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Adolescents who might not normally smoke still could be at risk of being recruited to use e-cigarettes, a study in the journal Pediatrics said.

The study, released Dec. 15, was based on a survey of 1,941 high school students in Hawaii in 2013. The survey looked at e-cigarette use and cigarette use, alcohol and marijuana use, psychosocial risk and protective variables such as parental support, academic involvement, smoking expectancies, peer smoking and sensation seeking. Both youths who used e-cigarettes and regular cigarettes and those who used e-cigarettes only were more likely to perceive e-cigarettes as healthier, according to the study. Teenagers who only used e-cigarettes were intermediate in levels of risk and protective factors between nonusers and those who used both cigarettes and e-cigarettes, the study said. For researchers, this posed a question about whether such cigarettes recruit low-risk youth to tobacco product use.

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