Correlates of ever and current use of emerging tobacco products among Mississippi youth

Background: Recently, snus and electronic cigarettes have been introduced to the US market, while waterpipes have gained popularity. The purpose is to assess use of these products among youth and identify demographic, behavioral, and situational predictors of use.

Methods: We administered the Mississippi Youth Tobacco Survey to high school students in the Fall of 2011. We applied a multi-stage sample design with public schools selected with a probability proportional to enrollment size. We randomly selected Classrooms within schools and all students in selected classes were eligible for participation. Data were collected by means of anonymous, self-administered questionnaires.

Results: 90% of sampled schools and 79% of sampled students participated (overall response rate 71%). Ever use for hookah, snus, and e-cigarettes was 4.4%, 8.5%, and 5.9%, respectively; and current use was 1.6%, 3.7%, and 2.3%. Bivariate analyses demonstrated ever use of these products tended to be higher for males, whites, and those in higher grades. Significant behavioral and situational predictors of ever use included current cigarette smoking, being a susceptible nonsmoker, living in home that allowed smoking, past 7 day SHS exposure, at least one of closest four friends smokes, believing that smoking helps you look cool, and regarding secondhand smoke as not very harmful.

Conclusions: Use of these products raises concerns about students being at risk for nicotine dependence or maintaining their dependence. Greater awareness of emerging tobacco product prevalence and high risk characteristics might inform efforts to determine public health policy and regulatory action.