{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T08:17:13Z","timestamp":1781079433961,"version":"3.54.1"},"reference-count":41,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T00:00:00Z","timestamp":1707868800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>E-cigarette use among adolescents is a national health epidemic spreading faster than researchers can amass evidence for risk and protective factors and long-term consequences associated with use. New technologies, such as machine learning, may assist prevention programs in identifying at risk youth and potential targets for intervention before adolescents enter developmental periods where e-cigarette use escalates. The present study utilized machine learning algorithms to explore a wide array of individual and socioecological variables in relation to patterns of lifetime e-cigarette use during early adolescence (i.e., exclusive, or with tobacco cigarettes). Extant data was used from 14,346 middle school students (<jats:italic>M<\/jats:italic><jats:sub>age<\/jats:sub> = 12.5, <jats:italic>SD<\/jats:italic> = 1.1; 6<jats:sup>th<\/jats:sup> and 8<jats:sup>th<\/jats:sup> grades) who participated in the Utah Prevention Needs Assessment. Students self-reported their substance use behaviors and related risk and protective factors. Machine learning algorithms examined 112 individual and socioecological factors as potential classifiers of lifetime e-cigarette use outcomes. The elastic net algorithm achieved outstanding classification for lifetime exclusive (AUC = .926) and dual use (AUC = .944) on a validation test set. Six high value classifiers were identified that varied in importance by outcome: Lifetime alcohol or marijuana use, perception of e-cigarette availability and risk, school suspension(s), and perceived risk of smoking marijuana regularly. Specific classifiers were important for lifetime exclusive (parent\u2019s attitudes regarding student vaping, best friend[s] tried alcohol or marijuana) and dual use (best friend[s] smoked cigarettes, lifetime inhalant use). Our findings provide specific targets for the adaptation of existing substance use prevention programs to address early adolescent e-cigarette use.<\/jats:p>","DOI":"10.1371\/journal.pone.0287878","type":"journal-article","created":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T18:27:01Z","timestamp":1707935221000},"page":"e0287878","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["An ecological examination of early adolescent e-cigarette use: A machine learning approach to understanding a health epidemic"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6790-7534","authenticated-orcid":true,"given":"Alejandro L.","family":"V\u00e1zquez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia M.","family":"Navarro Flores","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byron H.","family":"Garcia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2137-1391","authenticated-orcid":true,"given":"Tyson S.","family":"Barrett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6610-6890","authenticated-orcid":true,"given":"Melanie M.","family":"Domenech Rodr\u00edguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,2,14]]},"reference":[{"key":"pone.0287878.ref001","unstructured":"Office of the Surgeon General. 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