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. 2024 Apr:181:107924.
doi: 10.1016/j.ypmed.2024.107924. Epub 2024 Mar 1.

Time to first report of signs of nicotine dependence among youth who use e-cigarettes and cigarettes in the United States: A nationally representative cohort study, findings from the Population Assessment of Tobacco and Health, 2013-2019

Abigail Adjei  1 , Dale S Mantey  2 , Baojiang Chen  2 , Anna V Wilkinson  2 , Melissa B Harrell  2
Affiliations

Time to first report of signs of nicotine dependence among youth who use e-cigarettes and cigarettes in the United States: A nationally representative cohort study, findings from the Population Assessment of Tobacco and Health, 2013-2019

Abigail Adjei et al. Prev Med. 2024 Apr.

Abstract

Objective: To determine the time to first report of signs of nicotine dependence among youth exclusive e-cigarette users and compare this time to that for exclusive cigarette users.

Methods: Secondary analysis of data (Waves 1-5; 2013-2019) from the Population Assessment of Tobacco and Health was conducted. Youth never tobacco users in the United States who reported exclusive past-30-day (P30D) e-cigarette or cigarette use (n = 2940, N = 5,391,642) in at least one wave were included in the current analysis. Survival analysis was used to estimate the time to the first report of three nicotine dependence indicators (i.e., "use within 30 minutes of waking"; "cravings" and "really needing to use") following the first report of P30D use. Multivariable Cox proportional hazard models were used to estimate adjusted hazard ratios (aHR).

Results: There were no significant differences in the time to first report of "use within 30 minutes of waking" (aHR = 1.1, 95% CI = 0.87-1.40) and "cravings" (aHR = 1.09, 95% CI = 0.81-1.47) between exclusive P30D e-cigarette use and exclusive P30D cigarette use. However, compared to exclusive P30D e-cigarette use, the hazard of first reporting "really needing to use" tobacco was 39% (aHR 1.39; 95% CI: 1.05-1.84) times higher for those who reported exclusive P30D cigarette use after controlling for covariates.

Conclusion: Compared to exclusive P30D cigarette use, no differences in the time to first report of signs of nicotine dependence ("use within 30 minutes" and "cravings") were observed among exclusive P30D e-cigarette users. Policymakers and regulatory agencies should consider this evidence when assessing the abuse liability of e-cigarette products.

Keywords: Abuse liability; Cigarette use; E-cigarette use; Nicotine dependence.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests. Dr. Harrell was an expert witness for the State of Minnesota in its case against Juul Labs and Altria. Dr. Mantey was a consultant for the State of Minnesota in its case against Juul Labs and Altria.” The other authors have no other potential conflicts of interest to disclose.

Figures

Fig. 1.
Fig. 1.
Cumulative probability for the time to first report of nicotine dependence outcomes by tobacco use behavior (exclusive e-cigarette use and exclusive cigarette smoking) among youth (mean age = 17.6 years) past 30-day users (n = 2940, N = 5,391,642), PATH, US (Waves 2–5; 2014–2019).
Fig. 2.
Fig. 2.
Number of weeks following P30D use (exclusive e-cigarette or cigarette smoking) at which the cumulative probability of first reporting an indicator of nicotine dependence is 25% among youth (mean age = 17.6 years) exclusive past 30-day users (n = 2940, N = 5,391,642) PATH, US (Waves 2–5; 2014–2019).
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References

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Dataset Reference

    1. United States Department of Health and Human Services, November 5, 2019. National Institutes of Health. National Institute on Drug Abuse, and United States Department of Health and Human Services. Food and Drug Administration. Center for Tobacco Products. Population Assessment of Tobacco and Health (PATH) Study [United States] Restricted-Use Files. Inter-university Consortium for Political and Social Research [distributor]. 10.3886/ICPSR36231.v36. - DOI