O1040: Association Between Adolescent Electronic Vapor Product Use and Driving Risk Behaviors

Background: In recent years, electronic vapor product (EVP) use, or “vaping”, has substantially increased among teenagers. EVPs contain nicotine within an electronic vaporizer device that aerosolizes the substance for inhalation. Vaping has been shown to be associated with poly-substance drug use, sexual risk behaviors, youth violence, later use of other tobacco products, and multiple other risk behaviors in adolescents. However, there has been limited research on associations between EVP use and driving risk behaviors (DRB). This study sought to evaluate whether EVP use was associated with four primary DRB measured in a nationally representative dataset.

Methods: The 2015, 2017, and 2019 national Youth Risk Behavior Surveillance System (YRBSS) datasets were combined for analysis. Respondents were categorized based on their self-reported EVP use in the past 30 days (non-users vs. EVP users) and frequency of use (0 days as non-users, 1-9 as occasional, 10-29 as frequent, and 30 days as daily). Binomial logistic regressions were used to model the likelihood of DRB (wearing a seatbelt when riding in a car, riding with a drinking driver, drinking and driving, and texting while driving) as a function of EVP usage. Odds ratios (OR), adjusted odds ratios (aOR), and 95% confidence intervals (95% CI) were computed for all relevant models, with controls for the student’s age, sex, race/ethnicity, and grades over the past 12 months.

Results: The total sample included 40,929 students, 9,674 of whom were EVP users (23.48%, weighted to be nationally representative). In terms of DRB, EVP users were significantly less likely to wear a seatbelt while riding in a car (aOR=0.34, 95% CI: [0.27, 0.43]), and they were almost six times more likely to drive when they had been consuming alcohol (aOR=5.82, 95% CI: [4.83, 7.02]) (Table 1). They were also significantly more likely to text and drive or ride with a driver who has been drinking. When analyzing occasional, frequent, or daily EVP users, adolescents in all three categories were significantly more likely to engage in all DRB. For three DRB, occasional users were slightly more likely to engage in these behaviors compared to frequent/daily users (Table 2).

Conclusion: Our analysis revealed that adolescent EVP use of any frequency is significantly associated with heightened engagement in DRB. Our results concur with studies on other adolescent risk behaviors, indicating that EVP users are more likely to engage in other dangerous activities. Although these associations are non-causal, pediatricians should be aware of the link between vaping and DRB and counsel EVP-using patients on safe driving, potential dangers of EVPs, and avoidance of multiple other associated risk behaviors. Future research should aim to elucidate causes of concurrent risk behavior engagement, test interventions that may prevent DRBs, and educate adolescents regarding the detrimental effects of EVP use.