Association of initial e-cigarette and other tobacco product use with subsequent cigarette smoking in adolescents: a cross-sectional, matched control study. Issue Volume 30:Issue e2(2021) (17th March 2020)

• Record Type: Journal Article
• Authors: Shahab, Lion; Beard, Emma; Brown, Jamie
• Is Part Of: Tobacco control. Volume 30:Issue e2(2021)
• Page Start: 212
• Page End: 220
• Publication Date: 2020-03-17
• Subjects: electronic nicotine delivery devices -- harm reduction -- priority/special populations -- non-cigarette tobacco products; Tobacco use -- Prevention -- Periodicals; Tobacco use -- Periodicals; Smoking -- Law and legislation -- Periodicals; Smoking -- prevention & control -- Periodicals; Tobacco Use Disorder -- prevention & control -- Periodicals; Tobacco -- Periodicals; Electronic journals; 613.85
• DOI: 10.1136/tobaccocontrol-2019-055283
• Languages: English
• ISSNs: 0964-4563

Abstract

Abstract : Introduction: This study assessed whether initiating e-cigarette use increases the uptake of cigarette smoking in US adolescents compared with behavioural and synthetic controls. Methods: Data come from 78 265 adolescents in the National Youth Tobacco Survey (2014–2017) of whom 38 630 provided information about the first tobacco product they had used in 2014/15. Ever, past 30 day and established (30 day use and 100+ lifetime cigarettes) cigarette smoking was compared in adolescents who first used an e-cigarette (exposure group), a non-cigarette combustible (CT) or other non-combustible tobacco (NT) product (behavioural controls), and propensity score matched adolescents without initial e-cigarette use (synthetic controls). Results: Relative to behavioural controls, adolescents who tried e-cigarettes first were less likely to have ever smoked cigarettes (26% vs CT (42.4%; OR 0.48, 95% CI 0.40 to 0.57), or NT initiators (52.7%; OR 0.32, 95% CI 0.26 to 0.39)), to be past 30 day (6% vs CT (11.9%; OR 0.48, 95% CI 0.36 to 0.62), or NT initiators (20.0%; OR 0.26, 95% CI 0.19 to 0.35)) or be established cigarette smokers (0.7% vs CT (3.9%; OR 0.17, 95% CI 0.10 to 0.30), or NT initiators (8.4%; OR 0.08, 95% CI 0.04 to 0.13)). E-cigarette initiators were also less likely than synthetic controls (without initial e-cigarette use) to have ever smoked cigarettes (OR 0.76, 95% CI 0.62 to 0.93), be past 30 day (OR 0.71, 95% CI 0.55 to 0.91) or be established cigarette smokers (OR 0.26, 95% CI 0.13 to 0.51). Conclusion: Less than 1% of US adolescents who use e-cigarettes first were established cigarette smokers. They were less likely to be smokers than adolescents who tried other combustible or non-combustible tobacco products first and propensity score matched adolescents without initial e-cigarette use.