Initial Subjective Response to Nicotine Vaping Predicts Subsequent E-Cigarette Use in Early Adolescence: An ABCD Investigation.

Abstract

Introduction: Differences in sensitivity to substances are important for understanding variability in addiction propensity. The value of modeling subjective response to nicotine, particularly e-cigarettes, at first use as a predictor of future use remains largely untested.

Methods: This secondary analysis of the Adolescent Brain Cognitive Development (ABCD) Study data included 147 youth (51% female; mean age=13 at first assessment) who reported vaping of an e-cigarette and provided subjective response to that experience during the 4-years of baseline and annual follow-up data currently available. Analyses evaluated the longitudinal relationships between subjective response to vaping and subsequent annual e-cigarette episodes (i.e., quantity) and use days (i.e., frequency) using semi-parametric Bayesian mixture models. Effects were estimated at quantiles (25th, 50th, and 75th) of the e-cigarette use outcomes, representing lower, average (i.e., median), and higher use.

Results: Greater pleasurable sensations to vaping at first use predicted greater past-year e-cigarette use for all participants, with youth endorsing higher use exhibiting stronger relationships (βLower use=0.07-0.10; βMedian use=0.37-0.75; βHigher use=22.3-61.4). Greater initial unpleasant sensations to vaping also predicted greater subsequent use (βLower use=0.16-0.19; βMedian use=0.54-0.74). Among youth endorsing higher use, unpleasant subjective response was associated with future use quantity (β=22.00), but not frequency.

Conclusions: These findings suggest that initial subjective response to nicotine vaping in youth is a strong predictor of e-cigarette use behavior up to four years later, particularly in those endorsing higher use. This knowledge can be used to enhance early prevention efforts to reduce e-cigarette use in this vulnerable population.

Implications: This study advances initial subjective response to nicotine vaping in youth as a strong predictor of future e-cigarette use behavior, particularly in youth endorsing higher use. This knowledge can be used to help identify risk and protective factors for nicotine use, as well as enhance early prevention efforts to reduce e-cigarette use in this vulnerable population.