Xinguang Chen, University of Florida, Gainesville
Bin Yu, University of Florida, Gainesville
Ding-Geng Chen, University of North Carolina, Chapel Hill

Abstract: A growing number of young people smoke electronic (e-) cigarettes, presenting an emerging challenge to tobacco control. Analyses are needed to better understand the dynamics of mutual transitions between e-cigarette and conventional combustible (c-) cigarette smoking to advance evidence-based tobacco control. In this study we modeled the nonlinear dynamics of c- and e-cigarette smoking behavior transitions using the 2014 National Youth Tobacco Survey (NYTS) data. A model with five Markov-Chain transition stages linked by 21 transitional paths/probabilities was constructed, guided by the probabilistic discrete event systems (PDES) theory. The Moore-Penrose generalized inverse matrix was used to solve the proposed model that was under-determined. The estimated transitional probabilities indicate that each year, 7-8% of middle school students and 11% of high school students initiated smoking. E-cigarettes were more attractive then c-cigarettes but the behavior of smoking c-cigarettes was more stable than that of smoking e-cigarettes. Female students were more likely to remain as quitters or ex-smokers while male students were more likely to relapse and smoke again. Findings of this nonlinear dynamics modelling indicate potential increases in both e- and c-cigarette smoking among U.S. middle and high school students if no further measures are taken. The PDES-based approach is effective to investigate the nonlinear dynamics of mutual transitions of two risk behaviors in adolescents with one wave cross-sectional data.

Keywords: electronic cigarettes, tobacco control, cross-sectional data, mutual behavior transition, nonlinear system dynamics, discrete event systems, M-P generalized inverse matrix