J Adolesc Health. 2025 Dec 5:S1054-139X(25)00500-2. doi: 10.1016/j.jadohealth.2025.10.019. Online ahead of print.
ABSTRACT
PURPOSE: E-cigarette use has surged among US adolescents, with over two million reporting current use in 2023. Although factors such as curiosity, peer influence, and flavored products have been well-documented, less is known about how motivations for initiation and continued use vary across demographic subgroups. This study examines demographic-specific motivations for both initiation and continued use of e-cigarettes among adolescents in the United States.
METHODS: We analyzed data from the 2023 National Youth Tobacco Survey, using chi-square (χ2) tests to examine the relationship between demographic variables (sex, race/ethnicity) and reasons for e-cigarette initiation and current use.
RESULTS: Curiosity (26%) and peer influence (19%) emerged as leading reasons for e-cigarette initiation. For continued use, the top reasons were to get a high or a buzz from nicotine (31.5%) and feeling anxious, stressed, or depressed (22%). However, distinct patterns emerged by demographic groups. Female adolescents were more likely to cite emotional distress as a motivator for both initiation and continued use, whereas male adolescents more frequently reported curiosity and peer influence. Black adolescents were significantly influenced by peers, whereas White adolescents were more likely to endorse using e-cigarettes for nicotine “high.” Hispanic adolescents more often cited curiosity, whereas non-Hispanic peers were more affected by peer and family influence.
DISCUSSION: These findings underscore the need for targeted prevention strategies grounded in behavioral theory. Tailored interventions addressing mental health, peer dynamics, and curiosity, especially among racially and ethnically diverse adolescents, are vital to reducing youth vaping rates.
PMID:41351616 | DOI:10.1016/j.jadohealth.2025.10.019
