Bidirectional associations between e-cigarette use and alcohol use across adolescence. (1st March 2021)

• Record Type: Journal Article
• Authors: Lozano, Alyssa; Liu, Feifei; Lee, Tae Kyoung; Prado, Guillermo; Schwartz, Seth J.; Leventhal, Adam M.; Kelleghan, Annemarie R.; Unger, Jennifer B.; Barrington-Trimis, Jessica L.
• Is Part Of: Drug and alcohol dependence. Volume 220(2021)
• Publication Date: 2021-03-01
• Subjects: OR odds ratio -- CI confidence interval; e-Cigarettes -- Alcohol -- Adolescence -- Longitudinal analysis -- Tobacco; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2020.108496
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: E-cigarette use was positively associated with subsequent alcohol initiation. The association of e-cigarette use with subsequent alcohol initiation was stronger for males. Alcohol use was positively associated with subsequent e-cigarette initiation. Abstract: Introduction: Evidence on prospective bidirectional associations between e-cigarette and alcohol use among adolescents can inform prevention and policy but is largely absent from the literature. Methods: Data were drawn from a prospective cohort of students attending 10 Los Angeles high schools (N = 3396; baseline mean age = 14.1, SD = 0.4). Students completed surveys every 6-months from 2013 to 2017; 8 total waves. Analyses were restricted to (a) individuals who were never users of alcohol (N = 2394) or (b) individuals who were never users of e-cigarettes (N = 2704) at baseline. Repeated-measures, generalized linear mixed models were used to estimate the adjusted odds of past 6-month alcohol and e-cigarette initiation, in separate models. Results: Among alcohol never-users at baseline, 15.7 % (N = 375) initiated alcohol use over the study period. Compared to never-users of e-cigarettes, those who reported use of e-cigarettes had 3.5 times the odds of subsequently initiating alcohol use in the following wave (OR = 3.54; 95 % CI: 2.81, 4.47). Stronger associations were observed for males (OR = 4.94; 95 % CI: 3.78, 6.45) than for females (OR = 3.21; 95 % CI: 2.33, 4.41; p interaction = 0.04). Among e-cigarette never-users at baseline, 26.3 % (N = 709) initiated e-cigarette use over the study period. Compared to never-users of alcohol, those who reported use of alcohol had 3.2 times the odds of subsequently initiating e-cigarette use in the following wave (OR = 3.23; 95 % CI: 2.68, 3.89). This association did not differ by gender. Conclusions: E-cigarette and alcohol use can be markers to identify youth at risk for future alcohol and e-cigarette use, respectively. Research examining mechanisms underlying these associations is needed to infer causality.