Symptoms adolescents experience during their first time using a cigarette predict their current use, but little is known regarding the symptoms experienced during first e-cigarette use. We conducted a pilot study to understand the symptoms adolescents experience when they first tried cigarettes and e-cigarettes and the associations between these symptoms and current use. Participants were 41 adolescents in two U.S. cities who had tried cigarettes or e-cigarettes. We asked adolescents to recall the symptoms they experienced during their first cigarette or e-cigarette and categorized symptoms as negative (felt bad, coughing/chest pain, bad taste, upset stomach, dizzy/lightheaded) or positive (felt relaxed, rush/buzz). Adolescents reported fewer negative symptoms for first e-cigarette than first cigarette use (all p < 0.05). Current cigarette smoking was associated with endorsing fewer negative symptoms (OR = 0.49, 95% CI = [0.25, 0.95]) and more positive symptoms (OR = 7.11, 95% CI = [1.47, 34.33]) at first cigarette use. First e-cigarette use symptoms were not associated with current e-cigarette use. Adolescents reported fewer negative symptoms from first e-cigarette than from first cigarette, and e-cigarette symptoms did not influence use as they do for cigarettes. Additional research is needed to confirm these findings in longitudinal studies.
Keywords: addiction; adolescents; electronic cigarettes; smoking; tobacco.