E-cigarette use and other risk factors associated with tobacco smoking susceptibility among Australian adolescents
Maree Scully, Elizabeth Greenhalgh, Emily Bain, Melanie Wakefield, Sarah Durkin, Victoria White
Abstract
OBJECTIVE: To explore risk factors for smoking susceptibility among Australian adolescents to inform prevention policies and programs. METHODS: Cross-sectional survey of students aged 12-17 years who reported having never smoked (n=4,171). Bivariate associations between smoking susceptibility and a range of factors previously linked to youth smoking and smoking susceptibility were initially examined, with significant factors (p<0.05) included in a final multivariable logistic regression model. RESULTS: Eleven percent of adolescents who had never smoked were susceptible to smoking. Smoking susceptibility was independently associated with ever use of e-cigarettes (adjusted odds ratio [AOR]=3.26, 95% confidence interval [CI]: 1.83-5.81), perceiving those who smoke to be more popular (AOR=2.87, 95% CI: 1.62-5.10), having a close friend/s who smokes (AOR=2.66, 95% CI: 1.61-4.40), not perceiving smoking one or two cigarettes occasionally as personally dangerous (AOR=2.56, 95% CI: 1.61-4.09), and having symptoms of depression (AOR=1.59, 95% CI: 1.06-2.38). CONCLUSIONS: The strongest smoking-initiation risk factor identified was ever use of e-cigarettes, with social norms, harm misperceptions around low-rate tobacco use and mental health also linked to smoking susceptibility. IMPLICATIONS FOR PUBLIC HEALTH: Stronger e-cigarette regulations that reduce promotion to and access by youth, as well as interventions addressing the other identified risk factors, may help prevent future smoking uptake among Australian adolescents.