Date of Award


Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Dr. Shanta Rishi Dube

Second Advisor

Dr. Ruiyan Luo


Introduction: Electronic cigarettes (e-cigarettes) are battery-operated devices that entered the U.S. markets in 2007 and are marketed as safe alternatives to traditional cigarettes. The nicotine present in the e-cigarettes and the amount of vapor produced is a major concern for oral health. The purpose of this study is to report on the estimates for e-cigarette use from two different national surveys in the United States and to assess the association between e-cigarette use and outcomes related to dental care.

Methods: Data from the 2015-2016 National Health and Nutrition Examination Survey (NHANES) (n=5884), and from the 2015 National Health Interview Survey (NHIS) (n=33,672) were used in the analysis. SAS 9.4 was used to calculate the prevalence of e-cigarette use (ever and current use of e-cigarettes) and dental care (past year dental office visit) by sociodemographic variables for 2015-2016 NHANES and 2015 NHIS. Logistic regression models were used to examine the association between e-cigarette use and utilization of dental care separately for NHANES and NHIS, adjusting for age, sex, education, race, income, affordability of care and other tobacco use.

Results: The prevalence of ever use and current use from the 2015-2016 NHANES was 20.30% (95% C.I. 18.31-22.29) and, 5.40% (95% C.I. 4.73-6.06) respectively. In the 2015 NHIS the prevalence was 13.06% (95% C.I. 12.53-13.58) for ever e-cigarette use and 4.50% (95% C.I. 4.22-4.79) for current use. The prevalence of past year dental office visit from 2015-2016 NHANES was 58.78% (95% C.I. 54.88-62.68) and from NHIS was 62.71% (95% C.I. 62.02-63.4). Multivariate logistic regression models using NHANES data indicated that there is no difference between current e-cigarette users and non-users with respect to making a past year dental visit [AOR= 1.04 (95% C.I. 0.64-1.70)] and NHIS data indicated that current e-cigarette users were less likely to make a past year dental visit [AOR= 0.69 (95% C.I. 0.60-0.80)].

Conclusions: The non-overlapping of 95% confidence intervals for the prevalence of ever use indicate a significant difference between 2015-2016 NHANES and 2015 NHIS with respect to ever e-cigarette usage. Considering different factors such as sample size, response rate, position of the questions and mode of administration is encouraged before choosing the estimates from different surveys.

Available for download on Sunday, December 06, 2020