Do electronic cigarettes increase cigarette smoking in UK adolescents? Evidence from a 12-month prospective study. Issue 4 (17th August 2017)

• Record Type: Journal Article
• Authors: Conner, Mark; Grogan, Sarah; Simms-Ellis, Ruth; Flett, Keira; Sykes-Muskett, Bianca; Cowap, Lisa; Lawton, Rebecca; Armitage, Christopher J; Meads, David; Torgerson, Carole; West, Robert; Siddiqi, Kamran
• Is Part Of: Tobacco control. Volume 27:Issue 4(2018)
• Page Start: 365
• Page End: 372
• Publication Date: 2017-08-17
• Subjects: electronic nicotine delivery systems -- e-cigarettes -- smoking -- harm reduction -- prevention; 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-2016-053539
• Languages: English
• ISSNs: 0964-4563

Abstract

Abstract : Background: In cross-sectional surveys, increasing numbers of adolescents report using both electronic cigarettes (e-cigarettes) and cigarettes. This study assessed whether adolescent e-cigarette use was associated prospectively with initiation or escalation of cigarette use. Methods: Data were from 2836 adolescents (aged 13–14 years at baseline) in 20 schools in England. At baseline, breath carbon monoxide levels, self-reported e-cigarette and cigarette use, sex, age, friends and family smoking, beliefs about cigarette use and percentage receiving free school meals (measure of socioeconomic status) were assessed. At 12-month follow-up, self-reported cigarette use was assessed and validated by breath carbon monoxide levels. Results: At baseline, 34.2% of adolescents reported ever using e-cigarettes (16.0% used only e-cigarettes). Baseline ever use of e-cigarettes was strongly associated with subsequent initiation (n=1726; OR 5.38, 95% CI 4.02 to 7.22; controlling for covariates, OR 4.06, 95% CI 2.94 to 5.60) and escalation (n=318; OR 1.91, 95% CI 1.14 to 3.21; controlling for covariates, this effect became non-significant, OR 1.39, 95% CI 0.97 to 1.82) of cigarette use. Conclusions: This is the first study to report prospective relationships between ever use of e-cigarettes and initiation and escalation of cigarette use among UK adolescents. Ever use of e-cigarettes was robustly associated with initiation but more modestly related to escalation of cigarette use. Further research with longer follow-up in a broader age range of adolescents is required.