Why Are National Estimates So Different? A Comparison of Youth E-Cigarette Use and Cigarette Smoking in the MTF and PATH Surveys

Carol J. Boyd , Ph.D.,^a^,^b^,^c^,* Philip Veliz , Ph.D.,^a^,^b Rebecca J. Evans-Polce , Ph.D.,^a^,^b Andria B. Eisman , Ph.D.,^d & Sean Esteban McCabe , Ph.D.^a^,^b^,^e

+ Affiliations

^aCenter for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan

^bSchool of Nursing, University of Michigan, Ann Arbor, Michigan

^cAddiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan

^dSchool of Public Health, University of Michigan, Ann Arbor, Michigan

^eInstitute for Social Research, University of Michigan, Ann Arbor, Michigan

*Correspondence may be sent to Carol J. Boyd at the Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan School of Nursing, 400 North Ingalls Street, Suite 2235, Ann Arbor, MI 48109, or via email at: [email protected].

https://doi.org/10.15288/jsad.2020.81.497

Received: November 11, 2019

Accepted: February 27, 2020

Published Online: August 18, 2020

Abstract

Objective:

We compared estimates of adolescents’ nicotine product use and perceptions of harm from two national surveys: Monitoring the Future (MTF) and Population Assessment of Tobacco and Health (PATH). We explored one explanation for the different estimates for nicotine product use and adolescents’ perceptions of harm.

Method:

We used data source triangulation examining 30-day e-cigarette use and cigarette smoking, beliefs about harm, and friends’ use of these products in two samples of adolescents from the 2015–2016 MTF and PATH samples.

Results:

Differences were found, with MTF reporting higher prevalence rates in both past-30-day e-cigarette use (12.4% vs. 6.7%) and cigarette smoking (8.6% vs. 5.1%) when compared with PATH. Differences were significant at the .001 alpha level. MTF respondents were less likely than PATH respondents to view both e-cigarettes (17.7% vs. 48.6%) and cigarettes (75.6% vs. 82.4%) as harmful. The unadjusted odds ratio (OR) shows that PATH respondents had significantly lower odds of indicating either e-cigarette (OR = 0.509, 95% confidence interval [CI] [0.400, 0.648]) or cigarette smoking (OR = 0.571, 95% CI [0.433, 0.753]) when compared with MTF respondents. However, these differences in e-cigarette use (adjusted odds ratio [AOR] = 0.849, 95% CI [0.630, 1.144]) and cigarette smoking (AOR = 0.829, 95% CI = [0.578, 1.189]) were mediated when additional predictors were included in the model (i.e., friends use, risk of harm).

Conclusions:

Substantial differences were found between national surveys estimating population rates of e-cigarette use and cigarette smoking. Data source triangulation allowed for new explanations for several of the disparate nicotine use estimates between MTF and PATH.

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