Informing the regulation of e-cigarettes to restrict youth access

Aims: The FDA proposes to regulate e-cigarettes, with a focus on protecting youth. To better inform the FDA, we evaluated how adolescents obtain e-cigarettes, where they use e-cigarettes, and how they view e-cigarettes. Methods: We conducted surveys in 5 high schools and 2 middle schools in CT (N = 5152) in Spring 2014 to assess these important issues. The sample was 51% female and 15.3 (SD = 1.9) years old. Results: Among lifetime-e-cigarette users (23%), 37% reported obtaining e-cigarettes from friends, 13% from tobacco shops, 9% from gas stations, and 7% from online stores. Among adolescents (n = 429) or an online store (n = 367), 77% and 89%, respectively, reported that they were not denied purchase. Lifetime e-cigarette users reported using e-cigarettes in their home (51%), school (25%) and public places where smoking is not allowed (24%). Among the total sample, the availability of different flavors (17%), ability to do smoke tricks (14%), and the ability to customize flavors (9%) were the top appealing components of e-cigarettes. Logistic regression analyses showed that lifetime e-cigarette users were more likely than never-users to view the availability of different flavors (OR = 94.07), the ability to do smoke tricks (OR = 218.74), and the availability of odorless vapors (OR = 4.25) as appealing; whereas, non-users were more likely than lifetime users to view external features of e-cigarettes, such as its shape (OR = 5.11) and the ability to “light up” (OR = 4.38) as appealing. Conclusions: The findings underscore the need to regulate ecigarette sales to minors, including online purchases, and prohibit e-cigarette use indoors where cigarette smoking is prohibited. Furthermore, restricting various flavors, eliminating visible vapors, and reducing the appeal of the e-cigarette design may lessen youth interest