Reasons to use e-cigarettes among adults and youth in the Population Assessment of Tobacco and Health (PATH) study

Background: While e-cigarette use is increasing, reasons to use e-cigarettes are poorly summarized in the literature. The objective of this study was to organize reasons to use e-cigarette items into factors and determine associations between these factors and e-cigarette user characteristics. Methods: Data were drawn from youth (12-17) and adults (18 +) in Wave 1 (2013-2014) of the Population Assessment of Tobacco and Health (PATH) study. Exploratory factor analysis was conducted on 13 reasons to use survey items from experimental and established adult e-cigarette users and past 30 day youth e-cigarette users to determine two factors - "alternative to cigarettes" and "larger social environment". Weighted linear regression models tested the associations between e-cigarette user group and sociodemographics and reasons to use factors among youth and adults. Results: Adult current established e-cigarette users were associated with both alternative to cigarettes (beta = 0.128, p < .001) and larger social environment (beta = 0.063, p < .001) factors, while former established e-cigarette users were associated with alternative to cigarettes (beta = 0.064, p < .001). Several adult socio-demographic characteristics were associated with one but not the other factor, or both but in opposite directions. Youth that used e-cigarettes earlier today were also associated with both reasons to use factors (beta = 0.127-0.130, p < .01, each); however, youth using any other day in the past 30 days was not associated with either factor. Conclusions: Reasons to use are associated with patterns of e-cigarette use among youth and adults. These factors could support a comprehensive approach to addressing rising e-cigarette use among youth and adults and target certain user populations.