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. 2020 Nov 2;3(11):e2015893.
doi: 10.1001/jamanetworkopen.2020.15893.

Association of Electronic Nicotine Delivery System Use With Cigarette Smoking Progression or Reduction Among Young Adults

Jennifer L Pearson  1   2 , Eva Sharma  3 , Ning Rui  3 , Michael J Halenar  3 , Amanda L Johnson  4 , K Michael Cummings  5 , Hoda T Hammad  4 , Annette R Kaufman  6 , Cindy Tworek  4 , Maciej L Goniewicz  7 , Heather L Kimmel  8 , Susanne Tanski  9 , Wilson M Compton  10 , Hannah Day  4 , Bridget K Ambrose  4 , Maansi Bansal-Travers  7 , Marushka L Silveira  8   11 , David Abrams  12 , Jeannie Limpert  4 , Mark J Travers  7 , Nicolette Borek  4 , Andrew J Hyland  7 , Cassandra A Stanton  3   13
Affiliations

Association of Electronic Nicotine Delivery System Use With Cigarette Smoking Progression or Reduction Among Young Adults

Jennifer L Pearson et al. JAMA Netw Open. .

Erratum in

  • Incomplete Conflict of Interest Disclosures.
    [No authors listed] [No authors listed] JAMA Netw Open. 2024 Jun 3;7(6):e2426687. doi: 10.1001/jamanetworkopen.2024.26687. JAMA Netw Open. 2024. PMID: 38913381 Free PMC article. No abstract available.

Abstract

Importance: The prevalence of electronic nicotine delivery systems (ENDS) use, including e-cigarettes, among US young adults (YAs) has raised questions about how these products may affect future tobacco and nicotine use among YAs. Given this prevalence and that young adulthood is a critical period for the establishment of tobacco and nicotine use, it is important to consider the association between ENDS use and cigarette smoking specifically in this age group.

Objective: To examine whether ENDS use frequency or intensity is associated with changes in cigarette smoking among US YA ever smokers during 1 year.

Design, setting, and participants: This cohort study used 3 waves of data (2013-2014, 2014-2015, and 2015-2016) from the Population Assessment of Tobacco and Health (PATH) Study, an ongoing longitudinal cohort study of adults and youth. Unweighted 1:6 propensity score matching was used to match participants on wave 1 risk factors for ENDS use at wave 2. The changes in smoking between wave 2 and wave 3 were assessed using the matched sample. In total, 1096 ENDS-naive, ever cigarette-smoking YAs (18-24 years of age) at wave 1 who participated in wave 2 and wave 3 and who had complete data in the PATH Study were included in the analyses, which were conducted from August 2018 to October 2019.

Exposures: Never ENDS use (n = 987), any previous 30-day ENDS use (n = 109), 1 to 5 days of ENDS use in the previous 30 days (n = 75), and 6 or more days ENDS use in the previous 30 days at wave 2 (n = 34).

Main outcomes and measures: The analytic sample was selected using multiple variables based on peer-reviewed literature supporting associations with ENDS use. The main outcomes-changes in cigarette smoking behavior between wave 2 and wave 3-were defined using 2 measures: (1) change in smoking frequency, defined as the number of smoking days in the previous 30 days at wave 3 vs wave 2, and (2) change in smoking intensity, defined as the number smoking days in the previous 30 days multiplied by the mean number of cigarettes consumed on smoking days at wave 3 vs wave 2.

Results: The present cohort analyses included 1096 YA ever smokers who were ENDS naive at wave 1. The majority of the sample were women (609 [55.6%]) and White individuals (698 [63.7%]), and the mean (SD) age was 21.4 (1.9) years. In wave 1, 161 YAs (14.7%) were daily smokers in the previous 30 days. After propensity score matching, no statistically significant associations were observed between any definition of wave 2 ENDS use and changes in either the frequency or intensity of smoking at wave 3.

Conclusions and relevance: In this cohort study of US YA ever smokers, ENDS use was not associated with either decreased or increased cigarette smoking during a 1-year period. However, it is possible that the rapidly evolving marketplace of vaping products may lead to different trajectories of YA cigarette and ENDS use in the future.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Pearson reported receiving personal fees from Westat during the conduct of the study. Drs Pearson and Cummings reported receiving payment for expert testimony in lawsuits filed against the tobacco industry. Mr Halenar reported having a Population Assessment of Tobacco and Health (PATH) Study contract from the US Food and Drug Administration (FDA) Center for Tobacco Products (CTP) during the conduct of the study. Ms Johnson reported receiving grants and personal fees from Westat and from the PATH Study during the conduct of the study. Dr Cummings reported receiving payment as a consultant to Pfizer for services on an external advisory panel to assess ways to improve smoking cessation delivery in health care settings. Dr Goniewicz reported receiving grants from the National Institutes of Health (NIH) and the FDA during the conduct of the study; receiving grants from Pfizer and receiving personal fees from Johnson and Johnson outside the submitted work; and being a member of the National Academies of Sciences, Engineering, and Medicine Committee on the Review of the Health Effects of Electronic Nicotine Delivery Systems. Dr Tanski reported receiving grants from the National Institute on Drug Abuse (NIDA) and from the National Cancer Institute during the conduct of the study. Dr Compton reported having long-term stock holdings in General Electric Co, 3M Companies, and Pfizer outside the submitted work. Dr Abrams reported receiving grants from a Westat subcontract from the NIH-NIDA–FDA during the conduct of the study; receiving other NIDA grants paid to his employers; receiving salary from the Steven Schroeder Institute for Tobacco Research and Policy Studies at The Legacy Foundation, now Truth Initiative, New York University School of Global Public Health; and between mid-2015 and 2020, frequently communicating with Juul Labs personnel, for which there was no compensation, and receiving hospitality in the form of meals at some meetings outside the submitted work. Dr Hyland reported receiving a peer-reviewed contract from NIDA during the conduct of the study. Dr Stanton reported receiving a PATH Study contract from NIDA-CTP during the conduct of the study. No other disclosures were reported.

Figures

Figure.
Figure.. Description of Sample Size and Exposure Status for the Young Adult Analytic Sample From the Population Assessment of Tobacco Health Study Wave 1 to Wave 3.
ENDS indicates electronic nicotine delivery system.
See this image and copyright information in PMC

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References

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