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Tob Control. 2017 Jan;26(1):34-39. doi: 10.1136/tobaccocontrol-2015-052705. Epub 2016 Jan 25.

Longitudinal study of e-cigarette use and onset of cigarette smoking among high school students in Hawaii.

Author information

1
Prevention and Control Program, University of Hawaii Cancer Center, Honolulu, Hawaii, USA.
2
Cancer Control Program, Norris Cotton Cancer Center, Lebanon, New Hampshire, USA.
3
Department of Psychology, University of Connecticut, Storrs, Connecticut, USA.
4
Office of Public Health Studies, University of Hawaii at Manoa, Honolulu, Hawaii, USA.

Abstract

OBJECTIVE:

Use of electronic cigarettes (e-cigarettes) is prevalent among adolescents, but there is little knowledge about the consequences of their use. We examined, longitudinally, how e-cigarette use among adolescents is related to subsequent smoking behaviour.

METHODS:

Longitudinal school-based survey with a baseline sample of 2338 students (9th and 10th graders, mean age 14.7 years) in Hawaii surveyed in 2013 (time 1, T1) and followed up 1 year later (time 2, T2). We assessed e-cigarette use, tobacco cigarette use, and psychosocial covariates (demographics, parental support and monitoring, and sensation seeking and rebelliousness). Regression analyses including the covariates tested whether e-cigarette use was related to the onset of smoking among youth who had never smoked cigarettes, and to change in smoking frequency among youth who had previously smoked cigarettes.

RESULTS:

Among T1 never-smokers, those who had used e-cigarettes at T1 were more likely to have smoked cigarettes at T2; for a complete-case analysis, adjusted OR=2.87, 95% CI 2.03 to 4.05, p<0.0001. Among ever-smokers at T1, using e-cigarettes was not related to significant change in their frequency of smoking at T2. Uptake of e-cigarette use among T1 never-users of either product was predicted by age, Caucasian or Native Hawaiian (vs Asian-American) ethnicity, lower parental education and parental support, higher rebelliousness, and perception of e-cigarettes as healthier.

CONCLUSIONS:

Adolescents who use e-cigarettes are more likely to start smoking cigarettes. This result together with other findings suggests that policies restricting adolescents' access to e-cigarettes may have a rationale from a public health standpoint.

KEYWORDS:

Electronic nicotine delivery devices; Nicotine; Public policy

[Indexed for MEDLINE]
Free PMC Article

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