Pain is Associated with E-Cigarette Use and Dependence in Young Adults: Findings from Wave 7 (2022-2023) of the Population Assessment of Tobacco and Health (PATH) Study.

BACKGROUND: Use of electronic cigarettes (e-cigarettes) among young adults (i.e., individuals aged 18 - 24) has increased substantially in recent years. Consistent with an established reciprocal model of pain and substance use, evidence demonstrates that pain increases risk for initiation and continued use of e-cigarettes, as well as dual use of e-cigarettes and other tobacco products. Meta-analytic findings also indicate that many young adults experience chronic pain (~ 12%); however, we are not aware of any prior research examining associations between pain, e-cigarette use, and dependence among young adults.

METHOD: Data was drawn from 10,267 young adults (68% White; 50% Female) aged 18 - 24 who participated in Wave 7 (2022 - 2023) of the Population Assessment of Tobacco and Health (PATH) Study.

RESULTS: Logistic regression models indicated that moderate/severe pain (vs. no/low pain) was associated with greater odds of lifetime, current, and daily e-cigarette use. Moderate/severe pain was associated with greater odds of exclusive e-cigarette use, exclusive use of other tobacco products, and dual use of e-cigarettes and other tobacco products. Linear regression analyses further revealed that moderate/severe pain was positively associated with tobacco dependence.

CONCLUSION: These findings suggest that moderate/severe pain may serve as a risk factor for e-cigarette use, dependence, and dual e-cigarette and other tobacco product use among young adults. Future prospective research is needed to clarify temporal precedence in the onset of moderate/severe pain and e-cigarette use among young adults. Clinical interventions focused on e-cigarette prevention and cessation among young adults with chronic pain may also be warranted.