Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan:142:106316.
doi: 10.1016/j.ypmed.2020.106316. Epub 2020 Nov 30.

Effects of e-cigarette use on cigarette smoking among U.S. youth, 2004-2018

MeLisa R Creamer  1 , Lauren M Dutra  2 , Saida R Sharapova  3 , Andrea S Gentzke  3 , Kevin L Delucchi  4 , Ruben A Smith  5 , Stanton A Glantz  6
Affiliations

Effects of e-cigarette use on cigarette smoking among U.S. youth, 2004-2018

MeLisa R Creamer et al. Prev Med. 2021 Jan.

Abstract

Objective: To determine if the declining trend in U.S. youth cigarette smoking changed after e-cigarettes were introduced, and if youth e-cigarette users would have been likely to smoke cigarettes based on psychosocial and demographic predictors of smoking.

Methods: An interrupted time series analysis was used for cross-sectional data from the 2004 to 2018 National Youth Tobacco Surveys (NYTS) to assess changes in cigarette and e-cigarette use over time. A multivariable logistic regression model used 2004-2009 NYTS data on psychosocial risk factors to predict individual-level cigarette smoking risk from 2011 to 2018. Model-predicted and actual cigarette smoking behavior were compared.

Results: The decline in current cigarette smoking slowed in 2014 (-0.75 [95% CI: -0.81, -0.68] to -0.26 [95% CI: -0.40, -0.12] percentage points per year). The decline in ever cigarette smoking accelerated after 2012 (-1.45 [95% CI: -1.59, -1.31] to -1.71 [95% CI: -1.75, -1.66]). Ever and current combined cigarette and/or e-cigarette use declined during 2011-2013 and increased during 2013-2014 with no significant change during 2014-2018 for either variable. The psychosocial model estimated that 69.0% of current cigarette smokers and 9.3% of current e-cigarette users (who did not smoke cigarettes) would smoke cigarettes in 2018.

Conclusions: The introduction of e-cigarettes was followed by a slowing decline in current cigarette smoking, a stall in combined cigarette and e-cigarette use, and an accelerated decline in ever cigarette smoking. Traditional psychosocial risk factors for cigarette smoking suggest that e-cigarette users do not fit the traditional risk profile of cigarette smokers.

Keywords: Adolescent; Cigarette smoking; E-cigarettes; Tobacco use.

PubMed Disclaimer

Figures

Figure 1:
Figure 1:. Prevalence of Cigarette, E-cigarette, and Use of Cigarettes and/or E-cigarettes, US Middle School and High School Students, 2004–2018 NYTS.
Solid and dotted lines are fit from the autoregressive interrupted time series analysis. These lines are predicted values
See this image and copyright information in PMC

References

    1. Gentzke AS, Creamer M, Cullen KA, et al. Vital Signs: Tobacco product use among middle and high school students—United States, 2011–2018. MMWR: Morbidity and Mortality Weekly Report. 2019;68(6):157. doi:10.15585/mmwr.mm6806el. - DOI - PMC - PubMed
    1. Cullen KA, Ambrose BK, Gentzke AS, Apelberg BJ, Jamal A, King BA. Notes from the field: Use of electronic cigarettes and any tobacco product among middle and high school students—United States, 2011–2018. MMWR: Morbidity and Mortality Weekly Report. 2018;67(45):1276. doi:10.15585/mmwr.mm6745a5. - DOI - PMC - PubMed
    1. FDA. Statement from FDA Commissioner Scott Gottlieb, M.D., on proposed new steps to protect youth by preventing access to flavored tobacco products and banning menthol in cigarettes. https://www.fda.gov/news-events/press-announcements/statement-fda-commis... Published 2018. Accessed 16 May 2019.
    1. U.S. Department of Health and Human Services. Surgeon General releases advisory on e-cigarette epidemic among youth, https://www.hhs.gov/about/news/2018/12/18/surgeon-general-releasesadviso... Published 2018. Updated December 18, 2018. Accessed 16 May 2019.
    1. U.S. Department of Health and Human Services. E-Cigarette Use Among Youth and Young Adults. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion;2016.

Publication types