E-cigarette Use and Subsequent Smoking Frequency Among Adolescents

• Published in: Pediatrics (Evanston) 2018-12, Vol.142 (6), p.1
• Main Authors: Barrington-Trimis, Jessica L, Kong, Grace, Leventhal, Adam M, Liu, Feifei, Mayer, Margaret, Cruz, Tess Boley, Krishnan-Sarin, Suchitra, McConnell, Rob
• Format: Article
• Language: English
• Subjects: Adolescents; Cigarettes; Cohort analysis; Company business planning; Control; Electronic cigarettes; Health aspects; Health policy; Medical policy; Pediatrics; Planning; Public health; Regression analysis; Smoking; Teenagers; Tobacco; Tobacco habit; Vaping; Youth
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2018-0486

: media-1vid110.1542/5839992666001PEDS-VA_2018-0486 BACKGROUND AND OBJECTIVES: Electronic cigarette (e-cigarette) use is associated with cigarette initiation among adolescents. However, it is unclear whether e-cigarette use is associated with more frequent cigarette use after initiation. Also, the extent to which cigarette or dual cigarette and e-cigarette users transition to exclusive e-cigarette use or to the nonuse of either product is not yet known. Data were pooled from 3 prospective cohort studies in California and Connecticut (baseline: 2013-2014; follow-up: 2014-2016; = 6258). Polytomous regression models were used to evaluate the association of baseline e-cigarette use (never or ever) with cigarette use frequency at follow-up (experimental: initiation but no past-30-day use; infrequent: 1-2 of the past 30 days; frequent: 3-5 or more of the past 30 days). Polytomous regression models were also used to evaluate transitions between baseline ever or past-30-day single or dual product use and past-30-day single or dual product use at follow-up. Among baseline never smokers, e-cigarette users had greater odds of subsequent experimental (odds ratio [OR] = 4.58; 95% confidence interval [CI]: 3.56-5.88), infrequent (OR = 4.27; 95% CI: 2.75-6.62) or frequent (OR = 3.51; 95% CI: 1.97-6.24) cigarette use; the 3 OR estimates were not significantly different. Baseline past-30-day exclusive cigarette use was associated with higher odds at follow-up of exclusive cigarette or dual product use than of exclusive e-cigarette use. Tobacco control policy to reduce adolescent use of both e-cigarettes and cigarettes is needed to prevent progression to more frequent tobacco use patterns and reduce combustible cigarette use (with or without concurrent e-cigarette use) to lessen the adverse public health impact of e-cigarettes.