Background
Electronic cigarette (EC) consumption (‘vaping’) is rapidly increasing, not only in adults but also in adolescents. Little is known about the association between vaping and problem behaviors such as drinking.
Methods
We used data from the 11th Korea Youth Risk Behavior Web-based Survey, which was conducted in 2015 and included 68,043 participants who were Korean middle and high school students. The survey assessed EC, cigarette, and alcohol use. Multiple regression analysis was used to examine risk of current drinking and problem drinking across the following categories of users: never user (never used either product), former user (use of EC or cigarettes in the past, but not currently), vaping only, smoking only, and dual user (current use of both products).
Results
EC only users were 1.2% in males, and 0.3% in females. Dual user of both conventional cigarettes and ECs were 5.1% in males, and 1.2% in females. Drinking frequency, drinking quantity per once, and problem drinking were higher among vapers than non-vapers and former-vapers, moreover, were higher among daily vapers than intermittent vapers. Compared to never users, EC only users were higher on risk of current drink and problem drink. The dual users were highest on risk of current drink.
Conclusion
Vaping is independently associated with alcohol use problems in Korean students, even those not currently smoking. Moreover, dual use of cigarettes and ECs is strongly associated with alcohol use problems. Therefore, vaping students should be concerned about their hidden alcohol use problems.

Citations

• Changes in health behaviors and obesity of Korean adolescents before and during the COVID-19 pandemic: a special report using the Korea Youth Risk Behavior Survey
  Chang-Mo Oh, Yangha Kim, Jieun Yang, Sunhye Choi, Kyungwon Oh
  Epidemiology and Health.2023; 45: e2023018.     CrossRef
• Addiction-Related Outcomes of Nicotine and Alcohol Co-use: New Insights Following the Rise in Vaping
  Jude A Frie, Caitlin J Nolan, Jennifer E Murray, Jibran Y Khokhar
  Nicotine & Tobacco Research.2022; 24(8): 1141.     CrossRef
• Vaping
  Chelsey DeGomez, Jennifer Feirstein
  JAAPA.2022; 35(9): 25.     CrossRef
• Comparison of Tobacco Use and Cessation Behavior between Conventional Cigarette and Heated Tobacco Product Users: Based on the Analyses of the Eighth Korea National Health and Nutrition Examination Survey 2019
  Hyeree Yu, Cheol Min Lee
  Korean Journal of Family Medicine.2022; 43(5): 296.     CrossRef
• Prevalence of Vaping and Behavioral Associations of Vaping Among a Community of College Students in the United States
  Ogbebor E. Omoike, Kiana R. Johnson
  Journal of Community Health.2021; 46(1): 190.     CrossRef
• Use of Single, Dual, and Poly Tobacco Products in Korean Adolescents
  Min Kwon, Sophia J. Chung, Jinhwa Lee
  Asia Pacific Journal of Public Health.2021; 33(5): 571.     CrossRef
• Association between preference for using alcohol beverage-named e-liquids and alcohol use among high school youth
  Asti Jackson, Ran Wu, Grace Kong, Deepa R. Camenga, Meghan Morean, Patricia Simon, Krysten W. Bold, Angela M. Haeny, Suchitra Krishnan-Sarin
  Drug and Alcohol Dependence.2020; 209: 107903.     CrossRef
• Cross-fading: The importance of tissue injury research on dual misuse of alcohol and JUUL
  Lisa Chudomelka, Todd A. Wyatt
  Alcohol.2020; 86: 43.     CrossRef
• Association of E-cigarettes with adolescent alcohol use and binge drinking-drunkenness: A systematic review and meta-analysis
  Ava N. Rothrock, Halle Andris, Sarah B. Swetland, Valeria Chavez, Shira Isaak, Maria Pagane, Jake Romney, Steven G. Rothrock
  The American Journal of Drug and Alcohol Abuse.2020; 46(6): 684.     CrossRef
• Prevalence and Correlates of the Dual Use of Conventional and Electronic Cigarettes among Korean Adolescents: 2016-2018 Korean Youth Risk Behavior Survey
  Eon Sook Lee, Yu Jin Paek
  Journal of the Korean Society for Research on Nicotine and Tobacco.2020; 11(2): 64.     CrossRef
• Electronic and Conventional Cigarette Use and Drinking Behaviors in Korean Adolescents
  Young Gyu Cho
  Korean Journal of Family Medicine.2019; 40(4): 201.     CrossRef