1. In a cross-sectional study of U.S. high school students, those who used electronic vapor products were more likely than non-users to have engaged in sexual risk behaviors.
2. Findings were similar amongst those who used electronic vapor products occasionally, frequently, and daily.
Evidence Rating Level: 2 (Good)
Study Rundown: Although previous research has identified that use of electronic vapor products (EVPs) in adolescents is associated with risk behaviors such as substance use and violent behavior, few studies have investigated the association of EVP use with risky sexual behaviors. This study sought to examine the relationship between EVP use and sexual risk behavior (SRB) using a nationally representative sample of high school students. Overall, EVP use at any frequency was found to be associated with an increased prevalence of SRBs, including experiencing sexual violence. Although strengthened by its large sample size, this study has several limitations, including its employment of somewhat subjectively defined terms and inability to determine causation due to its cross-sectional design. Overall, findings from this study stress the importance of screening for SRBs in adolescents who engage in EVP use.
In-Depth [cross-sectional study]: This cross-sectional study of a nationally representative sample of high school students used data that was gathered from the 2017 National Youth Risk Behavior Survey to assess relationships between frequency of EVP and/or cigarette use, demographic variables, and sexual risk behaviors (SRBs). SRBs included ever engaging in sexual intercourse, engaging in sexual intercourse in the last 3 months, sexual intercourse younger than 13 or 16 years old, greater than 4 lifetime partners, alcohol or drug use before intercourse, condom use, and experiencing forced sexual intercourse, sexual violence, or sexual dating violence. Results were reported as adjusted prevalence ratios (aPRs). Overall, 6.5% of students had used EVPs only in the last 30 days, 2.8% had used cigarettes, and 6.5% had used both. EVP-only use was more prevalent in students who were male and identified as heterosexual, whereas combined EVP and cigarette use was more prevalent in students who were non-Hispanic white, and in those who identified as gay, lesbian, or bisexual. EVP-only users at any frequency were more likely to have engaged in 9 of 10 SRBs with the exception of lack of condom use. Of note, users of EVPs and/or cigarettes were more likely than non-users to have experienced forced sexual intercourse (aPR range: 1.92–2.75), sexual violence (aPR range: 1.92–2.52), and sexual dating violence (aPR range: 1.69–1.79).
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