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Article

Exploring Associations between Susceptibility to the Use of Electronic Nicotine Delivery Systems and E-Cigarette Use among School-Going Adolescents in Rural Appalachia

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Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
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Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
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Department of Graduate Studies, College of Nursing, East Tennessee State University, Johnson City, TN 37614, USA
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Department of Public Health, California State University, Fullerton, CA 92831, USA
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Department of Epidemiology, Milken School of Public Health, and Department of Sociology, The George Washington University, Washington, DC 20052, USA
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Northeast Regional Office, Tennessee Department of Health, Johnson City, TN 37604, USA
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James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37604, USA
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Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(14), 5133; https://doi.org/10.3390/ijerph17145133
Received: 10 June 2020 / Revised: 6 July 2020 / Accepted: 14 July 2020 / Published: 16 July 2020
(This article belongs to the Special Issue Risk Behaviors and Substance Abuse among Adolescents)
Electronic nicotine delivery systems (ENDS) use, including e-cigarettes, has surpassed the use of conventional tobacco products. Emerging research suggests that susceptibility to e-cigarette use is associated with actual use among adolescents. However, few studies exist involving adolescents in high-risk, rural, socioeconomically distressed environments. This study examines susceptibility to and subsequent usage in school-going adolescents in a rural distressed county in Appalachian Tennessee using data from an online survey (N = 399). Relying on bivariate analyses and logistic regression, this study finds that while 30.6% of adolescents are ever e-cigarette users, 15.5% are current users. Approximately one in three adolescents are susceptible to e-cigarettes use, and susceptibility is associated with lower odds of being a current e-cigarette user (OR = 0.03; CI: 0.01–0.12; p < 0.00). The age of tobacco use initiation was significantly associated with decreased current use of e-cigarettes (OR = 0.89; CI: 0.83–0.0.97; p < 0.01). Overall, the results of this exploratory study suggest the need for larger studies to identify unique and generalizable factors that predispose adolescents in this high-risk rural, socioeconomically disadvantaged region to ENDS use. Nevertheless, this study offers insight into e-cigarette usage among U.S adolescents in rural, socioeconomically disadvantaged environments and provides a foundation for a closer examination of this vulnerable population. View Full-Text
Keywords: electronic nicotine delivery systems; e-cigarettes; Appalachia; adolescents; rural susceptibility; social determinants of health electronic nicotine delivery systems; e-cigarettes; Appalachia; adolescents; rural susceptibility; social determinants of health
MDPI and ACS Style

Mamudu, H.M.; Nwabueze, C.; Weierbach, F.M.; Yang, J.; Jones, A.; McNabb, M.; Adeniran, E.; Liu, Y.; Wang, L.; Blair, C.J.; Awujoola, A.; Wood, D.L. Exploring Associations between Susceptibility to the Use of Electronic Nicotine Delivery Systems and E-Cigarette Use among School-Going Adolescents in Rural Appalachia. Int. J. Environ. Res. Public Health 2020, 17, 5133. https://doi.org/10.3390/ijerph17145133

AMA Style

Mamudu HM, Nwabueze C, Weierbach FM, Yang J, Jones A, McNabb M, Adeniran E, Liu Y, Wang L, Blair CJ, Awujoola A, Wood DL. Exploring Associations between Susceptibility to the Use of Electronic Nicotine Delivery Systems and E-Cigarette Use among School-Going Adolescents in Rural Appalachia. International Journal of Environmental Research and Public Health. 2020; 17(14):5133. https://doi.org/10.3390/ijerph17145133

Chicago/Turabian Style

Mamudu, Hadii M., Christen Nwabueze, Florence M. Weierbach, Joshua Yang, Antwan Jones, Michelle McNabb, Esther Adeniran, Ying Liu, Liang Wang, Cynthia J. Blair, Adeola Awujoola, and David L. Wood. 2020. "Exploring Associations between Susceptibility to the Use of Electronic Nicotine Delivery Systems and E-Cigarette Use among School-Going Adolescents in Rural Appalachia" International Journal of Environmental Research and Public Health 17, no. 14: 5133. https://doi.org/10.3390/ijerph17145133

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