Adolescents' Perceptions of Risks and Benefits of Conventional Cigarettes, E-cigarettes, and Marijuana: A Qualitative Analysis

J Adolesc Health. 2015 Aug;57(2):179-85. doi: 10.1016/j.jadohealth.2015.04.002. Epub 2015 Jun 23.


Purpose: Although rates of adolescent cigarette use have remained constant or decreased, rates of marijuana and e-cigarette use are rising. Knowledge and perceptions of risks and benefits of tobacco products impact adolescents' decisions to use these products. However, little is known regarding adolescents' knowledge and perceptions of risks of e-cigarettes and marijuana nor how these perceptions are formed. This study uses qualitative techniques to assess and compare adolescents' perceptions of the risks and benefits of cigarettes, e-cigarettes, and marijuana.

Methods: Twenty-four adolescents (nine females and 15 males) from Northern California participated in six small-group discussions. Adolescents were asked what good or bad things might happen from using these products. To assess how perceptions and knowledge of risks and benefits were formed, participants were asked where and from whom they had learned about these products.

Results: Adolescents described negative consequences of cigarette use but were much less sure regarding risks of marijuana and e-cigarette use. Conversely, they described few benefits of cigarettes but described a number of benefits of e-cigarette and marijuana use. Adolescents described learning about these products from the media, from family and friends, and from the school environment.

Conclusions: Adolescents have learned from multiple sources about risks of using cigarettes, but they receive much less and often incorrect information regarding marijuana and e-cigarettes, likely resulting in their positive and often ambivalent perceptions of marijuana and e-cigarettes.

Keywords: E-cigarettes; Qualitative research; Risk perceptions; Substance use; Tobacco.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adolescent Behavior / psychology*
  • Attitude to Health*
  • California
  • Electronic Nicotine Delivery Systems / adverse effects*
  • Electronic Nicotine Delivery Systems / psychology
  • Female
  • Humans
  • Internet
  • Male
  • Marijuana Smoking / adverse effects*
  • Marijuana Smoking / psychology
  • Risk Assessment
  • Risk Factors
  • Risk-Taking
  • Smoking / adverse effects*
  • Smoking / psychology
  • Social Environment
  • Social Perception*
  • Tobacco Products / adverse effects