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Tob Control. 2017 Jul 22. pii: tobaccocontrol-2017-053691. doi: 10.1136/tobaccocontrol-2017-053691. [Epub ahead of print]

Relationship between trying an electronic cigarette and subsequent cigarette experimentation in Scottish adolescents: a cohort study.

Author information

1
Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK.
2
Child and Adolescent Health Research Unit, School of Medicine, University of St Andrews, St Andrews, UK.
3
School of Medicine, University of St Andrews, St Andrews, UK.
4
Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK.
5
ScotCen Social Research, Edinburgh, UK.
6
Centre for Research on Environment Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, UK.
7
The Usher Institute of Population Health Sciences and Informatics, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK.

Abstract

BACKGROUND:

This study examines whether young never smokers in Scotland, UK, who have tried an e-cigarette are more likely than those who have not, to try a cigarette during the following year.

METHODS:

Prospective cohort survey conducted in four high schools in Scotland, UK during February/March 2015 (n=3807) with follow-up 1 year later. All pupils (age 11-18) were surveyed. Response rates were high in both years (87% in 2015) and 2680/3807 (70.4%) of the original cohort completed the follow-up survey. Analysis was restricted to baseline 'never smokers' (n=3001/3807), 2125 of whom were available to follow-up (70.8%).

RESULTS:

At baseline, 183 of 2125 (8.6%) never smokers had tried an e-cigarette and 1942 had not. Of the young people who had not tried an e-cigarette at baseline, 249 (12.8%) went on to try smoking a cigarette by follow-up. This compares with 74 (40.4%) of those who had tried an e-cigarette at baseline. This effect remained significant in a logistic regression model adjusted for smoking susceptibility, having friends who smoke, family members' smoking status, age, sex, family affluence score, ethnic group and school (adjusted OR 2.42 (95% CI 1.63 to 3.60)). There was a significant interaction between e-cigarette use and smoking susceptibility and between e-cigarette use and smoking within the friendship group.

CONCLUSIONS:

Young never smokers are more likely to experiment with cigarettes if they have tried an e-cigarette. Causality cannot be inferred, but continued close monitoring of e-cigarette use in young people is warranted.

KEYWORDS:

Denormalization; Electronic Nicotine Delivery Devices; Priority/special Populations

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