BACKGROUND: Electronic cigarette (e-cigarette) use has substantially increased in the past decade in the United States. The socio-demographic and lifestyle factors associated with e-cigarette use remain unclear, particularly among vulnerable populations. This study assessed predictors of e-cigarette use among individuals with asthma, using a nationally representative sample.
METHODS: Using the 2014 National Health Interview Survey (NHIS), we identified (N = 8,154) survey participants, aged ≥18 years. Weighted adjusted multivariable logistic regression was used to assess predictors of e-cigarette use.
RESULTS: The prevalence of e-cigarette use was 16.57% among study sample. Analysis revealed that cigarette smokers had the highest odds of using e-cigarettes; compared never smokers, current cigarette smokers had 35.07 times (95% CI: 27.17-45.25) and former cigarette smokers had 6.38 times (95% CI: 4.95-8.23) higher odds of using e-cigarettes. Among socio-demographic characteristics, we found that compared to individuals aged ≥ 65 years, those aged 18-24 (aOR = 8.62; 95% CI: 5.63-13.21), 25-24 (aOR = 5.99; 95% CI: 4.05-8.86), 35-49 (aOR = 3.52; 95% CI: 2.45-5.04), and 50-64 years (aOR = 2.19; 95% CI: 1.53-3.13) had higher odds of using e-cigarettes. Furthermore, males, compared to females, had 1.20 times (95% CI: 1.00-1.45) higher odds of using e-cigarettes. Both Hispanics (aOR = 0.72; 95% CI: 0.53-0.97) and Non-Hispanic Blacks (aOR = 0.26; 95% CI: 0.19-0.35) had lower odds of e-cigarette use compared to Non-Hispanic Whites, however, Non-Hispanic Others (e.g. multiple race/ethnicity) had 1.52 times (95%CI: 1.03-2.42) higher odds of using e-cigarettes. Compared to graduate students, only college students, had significantly higher odds of using e-cigarettes (aOR = 1.53; 95% CI: 1.07-2.18). Additionally, current alcohol users, compared to lifetime abstainers, had 2.37 times (95% CI: 1.75-3.97) higher odds of e-cigarette use. Self-reported health was a significant predictor of usage; those in very good/good health (aOR = 1.65; 95% CI: 1.27-2.14) and fair/poor health (aOR = 2.21; 95% CI: 1.60-3.04) had higher odds of using e-cigarettes, compared to self-reported excellent health. Lastly, only obese individuals had significant lower odds (aOR = 0.73; 95% CI: 0.58-0.92) of using e-cigarettes compared to normal weight individuals.
CONCLUSIONS: Self-reported cigarette smokers and young adults had the highest odds of e-cigarette use. Socio-demographic and lifestyle factors help with getting a better understanding of this device for future interventions and health promotion activities. There is a need for research to determine the efficacy and impact of e-cigarettes on health. Future research should determine factors associated with initiation of e-cigarettes and impact of e-cigarettes on wellbeing.