Physical activity among adolescent tobacco and electronic cigarette users: Cross-sectional findings from the Population Assessment of Tobacco and Health study.

Research examining relationships between protective health behaviors and tobacco use offers valuable insight regarding the behavior profiles of product users. In particular, protective health behavior trends among adolescent e-cigarette users have not been examined thoroughly to date. This study investigates physical activity patterns among adolescent e-cigarette users, smokers, and dual users of both products, as compared with never users of tobacco products. Data were collected from 8383 youth participants (12-17 years of age) enrolled in Wave 2 (2014-2015) of the nationally-representative Population Assessment of Tobacco and Health Study. Relationships between use of tobacco products and physical activity were examined via weighted multivariable logistic regression procedures. Compared with never users, each product use group demonstrated an increased likelihood to abstain from moderate-vigorous physical activity. While dual users (aOR = 0.52; 95% CI: 0.30-0.85) and smokers (aOR = 0.53; 95% CI: 0.35-0.71) were less likely than never users to participate in vigorous physical activity, no differences were observed between e-cigarette and never users (aOR = 1.04; 95% CI: 0.74-1.47). Dual users consistently demonstrated the lowest likelihood of physical activity participation. In conclusion, e-cigarette users were more likely to abstain from moderate-vigorous physical activity participation than never users. However, results did not indicate differences in vigorous or muscle-strengthening physical activity participation between e-cigarette users and never users. Though findings specific to moderate-vigorous physical activity demonstrate a behavioral similarity between e-cigarette users and smokers, key differences in vigorous physical activity were observed. Comparatively low physical activity among dual users suggests existence of a behavior profile gradient according to product use.