Association of electronic cigarette use with self-reported difficulty concentrating, remembering, or making decisions in US youth

INTRODUCTION: Electronic cigarette use (vaping) has become increasingly popular among youth. The aim of this study is to determine the cross-sectional association of vaping, smoking, and dual use of these tobacco products with self-reported serious difficulty concentrating, remembering, or making decisions (DCRMD), because of a physical, mental, or emotional condition (PMEC) in US youth. METHODS: The 2018 National Youth Tobacco Survey (NYTS) data with 18535 youth were used for analysis. All included youth who answered whether they have serious DCRMD and stated their vaping and smoking status. Multivariable weighted logistics regression models were used to examine the association of vaping and smoking with the risk of DCRMD in youth, considering a complex sampling design. RESULTS: Ever dual users (AOR=4.19; 95% CI: 2.97–5.92), exclusive ever cigarette smokers (AOR=1.50; 95% CI: 1.18–1.91) and exclusive ever e-cigarette users (AOR=3.13; 95% CI: 2.25–4.34) had significantly higher odds of self-reported DCRMD than never users in youth. Subgroup analysis on exclusive ever e-cigarette users who started vaping in middle school or earlier had significantly higher odds of self-reported DCRMD compared to those who started vaping in high school (AOR=1.77; 95% CI: 1.27–2.45). Meanwhile, male youth who were exclusive ever e-cigarette users had higher odds of self-reported DCRMD than female youth who were exclusive ever e-cigarette users (AOR=1.67; 95% CI: 1.25–2.22). CONCLUSIONS: Vaping, smoking and dual use were associated with self-reported serious difficulty concentrating, remembering, or making decisions because of a physical, mental, or emotional condition in youth, which provided initial evidence on the cross-sectional association between vaping and self-reported cognitive problems.