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Understanding the association between initial experimentation with a tobacco product and subsequent patterns of tobacco use among youth is important to informing prevention activities for youth in the US. We conducted an online survey from August to October 2017 among youth aged 13–18 years. The current analysis focused on respondents reporting initial experimentation with any tobacco product (n = 2,022). Using multinomial logistic regression, we examined the association between first tobacco product tried (cigarettes; cigars including cigarillos, little cigars, and bidis; electronic nicotine delivery systems (ENDS); smokeless and chewing tobacco; or hookah) with subsequent patterns of tobacco use while adjusting for covariates. Of the youth who experimented, 56.8% were non-current tobacco users. Of current tobacco users (n = 934), 13% were exclusive ENDS users, 5.3% exclusive combustible mono-users, 13.4% ENDS plus combustible poly-users, 3.3% combustible product only poly-users, and 8.2% other tobacco poly-users. The most common type of first tobacco product tried was ENDS (44.7%), followed by cigarettes (35.0%) and cigars (8.6%). Those who experimented with combustible tobacco products were less likely to be exclusive ENDS users [Relative Risk Ratio (RRR) = 0.46; 95% CI = 0.28, 0.73 for cigarettes; RRR = 0.32; 95% CI = 0.13, 0.81 for cigars; and RRR = 0.33; 95% CI = 0.14, 0.79 for hookah] when compared to non-current tobacco users (reference group). Tobacco product choices for initial experimentation appear to play a role in subsequent tobacco use patterns among youth. Understanding the reasons behind initial product choice may inform our understanding regarding the reasons for subsequent current tobacco product use, thus informing youth prevention efforts. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine perceptions including knowledge, attitudes, and beliefs about e-cigarettes among ethno-culturally diverse Latino adults living in the US, a rapidly growing minority group for which we know little about their e-cigarette perceptions. A total of 25 focus groups with Latinos (n = 180; ages 18–64 years) were conducted in 2014. E-cigarettes users and non-users were recruited via purposive sampling techniques. Participants completed brief questionnaires on sociodemographic factors and tobacco use. Focus group discussions were conducted in English and Spanish, audio-recorded, and transcribed. Data were analyzed using thematic analysis procedures. Participants were of diverse Latino backgrounds. Over one-third (35%) reported current cigarette smoking and 8% reported current e-cigarette or hookah use. Nonsmokers reported experimenting with e-cigarettes and hookah during social occasions. Participants' perceptions towards e-cigarettes were generally formed in comparison to conventional cigarettes. Perceived benefits of using e-cigarettes included their utility as a smoking cessation aid, higher social acceptability, and lower harm compared to conventional cigarettes. Negative perceptions of e-cigarettes included lower overall satisfaction compared to conventional cigarettes and high content of toxins. Socio-cultural factors (e.g. gender roles, familismo, and simpatía) also influenced perceptions of e-cigarette of study participants. Overall, Latino adults knew relatively little about the potential health risks associated with e-cigarette use. The limited knowledge about and misinformation of e-cigarettes among this rapidly growing minority group have important public health implications. Findings may inform culturally tailored health communication campaigns, which are much needed among underserved US Latino populations in light of low effectiveness of tobacco control and regulatory efforts. [ABSTRACT FROM AUTHOR]

Background: The prevalence of electronic cigarette use has grown over the past decade, with some users reportedly initiating e-cigarette use primarily due to flavors. This study examined the role of flavors in initiation among adult e-cigarette users, as well as the association of flavors with satisfaction and perceived addiction to vaping.Methods: The analysis sample consisted of 1492 current e-cigarette users aged 18 or older, drawn from an online quantitative survey conducted in 2016. Multivariable logistic regression and general linear models were used.Results: Most current e-cigarette users (62.9%) typically used flavors other than tobacco (including fruit, mint/menthol, sweet, candy, coffee and other), 24.2% typically used tobacco flavors, and 12.9% typically used non-flavored e-cigarettes. Flavor was a common reason for vaping initiation, selected by 29.5% of the sample. Flavor, particularly fruit flavor, was more likely to motivate young adults 18-24 to initiate vaping compared adults 35-44. Those who used flavors, particularly mint/menthol and flavors other than tobacco flavor, had higher odds of reporting high satisfaction with vaping and had higher odds of perceived addiction to vaping than respondents who did not use flavored e-cigarettes.Conclusions: Users of flavored e-cigarettes reported greater satisfaction and self-perceived addiction than users of non-flavored e-cigarettes. The appeal of flavors, particularly among young adults, has implications for regulatory policy regarding the marketing and promotion of flavored products. These findings may provide direction for the Food and Drug Administration's plans to restrict flavors other than menthol, mint, and tobacco. [ABSTRACT FROM AUTHOR]