Underage Youth Continue to Obtain E-Cigarettes from Retail Sources in 2022: Evidence from the Truth Continuous Tracking Survey
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Source and Inclusion Criteria
2.2. Measures
2.3. Statistical Analysis
3. Results
3.1. Sample Characteristics
3.2. Differences in Demographic Characteristics, Flavors Used, and Device Type by Source of E-Cigarette Acquisition
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Eaton, D.L.; Kwan, L.Y.; Stratton, K.; National Academies of Sciences, Engineering, and Medicine. Toxicology of E-Cigarette Constituents; National Academies Press: Washington, DC, USA, 2018. [Google Scholar]
- United States Food and Drug Administration. Deeming Tobacco Products to be Subject to the Federal Food, Drug, and Cosmetic Act, as Amended by the Family Smoking Prevention and Tobacco Control Act (Proposed Rule). FDA. 2019. Available online: https://www.fda.gov/about-fda/economic-impact-analyses-fda-regulations/deeming-tobacco-products-be-subject-federal-food-drug-and-cosmetic-act-amended-family-smoking (accessed on 1 December 2022).
- United States Food and Drug Administration. Center for Tobacco Products. Tobacco 21. FDA. 2022. Available online: https://www.fda.gov/tobacco-products/retail-sales-tobacco-products/tobacco-21 (accessed on 1 December 2022).
- Mirbolouk, M.; Boakye, E.; Obisesan, O.; Osei, A.D.; Dzaye, O.; Osuji, N.; Erhabor, J.; Stokes, A.C.; El-Shahawy, O.; Rodriguez, C.J.; et al. E-Cigarette Use among High School Students in the United States Prior to the COVID-19 Pandemic: Trends, Correlates, and Sources of Acquisition. Prev. Med. Rep. 2022, 29, 101925. [Google Scholar] [CrossRef] [PubMed]
- Denlinger-Apte, R.; Suerken, C.K.; Ross, J.C.; Reboussin, B.A.; Spangler, J.; Wagoner, K.G.; Sutfin, E.L. Decreases in Smoking and Vaping during COVID-19 Stay-at-Home Orders among a Cohort of Young Adults in the United States. Prev. Med. 2022, 156, 106992. [Google Scholar] [CrossRef] [PubMed]
- Kreslake, J.M.; Simard, B.J.; O’Connor, K.M.; Patel, M.; Vallone, D.M.; Hair, E.C. E-Cigarette Use among Youths and Young Adults during the COVID-19 Pandemic: United States, 2020. Am. J. Public Health 2021, 111, 1132–1140. [Google Scholar] [CrossRef]
- States That Issued Lockdown and Stay-at-Home Orders in Response to the Coronavirus (COVID-19) Pandemic. 2020. Available online: https://ballotpedia.org/States_that_issued_lockdown_and_stay-at-home_orders_in_response_to_the_coronavirus_(COVID-19)_pandemic,_2020 (accessed on 19 July 2022).
- Gaiha, S.M.; Lempert, L.K.; Halpern-Felsher, B. Underage Youth and Young Adult E-Cigarette Use and Access before and during the Coronavirus Disease 2019 Pandemic. JAMA Netw. Open 2020, 3, e2027572. [Google Scholar] [CrossRef] [PubMed]
- Gentzke, A.S.; Wang, T.W.; Cornelius, M.; Park-Lee, E.; Ren, C.; Sawdey, M.D.; Cullen, K.A.; Loretan, C.; Jamal, A.; Homa, D.M. Tobacco Product Use and Associated Factors among Middle and High School Students—National Youth Tobacco Survey, United States, 2021. MMWR Surveill. Summ. 2022, 71, 1–29. [Google Scholar] [CrossRef] [PubMed]
- Kong, G.; Morean, M.E.; Cavallo, D.A.; Camenga, D.R.; Krishnan-Sarin, S. Sources of Electronic Cigarette Acquisition among Adolescents in Connecticut. Tob. Regul. Sci. 2017, 3, 10–16. [Google Scholar] [CrossRef] [Green Version]
- Williams, R.S.; Derrick, J.; Ribisl, K.M. Electronic Cigarette Sales to Minors via the Internet. JAMA Pediatr. 2015, 169, e1563. [Google Scholar] [CrossRef] [Green Version]
- Levinson, A.H.; Lee, J.G.L.; Jason, L.A.; DiFranza, J.R. Asking for Identification and Retail Tobacco Sales to Minors. Pediatrics 2020, 145, e20193253. [Google Scholar] [CrossRef]
- Agaku, I.T. A Rapid Evaluation of the US Federal Tobacco 21 (T21) Law and Lessons from Statewide T21 Policies: Findings from Population-Level Surveys. Prev. Chronic Dis. 2022, 19, 210430. [Google Scholar] [CrossRef]
- Cwalina, S.N.; Braymiller, J.L.; Leventhal, A.M.; Unger, J.B.; McConnell, R.; Barrington-Trimis, J.L. Prevalence of Young Adult Vaping, Substance Vaped, and Purchase Location Across Five Categories of Vaping Devices. Nicotine Tob. Res. 2020, 23, 829–835. [Google Scholar] [CrossRef]
- Braak, D.C.; Cummings, K.M.; Nahhas, G.J.; Heckman, B.W.; Borland, R.; Fong, G.T.; Hammond, D.; Boudreau, C.; McNeill, A.; Levy, D.T.; et al. Where Do Vapers Buy Their Vaping Supplies? Findings from the International Tobacco Control (ITC) 4 Country Smoking and Vaping Survey. Int. J. Environ. Res. Public Health 2019, 16, 338. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Mackey, T.K.; Miner, A.; Cuomo, R.E. Exploring the E-Cigarette e-Commerce Marketplace: Identifying Internet e-Cigarette Marketing Characteristics and Regulatory Gaps. Drug Alcohol Depend. 2015, 156, 97–103. [Google Scholar] [CrossRef] [PubMed]
- StataCorp. Stata Statistical Software: Release 17; StataCorp LLC: College Station, TX, USA, 2021; Available online: https://www.stata.com/support/faqs/resources/citing-software-documentation-faqs/ (accessed on 1 December 2022).
- Gaiha, S.M.; Henriksen, L.; Halpern-Felsher, B.; Rogers, T.; Feld, A.L.; Gaber, J.; Andersen-Rodgers, E. Sources of Flavoured E-Cigarettes among California Youth and Young Adults: Associations with Local Flavoured Tobacco Sales Restrictions. Tob. Control 2021, 31, 659–662. [Google Scholar] [CrossRef]
- Balwicki, L.; Smith, D.; Balwicka-Szczyrba, M.; Gawron, M.; Sobczak, A.; Goniewicz, M.L. Youth Access to Electronic Cigarettes in an Unrestricted Market: A Cross-Sectional Study from Poland. Int. J. Environ. Res. Public Health 2018, 15, 1465. [Google Scholar] [CrossRef] [Green Version]
- Baker, H.M.; Kowitt, S.D.; Meernik, C.; Heck, C.; Martin, J.; Goldstein, A.O.; Ranney, L. Youth Source of Acquisition for E-Cigarettes. Prev. Med. Rep. 2019, 16, 101011. [Google Scholar] [CrossRef] [PubMed]
- Dai, H.; Henriksen, L.; Xu, Z.; Rathnayake, N. Using Place-Based Characteristics to Inform FDA Tobacco Sales Inspections: Results from a Multilevel Propensity Score Model. Tob. Control 2021, 31, e148–e155. [Google Scholar] [CrossRef] [PubMed]
- Kozel, K.G.; Lee, J.G.L. Challenges in North Carolina’s Tobacco Retailer Youth Access Program. N. C. Med. J. 2017, 78, 345. [Google Scholar] [CrossRef] [PubMed]
- Duan, Z.; Romm, K.F.; Henriksen, L.; Schleicher, N.C.; Johnson, T.O.; Wagener, T.L.; Sussman, S.Y.; Schillo, B.A.; Huang, J.; Berg, C.J. The Impact of Recent Tobacco Regulations and COVID-19 Restrictions and Implications for Future E-Cigarette Retail: Perspectives from Vape and Vape-and-Smoke Shop Merchants. Int. J. Environ. Res. Public Health 2022, 19, 3855. [Google Scholar] [CrossRef]
- FDA Finalizes Enforcement Policy on Unauthorized Flavored Cartridge-Based e-Cigarettes That Appeal to Children, including Fruit and Mint. Available online: https://www.fda.gov/news-events/press-announcements/fda-finalizes-enforcement-policy-unauthorized-flavored-cartridge-based-e-cigarettes-appeal-children (accessed on 18 August 2022).
- Gaiha, S.M.; Lempert, L.K.; McKelvey, K.; Halpern-Felsher, B. E-Cigarette Devices, Brands, and Flavors Attract Youth: Informing FDA’s Policies and Priorities to Close Critical Gaps. Addict. Behav. 2022, 126, 107179. [Google Scholar] [CrossRef]
- Williams, R. The Rise of Disposable JUUL-Type e-Cigarette Devices. Tob. Control 2019, 29, e134–e135. [Google Scholar] [CrossRef]
- Berg, C.J.; Melena, A.; Wittman, F.D.; Robles, T.; Henriksen, L. The Reshaping of the E-Cigarette Retail Environment: Its Evolution and Public Health Concerns. Int. J. Environ. Res. Public Health 2022, 19, 8518. [Google Scholar] [CrossRef]
Total (n = 1296) | Retail (n = 559, 43.1%) | Social (n = 737, 56.9%) | Chi-Square, p-Value | ||||
---|---|---|---|---|---|---|---|
N | % | N | % | N | % | ||
Age (years) | 64.1, <0.001 | ||||||
15–17 | 463 | 36.1 | 131 | 28.3 | 332 | 71.7 | |
18–20 | 833 | 63.9 | 428 | 51.4 | 405 | 48.6 | |
Gender | 4.7, 0.029 | ||||||
Male | 594 | 46.5 | 276 | 46.3 | 318 | 53.7 | |
Female | 702 | 53.5 | 283 | 40.3 | 419 | 59.7 | |
Race/Ethnicity | 1.8, 0.1250 | ||||||
White, Non-Hispanic | 712 | 57.1 | 321 | 45.0 | 391 | 55.0 | |
Black, Non-Hispanic | 132 | 10.6 | 64 | 47.9 | 68 | 52.1 | |
Hispanic | 280 | 22.0 | 105 | 37.6 | 175 | 62.4 | |
Asian, Non-Hispanic | 58 | 4.7 | 23 | 39.6 | 35 | 60.4 | |
Another race/ethnicity | 71 | 5.7 | 26 | 36.6 | 45 | 63.4 | |
United States Census Region | 3.6, 0.014 | ||||||
East | 259 | 20.0 | 123 | 47.4 | 136 | 52.6 | |
Midwest | 303 | 23.5 | 123 | 40.6 | 180 | 59.4 | |
South | 528 | 40.6 | 242 | 45.8 | 286 | 54.2 | |
West | 206 | 15.8 | 71 | 34.4 | 135 | 65.6 | |
Urban-Rural Classification | 2.6, 0.050 | ||||||
Urban/city area | 364 | 28.1 | 161 | 44.1 | 203 | 55.9 | |
Area next to a city | 511 | 39.4 | 239 | 46.7 | 272 | 53.3 | |
Small town or rural area | 382 | 29.5 | 143 | 37.5 | 239 | 62.5 | |
Not sure | 39 | 3.0 | 16 | 41.1 | 23 | 58.9 | |
Perceived Financial Status | 0.4, 0.775 | ||||||
Don’t meet basic expenses | 158 | 12.2 | 64 | 40.4 | 94 | 59.6 | |
Just meet basic expenses with nothing left over | 441 | 34.0 | 197 | 44.7 | 244 | 55.3 | |
Meet needs with a little left over | 433 | 33.4 | 188 | 43.2 | 245 | 56.8 | |
Live comfortably | 264 | 20.5 | 110 | 41.8 | 154 | 58.2 | |
Most Recent E-cigarette device type | 7.9, <0.001 | ||||||
Pod-based | 254 | 19.6 | 113 | 44.3 | 141 | 55.7 | |
Disposable | 591 | 45.7 | 296 | 50.0 | 295 | 50.0 | |
Vape pen | 330 | 25.4 | 108 | 32.7 | 222 | 67.3 | |
Tank | 64 | 5.0 | 26 | 40.6 | 38 | 59.4 | |
Not sure | 57 | 4.4 | 16 | 28.0 | 41 | 72.0 | |
E-cigarette flavor | 6.3, 0.044 | ||||||
Fruit/candy/dessert only | 469 | 36.2 | 282 | 60.2 | 187 | 39.8 | |
Menthol/mint/ice only | 227 | 17.5 | 136 | 59.9 | 91 | 40.1 | |
Another flavor (tobacco, alcoholic, clove/ spice, some other flavor, or indicated use of more than one flavor) | 600 | 46.3 | 319 | 53.2 | 281 | 46.8 | |
Source of E-cigarette Acquisition | N/A | ||||||
Friend | 487 | 37.7 | N/A | N/A | 487 | 37.7 | |
Family member | 173 | 13.3 | N/A | N/A | 173 | 13.3 | |
Another person (not a friend or family member) | 77 | 5.9 | N/A | N/A | 77 | 5.9 | |
Vape shop | 286 | 22.0 | 286 | 22.0 | N/A | N/A | |
Gas station/convenience store | 206 | 15.9 | 206 | 15.9 | N/A | N/A | |
Grocery store | 21 | 1.6 | 21 | 1.6 | N/A | N/A | |
Internet/Online | 27 | 2.1 | 27 | 2.1 | N/A | N/A | |
Mall, shopping center kiosk, or some other place | 19 | 1.5 | 19 | 1.5 | N/A | N/A |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Do, E.K.; Aarvig, K.; Donovan, E.M.; Schillo, B.A.; Vallone, D.M.; Hair, E.C. Underage Youth Continue to Obtain E-Cigarettes from Retail Sources in 2022: Evidence from the Truth Continuous Tracking Survey. Int. J. Environ. Res. Public Health 2023, 20, 1399. https://doi.org/10.3390/ijerph20021399
Do EK, Aarvig K, Donovan EM, Schillo BA, Vallone DM, Hair EC. Underage Youth Continue to Obtain E-Cigarettes from Retail Sources in 2022: Evidence from the Truth Continuous Tracking Survey. International Journal of Environmental Research and Public Health. 2023; 20(2):1399. https://doi.org/10.3390/ijerph20021399
Chicago/Turabian StyleDo, Elizabeth K., Kathleen Aarvig, Emily M. Donovan, Barbara A. Schillo, Donna M. Vallone, and Elizabeth C. Hair. 2023. "Underage Youth Continue to Obtain E-Cigarettes from Retail Sources in 2022: Evidence from the Truth Continuous Tracking Survey" International Journal of Environmental Research and Public Health 20, no. 2: 1399. https://doi.org/10.3390/ijerph20021399
APA StyleDo, E. K., Aarvig, K., Donovan, E. M., Schillo, B. A., Vallone, D. M., & Hair, E. C. (2023). Underage Youth Continue to Obtain E-Cigarettes from Retail Sources in 2022: Evidence from the Truth Continuous Tracking Survey. International Journal of Environmental Research and Public Health, 20(2), 1399. https://doi.org/10.3390/ijerph20021399