Health Care Provider E-Cigarette-Related Advice and E-Cigarette Harm Perceptions Among Youth

Purpose: Health care providers (HCP) are uniquely positioned to advise against electronic cigarette (e-cigarette) use, potentially influencing youth perceptions of e-cigarette harms. However, research examining these associations is scant. We examined whether HCP e-cigarette-related advice is associated with youth e-cigarette harm perceptions. Design: Cross-sectional study. Setting: National Youth Tobacco Survey data (2022). Subjects: 21,254 youth aged 9-18 years. Measures: E-cigarette harm perceptions (i.e., relative addictiveness, occasional use harm, and secondhand e-cigarette aerosol (SHA) harm) and HCP advice to abstain from using e-cigarettes (yes/no) were assessed. Analysis: Adjusted odds ratios were estimated using multinomial logistic regression models. Results: Among the sample, 33.9% perceived e-cigarettes as equally addictive to cigarettes, 39.9% perceived occasional e-cigarette use to cause a lot of harm, and 23.3% perceived SHA to cause a lot of harm. Youth who received HCP advice had higher odds of perceiving e-cigarettes as more addictive than cigarettes (OR: 1.64, 95% CI: 1.35-2.00) and causing a lot of harm (OR: 1.49, 95% CI: 1.16-1.90). Youth who received HCP advice had higher odds of perceiving SHA causing little harm (OR: 1.23, 95% CI: 1.04-1.44). Conclusion: HCP advice was associated with youth e-cigarette harm perceptions and perceptions that SHA causes little harm. HCP e-cigarette counseling may help inform understanding of harms, which may reduce or prevent use.