Harm perceptions of secondhand e-cigarette aerosol among youth in the United States

Delvon T. Mattingly, Osayande Agbonlahor, Jayesh Rai, Joy L. Hart, Alison C. McLeish, Kandi L. Walker

Research output: Contribution to journalArticlepeer-review


E-cigarette use among youth remains a public health concern. Although extant literature has examined the perceived harms of cigarette use and secondhand smoke, perceptions of harms associated with secondhand e-cigarette aerosol (SHA) are not well understood. Therefore, we used data from the 2020 U.S. National Youth Tobacco Survey (n = 13,292) in which participants indicated whether SHA caused no harm, little harm, some harm, or a lot of harm. We dichotomized SHA harm perceptions as harmless vs harmful. We included sociodemographics (i.e., age, sex, race/ethnicity, sexual orientation, urbanicity), e-cigarette use characteristics, and SHA exposure as covariates and estimated associations between SHA harm perceptions and each covariate using adjusted logistic regression. Most youth perceived SHA as harmful (87.9 %) compared to harmless (12.1 %). Older youth (vs younger youth) had higher odds of perceiving SHA as harmless, whereas male (vs female) youth had 49 % higher odds (95 % CI: 1.29–1.72) of perceiving SHA as harmless. As the number of days of e-cigarette use in the past 30 days increased (vs non-users), odds of perceiving SHA as harmless increased. Youth exposed to SHA (vs no exposure) in the past 30 days had 35 % higher odds of perceiving SHA as harmless (95 % CI: 1.16–1.57). To conclude, youth SHA harm perceptions varied overall and by sociodemographic characteristics, e-cigarette use, and SHA exposure. Educational campaigns to inform youth of the health risks associated with e-cigarettes and SHA are needed to reduce overall nicotine intake and disparities in nicotine exposure.

Original languageEnglish
Article number107535
JournalAddictive Behaviors
StatePublished - Feb 2023

Bibliographical note

Funding Information:
This research was supported, in part, by grants from the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH) and the Food and Drug Administration Center for Tobacco Products (U54HL120163), the National Institute of Environmental Health Sciences (NIEHS) of the NIH (P42 ES023716), and the American the American Heart Association (20YVNR35500014). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, the Food & Drug Administration, or the American Heart Association. The funding sponsors had no role in study design; data collection, analyses, or interpretation; manuscript preparation; or the decision to publish the results.

Publisher Copyright:
© 2022 Elsevier Ltd


  • Disparities
  • E-cigarette
  • Harm perceptions
  • Secondhand aerosol
  • Tobacco
  • Vaping

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Clinical Psychology
  • Toxicology
  • Psychiatry and Mental health


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