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J Adolesc Health. 2018 May;62(5):539-547. doi: 10.1016/j.jadohealth.2017.11.301. Epub 2018 Mar 2.

The Association Between Smoking and Electronic Cigarette Use in a Cohort of Young People.

Author information

1
Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; UK Centre for Tobacco and Alcohol Studies, Clinical Sciences Building, University of Nottingham, Nottingham, UK. Electronic address: Katherine.east@kcl.ac.uk.
2
Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; UK Centre for Tobacco and Alcohol Studies, Clinical Sciences Building, University of Nottingham, Nottingham, UK.
3
Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Centre for Implementation Science, Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
4
Public Health England, London, UK; Action on Smoking and Health UK, London, UK.
5
Action on Smoking and Health UK, London, UK.

Abstract

PURPOSE:

Electronic cigarette (e-cigarette) use is associated with smoking initiation among young people; however, it is also possible that smoking is associated with e-cigarette initiation. This study explores these associations among young people in Great Britain.

METHODS:

A longitudinal survey of 1,152 11- to 18-year-olds was conducted with baseline in April 2016 and follow-up between August and October 2016. Logistic regression models and causal mediation analyses assessed whether (1) ever e-cigarette use and escalation were associated with smoking initiation (ever smoking at follow-up) among baseline never smokers (n = 923), and (2) ever smoking and escalation were associated with e-cigarette initiation (ever e-cigarette use at follow-up) among baseline never e-cigarette users (n = 1,020).

RESULTS:

At baseline, 19.8% were ever smokers and 11.4% were ever e-cigarette users. Respondents who were ever e-cigarette users (vs. never users, 53% vs. 8%, odds ratio [OR] = 11.89, 95% confidence interval [CI] = 3.56-39.72) and escalated their e-cigarette use (vs. did not, 41% vs. 8%, OR = 7.89, 95% CI = 3.06-20.38) were more likely to initiate smoking. Respondents who were ever smokers (vs. never smokers, 32% vs. 4%, OR = 3.54, 95% CI = 1.68-7.45) and escalated their smoking (vs. did not, 34% vs. 6%, OR = 5.79, 95% CI = 2.55-13.15) were more likely to initiate e-cigarette use. There was a direct effect of ever e-cigarette use on smoking initiation (OR = 1.34, 95% CI = 1.05-1.72), and ever smoking on e-cigarette initiation (OR = 1.08, 95% CI = 1.01-1.17); e-cigarette and smoking escalation, respectively, did not mediate these effects.

CONCLUSIONS:

Among young people in Great Britain, ever e-cigarette use is associated with smoking initiation, and ever smoking is associated with e-cigarette initiation.

KEYWORDS:

Adolescent; E-cigarettes; Electronic cigarettes; Longitudinal studies; Nicotine; Smoking; Tobacco; Young people; Youth

Comment in

PMID:
29499983
PMCID:
PMC5938086
DOI:
10.1016/j.jadohealth.2017.11.301
[Indexed for MEDLINE]
Free PMC Article

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