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Pediatrics. 2018 Apr;141(4). pii: e20173594. doi: 10.1542/peds.2017-3594. Epub 2018 Mar 5.

Electronic Cigarette Use and Progression From Experimentation to Established Smoking.

Author information

1
Center for Tobacco Control Research and Education, benjamin.chaffee@ucsf.edu.
2
Departments of Preventive and Restorative Dental Sciences and.
3
Center for Tobacco Control Research and Education.
4
Medicine, University of California, San Francisco, San Francisco, California.
5
Philip R. Lee Institute for Health Policy Studies, and.

Abstract

BACKGROUND:

It has been shown that never-smoking adolescents who try electronic cigarettes (e-cigarettes) are at increased risk of subsequent conventional cigarette smoking. We evaluated associations between e-cigarette use and progression to established smoking among adolescents who had already tried cigarettes.

METHODS:

Among participants (age 12-17 years) in the nationally representative Population Assessment of Tobacco and Health survey who had smoked a cigarette (≥1 puff) but not yet smoked 100 cigarettes (N = 1295), we examined 3 outcomes at 1-year follow-up as a function of baseline e-cigarette use: (1) having smoked ≥100 cigarettes (established smoking), (2) smoking during the past 30 days, and (3) both having smoked ≥100 cigarettes and past 30-day smoking (current established smoking). Survey-weighted multivariable logistic regression models were fitted to obtain odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for smoking risk factors.

RESULTS:

Versus e-cigarette never use, having ever used e-cigarettes was positively associated with progression to established cigarette smoking (19.3% vs 9.7%), past 30-day smoking (38.8% vs 26.6%), and current established smoking (15.6% vs 7.1%). In adjusted models, e-cigarette ever use positively predicted current established smoking (OR: 1.80; 95% CI: 1.04-3.12) but did not reach statistical significance (α = .05) for established smoking (OR: 1.57; 95% CI: 0.99-2.49) and past 30-day smoking (OR: 1.32; 95% CI: 0.99-1.76).

CONCLUSIONS:

Among adolescent cigarette experimenters, using e-cigarettes was positively and independently associated with progression to current established smoking, suggesting that e-cigarettes do not divert from, and may encourage, cigarette smoking in this population.

PMID:
29507167
PMCID:
PMC5869336
DOI:
10.1542/peds.2017-3594
[Indexed for MEDLINE]
Free PMC Article

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