The use of substances Other than Nicotine in Electronic Cigarettes Among college students.

This study is not without limitations and thus findings should be interpreted within the context of its limitations. The present research reports on data collected in 2014. Hence, the current findings may underestimate the incidence of OSUE in the population, given the growing interest in e-cigarettes over recent years.2 Additional research is needed to establish trends over time in OSUE among college populations. The generalizability of the present findings is limited because data were collected from one specific Midwestern university. Future research should replicate and expand this work at other universities. Furthermore, because incidence or frequency of OSUE was not collected, it is not possible to know whether OSUE use was primarily a single episode or repeated behavior among respondents. Future research should include the measurement of frequency of OSUE, given that these 2 groups of OSUE users may differ substantially. Although suitable for estimating prevalence, the cross sectional design of the study cannot show causation and is susceptible to nonresponse bias. The relatively low survey response rate further increases the potential for nonresponse bias to affect study findings. That said, there is an increasing body of research that indicates that low response rates do not necessarily equate to biased results.37,38 Several strategies were implemented to reduce nonresponse, including incentivizing participation using a lottery with a relatively high probability of winning a prize39 and sending email reminders to those who had not initiated or completed the survey. Although self-reported drug abuse data are generally found to be valid and reliable,40,41 this study relied on self-report and thus underestimates of use or incorrect recall of information may have influenced findings, especially regarding internal validity. Despite its limitations, this study is one of a very few that provide insight regarding the use of other substances in e-cigarettes among college students. Although a relatively low prevalence rate of OSUE was found, as the popularity of e-cigarettes continues to grow, so could a real public health concern. This concern may have the potential to substantially affect college health, given that we know very little about the effects of cannabis and cannabis derivatives (typically comprising higher THC concentrations than traditional forms of cannabis) delivered through e-cigarettes. In addition, concern may be warranted regarding the potential dangers of using substances more dangerous than cannabis. For instance, although this study identified only a very small number of individuals reporting the use of what many would consider more dangerous illicit substances (eg, cocaine), there is the potential for an increase in the prevalence of OSUE and thus the potential for larger numbers of individuals vaping more dangerous drugs. Future research examining reasons for OSUE, drug use history, and e-cigarette and drug use trajectories of individuals who use other substances in e-cigarettes using longitudinal designs will be needed. This study is among one of a small but growing number of studies reporting on the use of other substances in e-cigarettes. This study provides valuable insight into the growing prevalence of e-cigarette use and OSUE among college students, their potential contribution to the use of harmful illicit substances, and differing primary reasons for misuse across e-cigarette users. This study adds to the extant literature specific to the college student population, of which there is very little information regarding OSUE, and findings stress the need for continued research emphasis on the combination of vaping and illicit substance use among college students, as limited knowledge exists on the impact of these behaviors, motivations behind it, and its potential public health impact.

A. Explain the limitations presented by the study population and sample size used. Support your explanation with examples from the study.

B. Discuss the advantages and disadvantages of the type of statistical analysis used. Support your discussion with examples from the study.

C. Identify the limitations of the study design used and explain why those limitations exist.

D. Explain how this study contributes to scientific literature. Support your explanation with specific examples.

E. Describe further investigations that could take place because of this study.