E CIGARETTE HEALTH CRISIS: WHAT DO WE KNOW ABOUT THE RISK PERCEPTIONS, ATTITUDES, NORMS, AND USE OF E CIGARETTES AMONG COLLEGE STUDENTS Dr. Taejin Jung, Dr. Minhao Dai, and Dr. Katherine Thweatt , State University of New York at Oswego Findings E cigarette use and its averse consequencesE cigarettes have rapidly become the most common tobacco products used by youth, exceeding the prevalence of combustible tobacco. 3.62 million high and middle school students (20.8% among high school students and 4.9% among middle school students) were current users of e cigarettes and other Electronic Nicotine Delivery Systems (ENDS) (Walley, Wilson, Winickoff, & Groner , 2019). E cigarette use increases risk for cough, wheezing, asthma exacerbations, and severe pulmonary disease (Report, 2018). The purpose of this research is to understand college studentsâ€™ perception and use e cigarette, main reasons and influencers of (not) using e cigarette, and main situations of prompting e cigarette use. Research QuestionsRQ1. How do college students perceive and use e cigarettes? RQ2. What are the reasons (not) of using e cigarettes? RQ3. What are the situations prompting e cigarette use? RQ4. Who are the influencers of using e cigarettes? RQ5. Are there differences of perceptions, uses, situations and influencers of e cigarette use between nonsmokers and non smokers? Research MethodsData collection: Online survey through Qualtrics with the survey distribution support by the Institute of Research and Assessment of SUNY Oswego. Measurement: Standardized survey questionnaire to measure demographic and e cigarette perception and use related variables. Sampling: Convenient sampling from SUNY Oswego students. Data collection period: December 2019. Sample size: 879 (About 10% response rate) Incentive: $10 cash rewards for 25 randomly selected respondents. Data analysis: SPSS was used to do descriptive and analytical analysis (e.g., Chi square test and t test). â€¢ Respondentsâ€™ average age is 21.4 years old. â€¢ Among respondents, majority of them are female (61%) and white (75.5%). â€¢ Students of all four undergraduate years and graduates responded. Among them, seniors responded most (29.7%). â€¢ Most students live at residence hall (49.2%) and privately owned apartment or house (44.1%). â€¢ Average age of the first ecigarette use is 18.1 years old. The typical age of incoming freshmen in U.S. college is 18 or 19. â€¢ Most current e cigarette smokers use e cigarette for â€œ1 3 years (57.3%)â€, followed by â€œ1~3 months (15.2%)â€ and â€œless than 3 months (11.8%).â€ â€¢ About one out of three respondents live with e cigarette smokers (37.7%) and allow smoking inside their residency (34.7%). â€¢ About six out of ten (58.6%) respondents think e cigarettes contain more nicotine than traditional tobacco products, while about three out of ten think about the same level of nicotine was included (32.3%). â€¢ 22.3% of respondents are current e cigarette smokers and 8.8% of them was ex e cigarette smokers and didnâ€™t smoke for the past three months. â€¢ Menthol/Mint is the most favored e cigarette flavor (60.8%) followed by fruit (14.6%) and cocktail of multiple flavors (10.1%). â€¢ Nine out of ten respondents use e cigarette with alcohol sometimes (55.3%) or always (32.0%). â€¢ About half of respondents use e cigarette with marijuana sometimes (36.5%) or always (14.8). â€¢ â€Easy to useâ€, â€œvariety of flavorsâ€, â€œfriends use themâ€, â€œget a buzzâ€, â€œlack of bad smellâ€, â€œgreater social acceptabilityâ€, â€œrelieve stressâ€, â€œsleek designâ€ and â€œcuriosityâ€ are main reasons to use e cigarette products among other reasons. â€¢ Vaping related negative health consequences (e.g., respiratory diseases, cancer/heart diseases, skin aging) are the main reasons of not using e cigarette products. When comparing smokers and nonsmokers â€¢ â€Social gathering â€œ and â€œbeing with friends who vapeâ€ are the two main situations that make people to smoke ecigarette more. â€¢ Parents followed by partners, siblings and friends are the main influencers of not using e cigarette. â€¢ E cigarette smokers are more likely to live with smokers (72% vs. 27.9%). â€¢ E cigarette smokers are more likely to allow other smokers to smoke in the living quarter (48.9% vs. 30.6%). â€¢ Non smokers are more like to think that e cigarette has same or lesser level of nicotine than traditional tobacco (42.8% vs. 36.6%). â€¢ E cigarette smokers are younger than non e cigarette smokers (20.69 vs. 21.68 age old). â€¢ Feeling of financial security is not a meaningful factor of using e cigarette. â€¢ E cigarette smokers have more close friends who smoke than non e cigarette smokers (4.16 vs. 2.39 people). â€¢ More none cigarette smokers support for the current e cigarette smoking policy like the e cigarette flavor ban than e cigarette smokers. [Conclusions and Discussions] â€¢ While about one out of five college students (22.3%) are current e cigarette smokers, 8.8% of them was ex e cigarette smokers and didnâ€™t smoke for the past three months, which implies the importance of smoking cessation campaign and education. â€¢ 87.3% and 51.3% of college students answered that they co use alcohol or marijuana sometimes or always when they smoke e cigarettes. E cigarettes could actually serve as a gateway drug to users which will make them more likely to use other illicit drugs like cocaine. â€¢ It is critical to understand the main reasons of using (or not using) e cigarettes. Peer pressure is the main reason of non smokers to become to use e cigarettes, while current smokers continue to use e cigarettes because of their positive functionalities such as easy to use, lack of bad smell and relieving stress. While e cigarette smokers are more susceptible of peer pressure, parents are the most important influencer to both smokers and nonsmokers on their smoking decision. â€¢ E cigarette smokers (compared to non smokers) are more likely to live with smokers and allow other smokers to smoke in the living quarters. Smoke free legislation is one of the most effective environmental smoking control strategies along with regulations on sales and marketing and taxation. â€¢ It is always true that peer pressure is one of the biggest predictors of beginning an use of e cigarettes. E cigarette smokers have more close friends who smoke than none cigarette smokers (4.16 vs. 2.39 people). [Conclusions and Discussions]â€¢ The average age of the first ecigarette use is 18.1 years old and average age of e cigarette smokers and younger than none cigarette smokers. Most college students began e cigarette use at the time of high school senior or college freshman. People who start smoking at an early age are more likely to develop a severe addition to nicotine that those who start at later age. So, it is critical to make early age anti smoking initiation campaign and education. â€¢ 27% of current e cigarette smokers use ecigarette product less than 1 year and 84.3% of them use it less than 3 years. So, it is critical to help short term e cigarette users to quit smoking.