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Association of Electronic Cigarette Use With Subsequent Initiation of Tobacco Cigarettes in US Youths.


ABSTRACT:

Importance

The use of electronic cigarettes (e-cigarettes) and other noncigarette tobacco products may increase the odds of cigarette initiation, even among low-risk youths.

Objective

To evaluate the associations of prior e-cigarette use and other tobacco product use with subsequent cigarette initiation within 2 years of follow-up.

Design, setting, and participants

In this prospective cohort study, data from waves 1 through 3 of the Population Assessment of Tobacco and Health Study (2013-2016) were used to assess youths aged 12 to 15 years who had never used cigarettes, e-cigarettes, or other tobacco products at wave 1. This was a nationally representative study of the US population. Data analysis was conducted in 2018.

Exposures

First noncigarette tobacco product used (none, e-cigarette, or other tobacco product) between wave 1 and wave 3.

Main outcomes and measures

Ever cigarette use and current cigarette use at wave 3.

Results

In the sample (N?=?6123), respondents were 49.5% female; 54.1% non-Hispanic, white; and the mean (SD) age was 13.4 (1.2) years. Of these, 8.6% reported e-cigarettes as their first tobacco product, while 5.0% reported using another noncigarette product first; 3.3% reported using cigarettes first. Cigarette use at wave 3 was higher among prior e-cigarette users (20.5%) compared with youths with no prior tobacco use (3.8%). Prior e-cigarette use was associated with more than 4 times the odds of ever cigarette use (odds ratio, 4.09; 95% CI, 2.97-5.63) and nearly 3 times the odds of current cigarette use (odds ratio, 2.75; 95% CI, 1.60-4.73) compared with no prior tobacco use. Prior use of other tobacco products was similarly associated with subsequent ever cigarette use (OR, 3.84; 95% CI, 2.63-5.63) and current cigarette use (OR, 3.43; 95% CI, 1.88-6.26) compared with no prior tobacco use. The association of prior e-cigarette use with cigarette initiation was stronger among low-risk youths (OR, 8.57; 95% CI, 3.87-18.97), a pattern not seen for prior other product use. Over the 2 years between 2013 and 2014 and 2015 and 2016, 21.8% of new cigarette ever use (178?850 youths) and 15.3% of current cigarette use (43?446 youths) among US youths aged 12 to 15 years may be attributable to prior e-cigarette use.

Conclusions and relevance

This study's findings support the notion that e-cigarette use is associated with increased risk for cigarette initiation and use, particularly among low-risk youths. At the population level, the use of e-cigarettes may be a contributor to the initiation of cigarette smoking among youths.

SUBMITTER: Berry KM 

PROVIDER: S-EPMC6484602 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Publications

Association of Electronic Cigarette Use With Subsequent Initiation of Tobacco Cigarettes in US Youths.

Berry Kaitlyn M KM   Fetterman Jessica L JL   Benjamin Emelia J EJ   Bhatnagar Aruni A   Barrington-Trimis Jessica L JL   Leventhal Adam M AM   Stokes Andrew A  

JAMA network open 20190201 2


<h4>Importance</h4>The use of electronic cigarettes (e-cigarettes) and other noncigarette tobacco products may increase the odds of cigarette initiation, even among low-risk youths.<h4>Objective</h4>To evaluate the associations of prior e-cigarette use and other tobacco product use with subsequent cigarette initiation within 2 years of follow-up.<h4>Design, setting, and participants</h4>In this prospective cohort study, data from waves 1 through 3 of the Population Assessment of Tobacco and Heal  ...[more]

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