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Is adolescent e-cigarette use associated with smoking in the United Kingdom?: A systematic review with meta-analysis.

ABSTRACT: INTRODUCTION:Though smoking is a public health problem the use of e-cigarettes has been associated with a reduction in smoking in developed countries. However, public health experts have raised concerns about the association of e-cigarette use with an increase in traditional cigarette smoking in adolescents. Review-level evidence is generally supportive of this concern, but as it is mainly based on studies from the USA we investigated if e-cigarette use is associated with traditional cigarette smoking in adolescents (aged 10-19 years) in the UK. METHODS:We conducted a systematic review of empirical studies. Databases (PubMed, Medline via ProQuest, CINAHL and SCOPUS) were searched between January 2005 and May 2018 using search terms based on the concepts: adolescents, traditional cigarette smoking, e-cigarettes, and UK. Using pre-defined inclusion and exclusion criteria, a total of eight studies (involving 73076 adolescents) were included in this review. Three of the included studies were eligible to be combined in a meta-analysis. The CASP appraisal tool was used to assess study quality while risk of bias was assessed using ROBINS-I. RESULTS:Studies included in the meta-analysis showed that adolescents who use e-cigarettes are up to six times more likely to smoke traditional cigarettes. Furthermore, results showed that traditional cigarette smoking can also precede e-cigarette use in adolescents and there was increased likelihood of an increase in initial product use (e-cigarette or traditional cigarette) when the alternate product was initiated. CONCLUSIONS:Public health policy makers in the UK still need clear conclusions about the effects and safety of e-cigarettes.

SUBMITTER: Aladeokin A

PROVIDER: S-EPMC7205081 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Is adolescent e-cigarette use associated with smoking in the United Kingdom?: A systematic review with meta-analysis.

Aladeokin Adewale A Haighton Catherine C

Tobacco prevention & cessation 20190422

<h4>Introduction</h4>Though smoking is a public health problem the use of e-cigarettes has been associated with a reduction in smoking in developed countries. However, public health experts have raised concerns about the association of e-cigarette use with an increase in traditional cigarette smoking in adolescents. Review-level evidence is generally supportive of this concern, but as it is mainly based on studies from the USA we investigated if e-cigarette use is associated with traditional cig ...[more]

PMID: 32411879

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Project description:BackgroundThis systematic review of prospective longitudinal primary studies sought to determine whether electronic cigarette (e-cigarette) use by teenagers who had never smoked conventional tobacco cigarettes (tobacco cigarettes) at baseline was associated with subsequently commencing tobacco cigarette smoking.MethodsThe review followed the principles of a systematic review and meta-analysis. A key word search identified peer-reviewed articles published between 1 January 2005 and 2 October 2019 from seven bibliographic databases and one search engine. Using pre-prepared inclusion/exclusion criteria two researchers independently screened abstracts, and subsequently, full text papers. Selected articles were quality assessed in duplicate. Data on study participants characteristics, exposure and outcome measures were recorded in an adapted Cochrane Data Extraction Form. Feasibility assessment was done to detect clinical heterogeneity and choose an approach to meta-analysis. Analysis comprised pairwise random effects meta-analyses, and sensitivity and subgroup analyses.ResultsFrom the 6619 studies identified, 14 one-off primary studies in 21 articles were suitable for inclusion. The participants ages ranged from 13 to 19 years and comprised teenagers based in Europe and North America. Nine of the 14 one-off studies, with follow-up periods between 4 and 24 months, met the criteria for inclusion in a meta-analysis of the association between ever use of e-cigarettes and subsequent initiation of tobacco cigarette use. Based on primary study adjusted odds ratios, our meta-analysis calculated a 4.06 (95% confidence interval (CI): 3.00-5.48, I2 68%, 9 primary studies) times higher odds of commencing tobacco cigarette smoking for teenagers who had ever used e-cigarettes at baseline, though the odds ratio were marginally lower (to 3.71 times odds, 95%CI: 2.83-4. 86, I2 35%, 4 primary studies) when only the four high-quality studies were analysed.ConclusionThe systematic review found that e-cigarette use was associated with commencement of tobacco cigarette smoking among teenagers in Europe and North America, identifying an important health-related harm. Given the availability and usage of e-cigarettes, this study provides added support for urgent response by policymakers to stop their use by teenagers to decrease direct harms in this susceptible population group, as well as to conserve achievements in diminishing tobacco cigarette initiation.

Project description:AimsTo conduct a systematic review and meta-analysis of studies in order to estimate the effect of US medical marijuana laws (MMLs) on past-month marijuana use prevalence among adolescents.MethodsA total of 2999 papers from 17 literature sources were screened systematically. Eleven studies, developed from four ongoing large national surveys, were meta-analyzed. Estimates of MML effects on any past-month marijuana use prevalence from included studies were obtained from comparisons of pre-post MML changes in MML states to changes in non-MML states over comparable time-periods. These estimates were standardized and entered into a meta-analysis model with fixed-effects for each study. Heterogeneity among the study estimates by national data survey was tested with an omnibus F-test. Estimates of effects on additional marijuana outcomes, of MML provisions (e.g. dispensaries) and among demographic subgroups were abstracted and summarized. Key methodological and modeling characteristics were also described. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.ResultsNone of the 11 studies found significant estimates of pre-post MML changes compared with contemporaneous changes in non-MML states for marijuana use prevalence among adolescents. The meta-analysis yielded a non-significant pooled estimate (standardized mean difference) of -0.003 (95% confidence interval = -0.012, +0.007). Four studies compared MML with non-MML states on pre-MML differences and all found higher rates of past-month marijuana use in MML states pre-MML passage. Additional tests of specific MML provisions, of MML effects on additional marijuana outcomes and among subgroups generally yielded non-significant results, although limited heterogeneity may warrant further study.ConclusionsSynthesis of the current evidence does not support the hypothesis that US medical marijuana laws (MMLs) until 2014 have led to increases in adolescent marijuana use prevalence. Limited heterogeneity exists among estimates of effects of MMLs on other patterns of marijuana use, of effects within particular population subgroups and of effects of specific MML provisions.

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Is adolescent e-cigarette use associated with smoking in the United Kingdom?: A systematic review with meta-analysis.

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Is adolescent e-cigarette use associated with smoking in the United Kingdom?: A systematic review with meta-analysis.

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