Longitudinal investigation of the association between alcohol use and subsequent e-cigarette use among young adults in the United States.

Abstract

Few studies have considered whether alcohol use is associated with subsequent e-cigarette initiation and/or use. This study examined prospective associations between three past 30-day measures of alcohol use (any use, frequency, quantity) and two e-cigarette-related outcomes (initiation, current use). The sample included 3453 tobacco-naïve young adults aged 18-24 who completed Waves 6-7 (data collected 2021-2023 in the United States) of the nationally representative Population Assessment of Tobacco and Health Study. Multivariable logistic regression models examined associations between Wave 6 alcohol use and Wave 7 e-cigarette use, controlling for sociodemographic covariates. A total of 229 participants (5.9%) reported e-cigarette initiation at Wave 7, of which 148 (66.0%) reported current use. Wave 6 past 30-day alcohol use (versus none) and quantity, but not frequency, were significantly associated with Wave 7 e-cigarette initiation. None of the alcohol-related variables were significantly associated with current e-cigarette use at follow-up. Young adults who reported past 30-day alcohol use and those who typically consumed more drinks per occasion were more likely to initiate e-cigarette use. E-cigarette-related prevention efforts should include targeted messaging for young adults who drink, and alcohol-related interventions should highlight e-cigarette uptake as a potential consequence of alcohol consumption.