Age differences in electronic nicotine delivery systems (ENDS) usage motivations and behaviors, perceived health benefit, and intention to quit

Introduction: Data from comprehensive studies are sparse regarding age differences in issues related to electronic nicotine delivery systems (ENDS) usage. This study examined age differences in usage motivations and behaviors, perceived health benefit, and quit intentions in a large and diverse sample recruited online. Methods: The sample included 1,432 current ENDS users, ages 18–64, drawn from a national online survey conducted in 2016. Descriptive and multivariable analyses were used. Results: The sample included participants in the following age groups: 18–24 (17.5%), 25–34 (38.6%), 35–44 (23.3%), and 45–64 (20.7%). With multiple adjustments, the 18–24 age group was more likely to vape for reasons such as flavors or friends’ use, and to use multiple flavors and products with varying nicotine content. For example, the odds (95% CI) of vaping initiation due to flavor attraction vs. other reasons in the 18–24 age group were 1.40 (1.02–1.92), 2.73 (1.85–3.99), and 2.12 (1.41–3.18) compared to the 25–34, 35–44, and 45–64 age groups, respectively. In contrast, compared to older age groups, the 18–24 age group was less likely to use ENDS as an alternative to cigarettes or as a quitting device; they also used ENDS less frequently and perceived less health benefit of ENDS use. The 18–24 age group, especially those who had only used ENDS, had the lowest odds of likely quitting use of tobacco/nicotine products compared to other groups (lower by 44–73%). Conclusion: There were significant age differences in ENDS usage motivations and behaviors, perceived health benefit, and quit intentions.