This study assesses perception of short-term and long-term harm associated with tobacco, e-cigarettes, and smoked marijuana in adolescents and young adults (AYA) with cystic fibrosis (CF).

A total of 205 AYA patients with CF completed an online survey, answering questions related to use, perception, and education related to traditional cigarettes, electronic cigarettes (e-cigarettes), and smoked marijuana. In addition, parents and health care providers of CF patients were asked questions on experiences in avoidance education.

AYA patients with CF have used tobacco and marijuana products at rates lower than that of nationally reported data; however, heavy use is considerably lower.

Patients perceive lower risk of negative outcomes associated with using e-cigarettes and smoked marijuana compared to combustible cigarettes. Ever-use of products is correlated with a lower perception of risk across all products. Avoidance education varies greatly between products as recalled by patients and parents, and as reported by CF health care providers. Reasons for undereducation include but are not limited to lack of familiarity with products, incorrect assumption of education, and time constraints.

The findings described in this study on safety perceptions and use of combustible tobacco, e-cigarettes, and marijuana in patients with cystic fibrosis underscore the importance of avoidance education in vulnerable patient populations. Insight derived from this study may also inform pediatric to adult clinic transition education, when chronic disease populations are at greatest risk for engaging in risky behaviors.

We report data on use, risk perception, and education of tobacco, electronic cigarettes, and cannabis in patients with cystic fibrosis, with focus on the adolescent and young adults. Such information will inform prevention education, especially during the critical transition period from pediatric to adult care when these behaviors are prevalent.