Electronic Vapor Product Prevalence and Correlates of Cigarette Smoking among High School Students in Maine   Titilola Balogun, MBBS, MPH, DrPH1 Toho Soma, MPH1  Tiffany Corvino1 Liam O’Brien, PhD2 and Reid Plimpton3 1 University of New England 2 Colby College 3Maine CDC, MCDPH INTRODUCTION DISCUSSION METHODS (continued) There is a high prevalence of the use of cigarettes and other tobacco products among Maine youth. From the 2017 MIYHS survey, 8.8% of high school students reported having smoked a cigarette in the past 30 days. The purposes of this study were to explore the geographical distribution of cigarette use among high school students across Maine, and to determine the association between various risk and protective factors, and youth cigarette and electronic vapor product use. The interaction between the explanatory question of interest and public health district (PHD) was analyzed for each pair of questions as well. These were also logistic regression models relating the tobacco question of interest to the explanatory question of interest and indicator variables for the PHDs. If a significant interaction was found (p < 0.05), separate odds ratio for each PHD were generated. These odds ratios were not controlled for gender. All odds ratios from all analyses also had 95% confidence intervals generated for them. Analyses were done using R version 3.5.1. The survey package was used to adjust all analyses for appropriate survey sampling weights. The results show that smoking may be a pointer to deeper mental health issues among youth. Those who reported receiving doctors or dentists’ advice on smoking had lower cigarette smoking rates but higher e-cigarette smoking rates. The cross sectional nature of the study limits our ability to infer causality.  CONCLUSION In-class instruction appears to be effective in tobacco prevention efforts among high school students. Students perceived low susceptibility to the harmful effects of tobacco and ease of access to cigarettes in addition to their exposure to tobacco advertisements. We propose that preventive health care provider visits should include questions about all tobacco products including vaping. Youth who are found to use tobacco products at health care provider visits should be offered mental health screenings. Health care providers, including dentists, should also be informed that electronic vapor products are currently not approved for smoking cessation by the Food and Drug Administration. METHODS Logistic regression models for survey data were used. All questions on the MIYHS were dichotomized, making logistic regression the most appropriate modeling strategy that allows for control of potential confounders. For each research question, a logistic regression was run with the tobacco question of interest as the response and the appropriate explanatory question as the explanatory variable. Gender was included in the model as a main effect, as well as an interaction with the explanatory question of interest. If the interaction was statistically significant (p < 0.05), separate odds ratios were generated for males and females relating the tobacco question of interest to the explanatory question of interest by running separate logistic regressions for each gender. RESULTS Table 1. Associations between Predictor Variables and Any Cigarette Smoking or Electronic Vapor Product Use in the Past 30 Days, Overall and by Gender   Cigarette Smoking Electronic Vapor Product Explanatory Variable Odds Ratio Odds Ratio by Gender Odds Ratio Odds Ratio by Gender Female Male In the 12 months, felt so sad or hopeless almost every day for two weeks or more in a row that they stopped doing some usual activities 5.03* 3.83* 2.66* 2.11* In the past 12 months, ever seriously considered attempting suicide 4.08* 2.56* 2.00* In the past 12 months, made a plan about how they would attempt suicide 2.64* 2.34* In the past 12 months, attempted suicide 5.48* 2.38* In the past 12 months, purposely hurt themselves without wanting to die, such as cutting or burning themselves on purpose 0.59* 2.49* Smoked a whole cigarette before age 13 1.20 1.00 In the past 12 months, were taught in any class about the dangers of tobacco use 0.73* Not tested Parents say it would be “a little bit wrong” or “not wrong at all” for their high school child to smoke cigarettes 7.92* 10.24* 4.24* Think there is “no risk” or “slight risk” of people harming themselves (physically or in other ways) if they smoke one or more packs of cigarettes per day 3.71* 2.27* Think it is “sort of easy” or “very easy” to get some cigarettes if they wanted 6.95* 4.91* See tobacco industry advertisements on signs or poster boards “a lot” when they go to a supermarket, grocery store, convenience store, or gas station mini-mart 1.94* In the past 12 months, had a doctor or someone in a doctor’s office talk to them about the dangers of tobacco use 0.76* 1.16* In the past 12 months, had a dentist or someone in a dentist’s office talk to them about the dangers of tobacco use 1.07 1.34* *p<0.05.