This is the link to the Research study of E-cigarettes and conventional cigarette use among US adolescents: A cross-sectional study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4142115/

I have attached pictures of the study to where the link will take you.

Read the study and answer the following questions in relation to the collection of data:

a) What was the population to which the authors wished to generalize this research?

b) Describe the study design used in this paper

c) Describe the "elements" that were used to collect data for this paper and whether new or existing data was used.

d) Describe the eligibility criteria used in selecting the "elements" to study.

e) Describe the sampling frame used in this study. Explain who comprised those within the population that could not be sampled (coverage error)

f) Outline the data collection process (quantitative, qualitative, mixed).

INTRODUCTION Go to: > E-cigarettes are devices that deliver a heated aerosol of nicotine in a fashion that mimics conventional cigarettes, while delivering lower levels of toxins than a conventional combusted cigarette.l"-1r E-cigarettes are being aggressively marketed using the same messages and media channels (plus the internet) that cigarette companies used to market conventional cigarettes in the 1950s and 1960s,: including on television and radio where cigarette advertising has been prohibited for more than 40 years. In addition to these traditional media, ecigarettes have established a strong advertising presence on the internet, and e-cigarette companies heavily advertise their products through electronic communication. Studies have demonstrated for decades that youth exposure to cigarette advertising causes youth smoking E-cigarettes are also sold using characterizing avors (e. g., strawberry, licorice, chocolate) that are banned in cigarettes in the United States because they appeal to youth. The 2011 and 2012 National Youth Tobacco Survey (NYTS) revealed that ecigarette use among youth in grades 6 through 12 doubled between 2011 and 2012 from 3.3% to 6.8%.2 As with adults?m concurrent dual use of e-cigarettes and conventional cigarettes was also high, with 76.3% of current e-cigarette users reporting concurrent use of conventional cigarettes in 2012.E Likewise, e-cigarettes were introduced to Korea in 2007 using similar marketing techniques as those used in the US, and use among adolescents rapidly increased: in 2011, 4.7% of Korean adolescents were using e-cigarettes, 76.7% of whom were dual users; The prevalence of e-cigarette use is also rising among adults in the US. In a web-based survey, 3.3% of adults in 2010 and 6.2% in 2011 had ever used an e-cigarette. In addition, awareness of these products among adults increased from 40.9% in 2010 to 57.9% in 2011. Current cigarette smokers had signicantly higher levels of ever e-cigarette use than former and never cigarette smokers in both years. E-cigarettes are marketed as smoking cessation aids; Q' and many adult e-cigarette users cite the desire to stop smoking conventional cigarettes as their reason for using them.' D' However, the value of e- cigarettes as a cigarette substitute has been questioned because of high levels of dual use with conventional cigarettes; ' U, E'3 In addition, two longitudinal population studies of adult smokers contradict claims that ecigarettes are effective cessation aids: one (in the US, UK, Canada and Australia) found that e- cigarette use is not associated with quitting conventional cigarettes2 and the other (in the US) found signicantly less quitting .3 (A randomized clinical trial; found that e-cigarettes were not superior to nicotine patches for smoking cessation, but both interventions showed low quit rates and there was not a control group of spontaneous quitters.) A cross-sectional US study also2 found that unsuccessful cigarette quitters were signicantly more likely to have ever tried e-cigarettes in comparison to individuals who had never tried to quit. Likewise, a cross-sectional study of Korean adolescents found that they were using c- cigarettes as smoking cessation aids (OR: 1.58 [95% CI 1.39-1.79] for e-cigarette use among students who had made a quit attempt compared to those who had not) but were less likely to have quit smoking (OR: 0.10 [0.090.12]). To further understand the relationship between e-cigarette use with conventional cigarette use and quitting, this study used data from the 2011 and 2012 National Youth Tobacco Surveys (NYTS) to examine the relationship between e-cigarette use and conventional cigarette smoking and smoking cessation among US adolescents. METHODS Go to: > Data source The N YTS is a nationally representative crosssectional sample of students from US middle and high (grades 612) schools located in all 50 states and the District of Columbia that was developed to inform national and state tobacco prevention and control programs.a The 2011 sample included 18,866 students (response rate 88%) from 128 schools (83.2% response rate), and the 2012 sample included 24,658 students (91.7% response rate) from 228 schools (80.3% response rate). The N YTS is an anonymous, self administered 81item pencilandpaper questionnaire that includes indicators of tobacco use (including cigarettes, cigars, smokeless tobacco, kreteks, pipes, and emerging tobacco products), tobaccorelated beliefs, attitudes about tobacco products, smoking cessation, exposure to secondhand smoke, ability to purchase tobacco products, and exposure to pro and antitobacco influences.E It uses a threestage clustered probability sampling design without replacement to select Primary Sampling Units (county, several small counties, portion of large county), schools within each PS U, and students within each school. NonHispanic Black and Hispanic students are oversampled. Permission to participate is obtained from legal guardians; Variables Conventional cigarette \"experimenters\" were adolescents who responded \"yes" to the question \"Have you ever tried cigarette smoking, even one or two puffs?\" \"Ever smokers\" of conventional cigarettes were those who replied \"100 or more cigarettes (5 or more packs)\" to the question \"About how many cigarettes have you smoked in your entire life?\" \"Current smokers\" of conventional cigarettes were those who had smoked at least 100 cigarettes and smoked in the past 30 days. Intention to quit smoking within the next year in 2011 was measured among current cigarette smokers using the question \"I plan to stop smoking cigarettes for good within the next. ..\" Respondents who chose any time within the next year (7 days, 30 days, 6 months, or 1 year) were classied as \"intending to quit;\" those who responded \"I do not plan to stop smoking cigarettes within the next year" were classied as \"not intending to quit.\" This question was not asked in 2012. We measured quit attempts with the question \"During the past 12 months, how many times did you stop smoking for one day or longer because you were trying to quit smoking cigarettes for good?\" Those who responded one or more times were considered having made an attempt; those who responded \"I did not try to quit during the past 12 months" were considered not having made a quit attempt. Thirtyday, 6month and 1year abstinence from conventional cigarettes was based on responses to the question \"When was the last time you smoked a cigarette, even one or two puffs?\" \"Not in the past 30 days but in the past 6 months" was coded as 30day abstinence, \"not in the past 6 months but in the past year\" as 6month abstinence, and \"1 to 4 year ago" or \"5 or more years ago\" as 1year abstinence. \"Ever ecigarette users\" were adolescents who responded \"Electronic Cigarettes or Ecigarettes, such as Ruyan or NJO \" to the question \"Which of the following tobacco products have you ever tried, even just one time?\" \"Current ecigarette users\" were those who responded ecigarettes to the question \"During the past 30 days, which of the following tobacco products did you use on at least one day?\" Covariates included race, gender, and age (in years, continuous)Race and ethnicity were coded based on answers to the question, \"Are you Hispanic or Latino?" and \"What race or races do you consider yourself to be?\" (White, Black, Asian, American Indiaanlaskan Native, or Native Hawaiiaanacic Islander). Responses were collapsed into nonHispanic white, nonHispanic black, and other to obtain at least 20 ever ecigarette users in each category. Analysis The 92.0% of respondents (17,353/18,866) in 201 1 and 91.4% (22,529/24,658) of respondents in 2012 with complete data on conventional cigarette use, e-cigarette use, and covariates were included in this analysis using SAS-callable SUDAAN (SAS version 9.3, SUDAAN version 11.0.0), which accounted for the stratified clustered sampling design of the NYTS, and STATA 12.1, which was used to pool the data from both years. Sampling weights were used in all analyses to adjust for nonresponse, the probability of selection, and to match the sample's sociodemographic characteristics with those of US middle and high school students in 2011.25-26 PROC CROSSTAB was used for chi-square analyses of categorical demographic variables by e-cigarette use. PROC DESCRIPT and PROC REGRESS (generalized linear model) provided means and p-values for bivariate analyses of continuous and ordinal variables. All descriptive statistics and odds ratios were adjusted for stratification variables and weights. PROC RLOGIST was used to obtain odds ratios and 95% confidence intervals from multivariable logistic regression models of e-cigarette use and cigarette smoking, intention to quit, quit attempts, and abstinence from cigarettes, adjusting for demographic covariates. Because the NYTS study designs in 2011 and 2012 were essentially identical, we pooled adjusted odds ratios for e-cigarette use in 2011 and 2012 (Table 2) using a fixed effects meta-analysis with STATA metan. As expected, there was no evidence of heterogeneity between the two years (median p-values for heterogeneity = .303, .341; range .088 to .984). Table 2 Pooled analysis of ever e-cigarette use and current" e-cigarette use and cigarette smoking for 2011 and 2012 surveys" Cigarette smoking status Abstinence from cigarettes Dependent Ever Smoking Current Smoking (2100 30-day -month 1-year Variable (2100 cigs) cigs, 21 cig past 30 days) abstinence,e abstinenceg abstinenceCh OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI) Cigarette experimenters (21 puff of a cigarette, n=10,850) Ever e-cig used 6.31 (5.39-7.39) 5.96 (5.67-6.27) 0.24 (0.21-0.28) 0.24 (0.21-0.28) 0.25 (0.21-0.30) Current e-cig 7.42 (5.63-9.79) 7.88 (6.01-10.32) 0.11 (0.08-0.15) 0.11 (0.08-0.15) 0.12 (0.07-0.18) useb Ever cigarette smokers (2100 cigs, n=1,832) Ever e-cig use 0.61 (0.42-0.89) 0.53 (0.33-0.83) 0.32 (0.18-0.56) Current e-cig 0.35 (0.18-0.69) 0.30 (0.13-0.68) 0.34 (0.13-0.87) useb Open in a separate window Having ever tried an e-cigarette "Used an e-cigarette in the past 30 days. Excludes respondents with missing values for e-cigarette use, cigarette smoking, and covariates Based on answers to "When was the last time you smoked a cigarette, even one or two puffs?" responded "not during the past 30 days but sometime during the past 6 months" to abstinence question responded: "not during the past 6 months but sometime during the past year" to the abstinence question hresponded "1 to 4 years ago" or "5 or more years ago" to abstinence questionRESULTS Go to: In 2011, 3.1% of the study sample had ever tried e-cigarettes (1.7% dual ever use, 1.5% only e-cigs), and 1.1% were current e-cigarette users (0.5% dual use, 0.6% only e-cigs). In 2012, 6.5% of the sample had tried e-cigarettes (2.6% dual use, 4.1% e-cigarettes only) and 2.0% were current e-cigarette users (1.0% dual use, 1.0% only e-cigs). Ever and current e-cigarette use varied significantly by sociodemographic characteristics (Table 1). Ever e-cigarette users were significantly more likely to be male (p<.01 white and older ever conventional cigarette smokers cigarettes in lifetime were significantly more likely than never to have tried e-cigarettes be current e-cigarette users compared nonsmokers former used among had been established of cigarettes. smokers. table sociodemographic characteristics respondents the national youth tobacco survey by use all usele usebeg usehe gender male female race nh black other cig. smoking dual smoker nonsmoker mean age open a separate window an c-cigarette past days. excludes with missing values for covariates percentages row characteristic smoked at least percentage entire sample who c-cigarettes puff are currently using p high levels was associated very odds experimentation e-table higher consumption both years figure d>20 60% 2012 50% 40% 30% 20% 10% 0% 20 Conventional cigarettes/day Never Former Currente-cig user Figure 1 Current e-cigarette use was associated (p<.003 in both years with heavier smoking among conventional smokers cigarettes lifetime smoked past days participants were a representative sample of u.s. middle and high school students the national youth tobacco survey. current e-cigarette users had used c-cigarettes days. former c- cigarette tried e-cigarettes but not never an e-cigarette. per day is number on during pooled analyses experimenters puff ever use was positively associated odds being established smoker or="6.31" also see table for separate by year.table association adolescents reporting experimentation survey n="5,169," dependent variable cd ci e-cig age nh white ref black other male c-cig open window at least lifetime. even one two puffs respondents missing values covariates lower abstinence. abstinence from cigarettes. abstinencesh abstinencech d.33 d.28 usc based answers to last time you c-cigarette sometime months question bresponded: year ago more negatively one-year abstinencese d.64 excludes adjusted planning stop within next contrast neither nor significantly having made quit attempt after adjusting covariates. we ran all unadjusted demographic variables little impact effects e- indicating that results due confounding go to:> As with adults?m dual use of ecigarettes and conventional cigarettes is high among adolescents and increasingly rapidly. Adolescents who had ever experimented with cigarettes (smoked at least a puff) and used ecigarettes were more likely to report having smoked at least 100 cigarettes and to be current smokers than adolescents who never used ecigarettes. Thus, in combination with the observations that ecigarette users are heavier smokers and less likely to have stopped smoking cigarettes, these results suggest that e cigarette use is aggravating rather than ameliorating the tobacco epidemic among youth. These results call into question claimsg' ' that e-cigarettes are elfective as smoking cessation aids. Our US results are consistent with those for Korean youth,; with high levels of dual use in both populations. Current ecigarette users (past 30 days) were much less likely to have abstained from smoking cigarettes in the past 30 days in both populations (21 puff but not in past 30 days, OR=0. 10 [0.090.12] in Korean youth vs. OR=0. 15 [0.080.28] for experimenters with cigarettes in US youth). Among current cigarettesmoking youth in Korea there was a signicant association between current ecigarette use and attempting to quit smoking in the past 12 months [0R=1.67, [1.48 1.90)), but there was not a signicant association for US youth (OR=1.20, [0.652.23J). This difference may reflect behavioral dilferences between the two countries, but may also reect the lower power in our study. The Korean sample was much larger than ours (75,643 versus 17,320} with higher prevalence of current (12.1% versus 5.0%) and ever cigarette smoking (26.3% versus 5.6%) and current (4.7% versus 1.1%) and ever ecigarette use (9.4% versus 3.1%). Although ecigarettes deliver many fewer toxins and at much lower levels than conventional cigarettes?" they contain nicotine, a highly addictive substance,E in doses designed to mimic cigarettes. Animal models suggest that, through its impact on cholinergic pathways, nicotine may have permanent effects on the brain and behavior,' such as dysregulation of the limbic system, which can lead to longterm difculties with behavioral regulation, attention, memory and motivation. among other functions. ' The adolescent human brain may be particularly vulnerable to the effects of nicotine because it is still developing. EB Limitations This is a crosssectional study, which only allows us to identify associations, not causal relationships. Our results are also limited by the lack of information about motivation for using ecigarettes (e.g., popularity, trendy, smoking cessation) and the fact that they only apply to middle and high school students, not all US youth. In comparison to the 8.0% and 8.6% of respondents who had missing data in 2011 and 2012. respectively, and were dropped, our analytical sample was slightly more female (2011: 49.4% versus 42.9%, p=.[}0'}'4, 2012: 49.9% versus 38.3%, p<.0001 and less white versus p="<.0001," ctable in only our sample also had a lower prevalence of ecigarette user was slightly younger than the students with missing data. there were no signicant differences by any other demographic or cigarette smoking variables. conclusion while crosssectional nature study does not allow us to identify whether most youth are initiating conventional cigarettes then moving on dual use ecigarettes vice versa results suggest that discouraging cigarettes. among experimenters is associated established rates abstinence from debate over has centered e-cigarettes could be useful as harm reduction strategy adult smokers. this paper together those korea may contribute nicotine addiction unlikely discourage youth. adolescents: cross-sectional lauren m. dutra scda stanton a. glantz phda author information . copyright license disclaimer publisher final edited version article available at jama pediatr see commentary reply pediatryolume page been corrected. correction volume data> Supplementary Materials Abstract Go to: Importance E-cigarette use is increasing rapidly among adolescents and e-cigarettes are currently unregulated. Objective Examine e-cigarette use and conventional cigarette smoking. Design Cross-sectional analyses of survey data. Setting 2011 and 2012 National Youth Tobacco Surveys (NYTS) Participants Representative sample of US middle and high school students in 2011 (n=17,353) and 2012 (n=22,529) Exposures Ever and current e-cigarette use Main outcome measures Experimentation with, ever, and current smoking; smoking abstinence Results In pooled analyses, among cigarette experimenters (21 puff), ever e-cigarette use was associated with higher odds of ever smoking cigarettes (2100 cigarettes; OR= 6.31, 95% CI [5.39-7.39) and current cigarette smoking (OR=5.96 [5.67-6.27]). Current e-cigarette use was positively associated with ever smoking cigarettes (OR=7.42 [5.63-9.79]) and current cigarette smoking (OR= 7.88 [6.01-10.32]. In 2011, current cigarette smokers who had ever used e-cigarettes were more likely to intend to quit smoking within the next year (OR=1.53 [1.03-2.28]). Among experimenters with conventional cigarettes, ever use of e- cigarettes was also associated with lower 30-day (OR=0.24 [0.21-0.28]), 6-month (OR=0.24 [0.21-0.28]), and 1-year (OR=0.25 [0.21-0.30]) abstinence from cigarettes. Current e-cigarette use was also associated with lower 30-day (OR=0.11 [0.08-0.15]), 6-month (OR=0.11 [0.08-0.15]), and 1-year (OR=0.12 [0.07- 0.18]) abstinence. Among ever smokers of cigarettes (2100 cigarettes), ever e-cigarette use was negatively associated with 30-day (OR=0.61, [0.42-0.891), 6-month (OR=0.53, [0.33-0.83]) and one-year (OR=0.32 [0.18-0.56) abstinence from conventional cigarettes. Current e-cigarette use was also negatively associated with 30-day (OR=0.35 [0.18-0.69]), 6-month (OR=0.30 [0.13-0.68]), and one-year (OR=0.34 [0.13-0.87]) abstinence. Conclusions E-cigarette use was associated with higher odds of ever or current cigarette smoking, higher odds of established smoking, higher odds of planning to quit smoking among current smokers, and, among experimenters, lower odds of abstinence from conventional cigarettes. Relevance Results suggest e-cigarette use does not discourage, and may encourage, conventional cigarette use among US adolescents