Introduction
Changes to federal legislation allowed nicotine-based e-cigarettes legal entry into the Canadian market in 2018. This included pod-type e-cigarettes (pods), such as JUUL, that were later found to be associated with steeply increasing prevalence and greater frequency of e-cigarette use among US and Canadian youth. Multiple studies of risk factors of JUUL use and use initiation have been conducted among various population groups in the US, but little evidence exists pointing to similar risk factors of pod use among Canadian youth and young adults. Understanding these risk factors can inform use prevention and intervention strategies in Canadian and other jurisdictions.
Methods
A total of 668 Canadian youth and young adults recruited by the 2018-19 Youth and Young Adult Panel Study were provided a baseline survey 3 months before and a follow-up survey 9 months after the relaxation of federal nicotine e-cigarette regulations. We used multivariable logistic regression to understand and rank importance of baseline predictors of future pod use among respondents.
Results
Past-month cannabis use (OR [odds ratio] = 2.66, 95% CI: 1.66–4.21, p < 0.001), established cigarette use (OR = 3.42, 1.53–7.65, p < 0.01), past cigarette experimentation (OR = 2.40, 1.34–4.31, p < 0.01), having many friends who vaped (OR = 2.15, 1.37–3.34, p < 0.001), age below 18 compared to age over 22 (OR = 5.26, 2.63–10.00, p < 0.001) and male sex (OR = 1.69, 1.16–2.50, p < 0.01) were significant and the most influential predictors of future pod use.
Conclusion
Similar factors drove pod use among Canadian and US youth and young adults. Appropriate preventive strategies can benefit from considering polysubstance use among high school–aged youth.