Determinants of Youth Exposure to Nicotine-Containing Aerosols: Findings from a College Survey.

Electronic Nicotine Delivery Systems (ENDSs) expose users to nicotine, volatile organic chemicals, and ultrafine particles that pose emerging toxicological concerns for youth. The prevalence of vaping among college students quadrupled between 2017 and 2019. The Vaping Initiation, Continuation, Termination, or Resumption in Youth (VICTORY) study explored a random sample of 543 undergraduate students at a Midwestern university, using an anonymous online survey, for factors associated with initiation and regular inhalation of vape-derived aerosols. Results showed that 50% of participants had ever used a vape, and 67% had used tobacco, vape, or marijuana. The mean age of first use of tobacco was 15.16 years, significantly younger than the mean ages for vaping (16.33) and marijuana (16.60). There were no significant gender differences in ENDS use, although more males reported tobacco as their first substance (18% difference). Notably, 40% reported non-alcoholic substance or alcohol use in the past 30 days. Decision-tree analysis revealed complex relationships between vaping aerosols, tobacco, alcohol use, marijuana use, and living arrangements. Logistic regression identified key predictors of regular vaping, including higher school year, lower household income, employment status, and younger age at first use. These findings highlight the need for tailored public health interventions and continued monitoring to address the growing trend of youth vaping.