among past month users, 42.8% believed that e-cigarette use did not increase the risk of COVID-19 because it affects the lungs compared to 29.4% of ever-users who did not use in the past 30 days. After controlling for demographics, AYAs who agreed that vaping increases the risk of COVID-19 were less likely to have used e-cigarettes in the past month (OR = 0.80 [95% CI: 0.66, 0.98]).
Conclusions
Ever e-cigarette users who did not believe that e-cigarette use increases the risks of COVID-19 were more likely to have used e-cigarettes in the past month. Since youth perceptions about the risk of COVID-19 are inconsistent with emerging scientific evidence, prevention messaging should seek to explain how e-cigarette use is linked to respiratory problems and could affect COVID-19 outcomes.
Sources of Support
The research reported in this article was supported by the Taube Research Faculty Scholar Endowment to Bonnie Halpern-Felsher. Additional support was from grant U54 HL147127 from the National Heart, Lung, and Blood Institute (NHLBI) and the Food and Drug Administration Center for Tobacco Products. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the Food and Drug Administration. Dr. Halpern-Felsher is an expert for some e-cigarette litigation and tobacco-related policies. None of the other authors have any conflicting interests.