E-Cigarettes and Other Teen Drug Use

E-cigarettes and vaporizers went from virtually non-existent among teens in 2010 to a fairly common phenomenon a few years later. In 2014, over 15% of high schoolers had used e-cigarettes in the past 30 days.


E-cigarettes are battery-powered devices with a heating element that produces an aerosol, or vapor, that users inhale. The specific contents of the vapor are often not disclosed and are currently unregulated.  The liquid that is vaporized in e-cigarettes can contain nicotine and comes in flavors, such as bubble gum and milk chocolate cream, that may be attractive to teens.


In a recent study, YSI researchers ask what other types of substance use are common for teens who use e-cigarettes. They look at e-cigarette use and the concurrent use of the four most commonly used substances: marijuana, alcohol, tobacco cigarettes, and prescription drugs. Then they use relatively new ways to analyze the data by seeing what patterns of use can be found among e-cigarette users. In particular they explore whether these young e-cigarette users are (a) youth who do not use traditional drugs of abuse or (b) polysubstance users.


The study examines surveys by adolescents in 8th, 10th, and 12th grades in the US. Altogether the answers come from 16,615 participants in the 2014 Monitoring the Future survey. Data are analyzed separately for each grade and are nationally representative. Using latent class analysis, the study can identify classes (or types) or substance users for each grade.


The results show that in general youth who use e-cigarettes are highly likely to use other substances as well. Youth in 8th grade who had had an e-cigarette in the past 30 days were 10 times more likely (than youth with no e-cigarette use in the past 30 days) to have smoked cigarettes in the past 30 days; in 10th grade it was 8 times higher and in 12th grade 6 times higher. Binge drinking, marijuana use, and prescription drug abuse in the past 30 days were at least four times higher among e-cigarettes users in 8th and 10th grades, and at least three times higher in 12th grade.


To the question whether these young e-cigarette users (a) come from the large pool of youth who do not use traditional drugs of abuse or (b) are polydrug users, the answer is both. The study finds that the proportion coming from each group differs by grade level. Youth who do not use traditional drugs of abuse account for about 50% of e-cigarette users in 8th grade, 35% in 10th grade, and 17% in 12th grade. These past 30-day e-cigarette users come from the “low-level users” class, characterized by low probability of use for all substances.  Other e-cigarette users come from a smaller, “poly-users” group found characterized by a higher likelihood of using e-cigarettes and other drugs. In 12th grade an additional group emerges, labeled “predominant e-cigarette users.” This group of e-cigarette users falls between the low level group and poly-substance group in terms of probability for binge drinking, cigarette use, and marijuana use.


In conclusion, among younger adolescents in 8th and 10th grades, 35% to 50% of e-cigarette users do not use any other traditional drugs of abuse. These grades are strategic for future panel studies to determine whether e-cigarette use is a risk factor or a protective factor for transition to the use of other substances.


Miech, R. A., O’Malley, P. M., Johnston, L. D., & Patrick, M. E. (2016). E-cigarettes and the drug use patterns of adolescents. Nicotine & Tobacco Research, 18(5), 654-659. doi: 10.1093/ntr/ntv217. http://www.ncbi.nlm.nih.gov/pubmed/26416823