Perceptions of Health Risks and Accessibility: A Social Media-Based Pilot Study of Factors Influencing Use of Vaping and Combustible Tobacco Products

Enitan Banjo, Zoya Ahadian, Nikita Kasaraneni, Howard Chang, Sarala Perera, Kristen Emory and Laura E. Crotty Alexander ()
Additional contact information
Enitan Banjo: Department of Health Sciences, California State University, Dominguez Hills (CSUDH), Carson, CA 90747, USA
Zoya Ahadian: Department of Medicine, Division of Pulmonary, Critical Care, Sleep and Physiology, University of California San Diego (UCSD), San Diego, CA 92093, USA
Nikita Kasaraneni: Department of Medicine, Division of Pulmonary, Critical Care, Sleep and Physiology, University of California San Diego (UCSD), San Diego, CA 92093, USA
Howard Chang: Department of Medicine, Division of Pulmonary, Critical Care, Sleep and Physiology, University of California San Diego (UCSD), San Diego, CA 92093, USA
Sarala Perera: Department of Medicine, Division of Pulmonary, Critical Care, Sleep and Physiology, University of California San Diego (UCSD), San Diego, CA 92093, USA
Kristen Emory: Department of Health Sciences, California State University, Dominguez Hills (CSUDH), Carson, CA 90747, USA
Laura E. Crotty Alexander: Department of Medicine, Division of Pulmonary, Critical Care, Sleep and Physiology, University of California San Diego (UCSD), San Diego, CA 92093, USA

IJERPH, 2025, vol. 22, issue 5, 1-11

Abstract: The prevalence of e-cigarette use (vaping) in young adults is concerning, particularly because the initiation of combustible tobacco use is higher in e-cigarette vapers. It is unclear why young, never-smoker vapers decide to start smoking cigarettes, but they may be influenced by perceptions of health risks and accessibility. We designed a social media questionnaire to assess factors driving the initiation of combustible tobacco use by e-cigarette vapers (multi-inhalant use) and switches between inhalant types. Respondents reported an earlier initiation of combustible tobacco versus vaping (18 vs. 19, respectively, p < 0.0001), greater ease of obtaining combustibles versus vaping products ( p < 0.01), and pleasure of vaping being equivalent to that of smoking. The majority of subjects (57%) reported smoking first prior to adding vaping devices, 32% reported initiating both smoking and vaping within 12 months of one another, and 11% reported initiating vaping first. Among respondents (n = 864) who switched from vaping to smoking (n = 104), the primary reasons included 1. the perception that smoking was healthier (44%) and 2. greater accessibility of cigarettes (40%). For those who switched from smoking to vaping (n = 178), the predominant motivations included 1. having friends or family who vape (40%) and 2. the perception that vaping was healthier (36%). Among multi-inhalant users (n = 223), key factors driving this behavior included 1. increased enjoyment (47%) and 2. greater variety (42%). Our findings imply that there is no single, dominant reason driving the initiation of combustible use or switching from one inhalant to another. Further, tobacco users are receiving mixed messaging, leading many to believe that combustible tobacco is the healthier option. Public health interventions are needed to prevent the initiation of e-cigarette vaping by youth and to educate the public about the health effects of tobacco products.

Keywords: tobacco; e-cigarette vaping; cigarette smoking; multi-inhalant use; cessation; adolescents (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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