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. 2018 Dec;142(6):e20180486.
doi: 10.1542/peds.2018-0486. Epub 2018 Nov 5.

E-cigarette Use and Subsequent Smoking Frequency Among Adolescents

Jessica L Barrington-Trimis  1 , Grace Kong  2 , Adam M Leventhal  3 , Feifei Liu  3 , Margaret Mayer  2 , Tess Boley Cruz  3 , Suchitra Krishnan-Sarin  2 , Rob McConnell  3
Affiliations

E-cigarette Use and Subsequent Smoking Frequency Among Adolescents

Jessica L Barrington-Trimis et al. Pediatrics. 2018 Dec.

Abstract

: media-1vid110.1542/5839992666001PEDS-VA_2018-0486Video Abstract 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.

Methods: Data were pooled from 3 prospective cohort studies in California and Connecticut (baseline: 2013-2014; follow-up: 2014-2016; N = 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.

Results: 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.

Conclusions: 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.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Prevalence of cigarette initiation between baseline and follow-up and, among initiators, frequency of cigarette use at follow-up for never e-cigarette users and e-cigarette users at baseline. A, Never e-cigarette users. B, E-cigarette users.
FIGURE 2
FIGURE 2
Prevalence of past-30-day tobacco product use at baseline and follow-up.
See this image and copyright information in PMC

References

    1. Barrington-Trimis JL, Urman R, Leventhal AM, et al. E-cigarettes, cigarettes, and the prevalence of adolescent tobacco use. Pediatrics. 2016;138(2):e20153983. - PMC - PubMed
    1. Dutra LM, Glantz SA. E-cigarettes and national adolescent cigarette use: 2004-2014. Pediatrics. 2017;139(2):e20162450. - PMC - PubMed
    1. Leventhal AM, Strong DR, Kirkpatrick MG, et al. Association of electronic cigarette use with initiation of combustible tobacco product smoking in early adolescence. JAMA. 2015;314(7):700–707 - PMC - PubMed
    1. Barrington-Trimis JL, Urman R, Berhane K, et al. E-cigarettes and future cigarette use. Pediatrics. 2016;138(1):e20160379. - PMC - PubMed
    1. Unger JB, Soto DW, Leventhal A. E-cigarette use and subsequent cigarette and marijuana use among Hispanic young adults. Drug Alcohol Depend. 2016;163:261–264 - PMC - PubMed

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