Why are national estimates so different? A comparison of youth e-cigarette use and cigarette smoking in the MTF and PATH surveys (2020)

OBJECTIVE: We compared estimates of adolescents' nicotine product use and perceptions of harm from two national surveys: Monitoring the Future (MTF) and Population Assessment of Tobacco and Health (PATH). We explored one explanation for the different estimates for nicotine product use and adolescents' perceptions of harm.
METHOD: We used data source triangulation examining 30-day e-cigarette use and cigarette smoking, beliefs about harm, and friends' use of these products in two samples of adolescents from the 2015-2016 MTF and PATH samples.
RESULTS: Differences were found, with MTF reporting higher prevalence rates in both past-30-day e-cigarette use (12.4% vs. 6.7%) and cigarette smoking (8.6% vs. 5.1%) when compared with PATH. Differences were significant at the .001 alpha level. MTF respondents were less likely than PATH respondents to view both e-cigarettes (17.7% vs. 48.6%) and cigarettes (75.6% vs. 82.4%) as harmful. The unadjusted odds ratio (OR) shows that PATH respondents had significantly lower odds of indicating either e-cigarette (OR = 0.509, 95% confidence interval [CI] [0.400, 0.648]) or cigarette smoking (OR = 0.571, 95% CI [0.433, 0.753]) when compared with MTF respondents. However, these differences in e-cigarette use (adjusted odds ratio [AOR] = 0.849, 95% CI [0.630, 1.144]) and cigarette smoking (AOR = 0.829, 95% CI = [0.578, 1.189]) were mediated when additional predictors were included in the model (i.e., friends use, risk of harm).
CONCLUSIONS: Substantial differences were found between national surveys estimating population rates of e-cigarette use and cigarette smoking. Data source triangulation allowed for new explanations for several of the disparate nicotine use estimates between MTF and PATH.