Teenagers who don’t think cigarettes are cool anymore may be embracing electronic cigarettes under the influence of friends and family, according to research by Keck School of Medicine of the University of Southern California (USC) scientists.

The study, published July 27, 2015 in the peer-reviewed journal Pediatrics, surveyed more than 2,000 Southern California 11th and 12th graders and discovered that psychosocial factors including attitudes of family and friends toward e-cigarettes, as well as a belief that e-cigarettes pose no health risks, may be “renormalizing” tobacco use among adolescents. The researchers also found that 40 percent of the adolescents using e-cigarettes had never smoked a cigarette.

“Almost half of the current e-cigarette users in the survey reported they didn’t believe there were health risks associated with e-cigarette use,” said Jessica Barrington-Trimis, PhD, postdoctoral scholar and research associate at the Keck School of Medicine and lead author on the study. “However, in spite of the huge increase in e-cigarette use among adolescents, there has been limited study of the health risk. E-cigarettes may be less harmful than cigarettes but they’re probably not harmless.”

There is also concern that e-cigarettes could become the new “gateway” to tobacco use for adolescents, undoing years of education that turned teenagers away from tobacco. The study found that friends’ attitudes and others’ use of e-cigarettes in the home were associated both with e-cigarette and with cigarette use among adolescents. Additional studies are needed to determine if e-cigarettes are leading teens to regular cigarettes, Barrington-Trimis said.

The researchers obtained their data from the Children’s Health Study, an ongoing survey launched in 1993 by USC. The study follows more than 11,000 schoolchildren in Southern California, focusing on the long-term effects of air pollution on their respiratory health.

The study was conducted and funded by the Tobacco Centers of Regulatory Science (TCORS), a $20 million grant funded program in the Department of Preventive Health, Keck School of Medicine. The Keck School of Medicine was one of 14 TCORS established nationwide in 2014 by the federal Food and Drug Administration to help the agency develop a scientific base for decisions about the manufacturing, marketing and distribution of tobacco products to the public.

by Leslie Ridgeway


Barrington-Trimis, J.L., Berhane, K., Unger, J.B., Cruz, T.B., Huh, J., Levanthal, A.M., Urman, R., Wang, K., Howland, S., Gilreath, T.D., Chou, C.P., Pentz, M.A., and McConnell, R. (2015) Psychosocial factors associated with adolescent electronic cigarette and cigarette use. Pediatrics, Vol 136 (Iss2), August 2015. Published online July 27, 2015; doi: 10.1542/peds.2015-0639