Adolescents' and Young Adults' Recalled Exposure to E-Cigarette Retail Stores on the Path to School: Association With Past 30-Day Use and Susceptibility to Use

PURPOSE: School-aged youth use e-cigarettes more than any other tobacco product, and e-cigarette marketing exposure near schools remains a concern. However, few studies have examined adolescents' and young adults' (AYAs) exposure to stores selling e-cigarettes along their path to/from school and the association between retailer exposure and AYA e-cigarette use and susceptibility to use. METHODS: We conducted a web-based survey of 5,326 United States; 13-24-year-olds. Participants reported e-cigarette use, susceptibility to use e-cigarettes among those who never used, and exposure to retail stores selling e-cigarettes on their school commute. We used age-stratified logistic regression models to examine associations of store exposure (any store, age-restricted/adult-only (21+) stores (e.g., vape shops), store(s) ≤10 minutes) with (1) current (past 30-day) e-cigarette use and (2) susceptibility. Analyses adjusted for age, gender, race and ethnicity, and urbanicity. RESULTS: Over one-half (56.7%) of all AYAs were exposed to e-cigarette retail store(s) on their school commute; among participants <21 years, 54.0% were exposed. AYAs with such e-cigarette retail store exposure had elevated odds of current e-cigarette use (adjusted odds ratio [AOR]: 2.15, 95% confidence interval [CI]: 1.86-2.48) and use susceptibility (1.33, 1.14-1.54). Exposure to adult-only stores was associated with current use (3.32, 2.82-3.91) and to stores ≤10 minutes from school was associated with current use (1.30, 1.13-1.51) and susceptibility to use (1.21, 1.03-1.43). DISCUSSION: AYAs are frequently exposed to stores selling e-cigarettes on their school commute, which is positively associated with current use and susceptibility to use. Efforts to curb AYA e-cigarette use could focus on environmental factors, such as limiting retail licensing near schools.