A Pilot Feasibility Study of an Online Youth Tobacco Survey Administration among High School Students.

The COVID-19 pandemic restrictions forced many schools to shift to remote or hybrid learning, disrupting surveillance systems such as the New Jersey Youth Tobacco Survey, traditionally administered in schools by paper and pencil. In spring 2021, we conducted a feasibility study among a convenience sample of six public high schools to assess the use of an online survey to allow for remote participation. In each school, 4 to 6 classes were selected randomly, and all students within a sampled class were selected to participate in the survey. A total of 702 students completed surveys. School contacts were asked to provide qualitative feedback about the survey administration. Feedback was generally positive, with a few suggestions for improvement. Approximately 19% of students reported the ever use of e-cigarettes. Among current e-cigarette users, there was a shift in popularity from prefilled or refillable pods or cartridges (23.3%) to disposable e-cigarettes (53.5%). Less than 10% of current e-cigarette users reported using tobacco-flavored e-cigarettes, despite a statewide flavor ban on all other flavors.

Examining the Survey Setting Effect on Current E-Cigarette Use Estimates among High School Students in the 2021 National Youth Tobacco Survey.

The 2021 National Youth Tobacco Survey (NYTS) was completed by youth online during class time, either in school or at home due to the COVID-19 pandemic. Given the role of NYTS data in tobacco regulatory science, it is vital to understand the effect of survey settings (home, school) on tobacco-use estimates. We used a series of multivariable logistic regressions to examine whether survey settings (home vs. school) predicted current e-cigarette use among high school students, controlling for other known predictors of e-cigarette use as well as the pandemic learning model that was dominant in students' counties (e.g., nearly all at-home, majority in school). We observed a significant survey setting effect. Those who completed the survey in school had higher odds of current e-cigarette use than those who completed the same survey at home (AOR = 1.74); this effect was attenuated when we controlled for the pandemic learning model (AOR = 1.38). Moreover, e-cigarette use was independently associated with students' learning model; students whose schools were nearly entirely in-person had the highest odds of e-cigarette use compared to students whose learning model was nearly all at-home (AOR = 1.65). Survey setting is a methodological artifact in the 2021 NYTS. Perceived privacy and peer effects can potentially explain this artifact.

Over 1 year later: smokers' EVALI awareness, knowledge and perceived impact on e-cigarette interest.

OBJECTIVES: The e-cigarette or vaping product use-associated lung injury (EVALI) outbreak caused serious lung injuries in over 2800 people in the USA in 2019. By February 2020, most cases were determined as linked with vaping tetrahydrocannabinol (THC), including black market products using vitamin E acetate. This study examined smokers' EVALI awareness, knowledge and perceived impact on their e-cigarette interest approximately 16 months after its peak. DESIGN: Between January and February 2021, we surveyed 1018 adult current smokers from a nationally representative US research panel. Participants were asked if they had heard about EVALI prior to COVID-19, knew its main cause, and if EVALI had impacted their interest in future e-cigarette use. RESULTS: Approximately 54% of smokers had heard of EVALI. Among those who had heard of EVALI (n=542), 37.3% believed its main cause was e-cigarettes used to vape nicotine, like JUUL. Fewer (16.6%) thought the main cause was products for vaping marijuana/THC, and 20.2% did not know. About 29% had heard vitamin E acetate was associated with EVALI, and 50.9% indicated EVALI made them less interested in using e-cigarettes in the future. EVALI awareness was significantly associated with e-cigarette risk perceptions (ie, that e-cigarettes are as harmful as smoking). CONCLUSIONS: Despite the passage of time, considerable lack of knowledge and misperceptions about EVALI remain among those who smoke. Our findings suggest the need for continued efforts to promote better understanding of EVALI and appropriate behavioural and policy responses.