Harm Perceptions of Tobacco/Nicotine Products and Child Exposure: Differences between Non-Users, Cigarette-Exclusive, and Electronic Cigarette-Exclusive Users

Alayna P Tackett; Samantha W Wallace; Caitlin E Smith; Elise Turner; David A Fedele; Irina Stepanov; William V Lechner; Jessica J Hale; Theodore L Wagener

doi:10.1177/1179173X21998362

Harm Perceptions of Tobacco/Nicotine Products and Child Exposure: Differences between Non-Users, Cigarette-Exclusive, and Electronic Cigarette-Exclusive Users

Tob Use Insights. 2021 Mar 30:14:1179173X21998362. doi: 10.1177/1179173X21998362. eCollection 2021.

Authors

Affiliations

¹ Department of Preventive Medicine, Keck School of Medicine, University of Southern California Los Angeles, USA.
² University of North Texas Health Science Center; Fort Worth, USA.
³ Department of Psychology, Oklahoma State University, USA.
⁴ Department of Clinical & Health Psychology, University of Florida, Gainesville, USA.
⁵ Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, USA.
⁶ Kent State University, Department of Psychological Science, USA.
⁷ Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, USA.
⁸ Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, USA.

Abstract

Objective: This study examined caregiver perception of harm and child secondhand exposure to nicotine in a sample of e-cigarette-exclusive, cigarette-exclusive, and non-tobacco/nicotine users (non-users).

Methods: Cigarette-exclusive (n = 19), e-cigarette-exclusive (n = 12), and non-users (n = 20) and their children (N = 51, M_age = 10.47) completed self-report questionnaires about perceptions of harm, child secondhand exposure, and provided urine to assess child nicotine exposure (cotinine). ANOVAs examined differences between caregiver use status on tobacco harm perceptions and child cotinine levels. Independent samples t-test compared differences in caregiver-reported child secondhand exposure in the home and car.

Results: All 3 caregiver groups rated cigarettes as highly harmful (P = .14), but e-cigarette users rated all 3 types of e-cigarette products (Cartridge-based: P < .001; Tank: P < .001; Box Mod: P < .001) as less harmful than cigarette users and non-users. Caregivers from the e-cigarette user group reported greater child secondhand exposure than caregivers using cigarettes (past 7-day in-home exposure (P = .03); past 7-day exposure in-home + in-car exposure (P = .02); in-home exposure by caregivers and other people exposure (P = .02)). Children from the cigarette user group had significantly higher levels of cotinine (M = 16.6, SD = 21.7) compared to children from the Non-User group (M = .43, SD = .95; P = .001), but no significant difference when compared to children from the E-Cigarette User group (M = 6.5, SD = 13.5).

Discussion: In this sample, caregivers who used e-cigarettes perceived them as less harmful, reported using them more frequently at home and in the car, even when their children were present, compared to cigarette users. As a result, children appear to be exposed to nicotine at levels similar to children living with cigarette users. Future caregiver prevention and intervention efforts should target education around the potential harms of secondhand e-cigarette aerosol to children.

Keywords: Secondhand smoke exposure; child health; secondhand aerosol exposure.

Abstract

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