Abstract
Background
Although electronic cigarettes (e-cigarettes) may help some smokers quit, some young
adult never-smokers are now using e-cigarettes recreationally, potentially increasing
their risk for initiation of smoking. We aimed to determine the association between
baseline e-cigarette use and subsequent initiation of cigarette smoking among initially
never-smoking young adults.
Methods
We conducted a prospective cohort study with assessments at baseline (March 2013)
and follow-up (October 2014). We used sampling frames representing 97% of the US population
to recruit a nationally representative sample of never-smoking young adults aged 18
to 30 years. The independent variable was baseline ever use of e-cigarettes. The main
outcome measure was initiation of traditional cigarette smoking between baseline and
18-month follow-up.
Results
Baseline surveys were completed by 1506 never-smoking young adults, of whom 915 (60.8%)
completed follow-up. There were no demographic differences between responders and
nonresponders. After applying survey weights—which accounted for both nonresponse
and overcoverage or undercoverage—2.5% of the represented population of never-smokers
(801,010 of 32,040,393) used e-cigarettes at baseline. Cigarette smoking was initiated
by 47.7% of e-cigarette users and 10.2% of nonusers (P = .001). In fully adjusted multivariable models, e-cigarette use at baseline was
independently associated with initiation of smoking at 18 months (adjusted odds ratio, 6.8;
95% confidence interval, 1.7-28.3). Results remained similar in magnitude and statistically
significant in all sensitivity analyses.
Conclusions
Baseline e-cigarette use was independently associated with initiation of traditional
cigarette smoking at 18 months. This finding supports policy and educational interventions
designed to decrease use of e-cigarettes among nonsmokers.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Intentions to smoke cigarettes among never-smoking US middle and high school electronic cigarette users: National Youth Tobacco Survey, 2011-2013.Nicotine Tob Res. 2015; 17: 228-235https://doi.org/10.1093/ntr/ntu166
- Beliefs and experimentation with electronic cigarettes: a prospective analysis among young adults.Am J Prev Med. 2014; 46: 175-178https://doi.org/10.1016/j.amepre.2013.10.007
- Monitoring the Future National Results on Adolescent Drug Use: Overview of Key Findings, 2014.(Ann Arbor, MI)2015
- Risk factors for exclusive e-cigarette use and dual e-cigarette use and tobacco use in adolescents.Pediatrics. 2015; 135: 1-9
- NIH electronic cigarette workshop: developing a research agenda.Nicotine Tob Res. 2015; 17: 259-269https://doi.org/10.1093/ntr/ntu214
- Tobacco Use among Middle and High School Students—United States, 2011-2014. Vol. 64. 2015 (Atlanta; Available at)http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6414a3.htmDate accessed: April 24, 2017
- Levels of selected carcinogens and toxicants in vapour from electronic cigarettes.Tob Control. 2014; 23: 133-139https://doi.org/10.1136/tobaccocontrol-2012-050859
- Electronic nicotine delivery systems (“e-cigarettes”): review of safety and smoking cessation efficacy.Otolaryngol Head Neck Surg. 2014; 151: 381-393https://doi.org/10.1177/0194599814536847
- Electronic cigarettes for smoking cessation and reduction.Cochrane Database Syst Rev. 2014; (CD010216)https://doi.org/10.1002/14651858.CD010216.pub2
- E-cigarettes and smoking cessation in real-world and clinical settings: a systematic review and meta-analysis.Lancet Respir Med. 2016; 4: 116-128https://doi.org/10.1016/S2213-2600(15)00521-4
- E-cigarette use and smoking reduction or cessation in the 2010/2011 TUS-CPS longitudinal cohort.BMC Public Health. 2016; 16: 1105https://doi.org/10.1186/s12889-016-3770-x
- Electronic cigarette use was not associated with quitting of conventional cigarettes in youth smokers.Pediatr Res. 2017; https://doi.org/10.1038/pr.2017.80
- Impact of exposure to electronic cigarette advertising on susceptibility and trial of electronic cigarettes and cigarettes in US young adults: a randomized controlled trial.Nicotine Tob Res. 2016; 18: 1331-1339https://doi.org/10.1093/ntr/ntv235
- Impact of flavour variability on electronic cigarette use experience: an internet survey.Int J Environ Res Public Health. 2013; 10: 7272-7282https://doi.org/10.3390/ijerph10127272
- The importance of product definitions in US e-cigarette laws and regulations.Tob Control. 2016; 25: e44-e51https://doi.org/10.1136/tobaccocontrol-2014-051913
- Attitudes toward e-cigarettes, reasons for initiating e-cigarette use, and changes in smoking behavior after initiation: a pilot longitudinal study of regular cigarette smokers.Open J Prev Med. 2014; 4: 789-800https://doi.org/10.4236/ojpm.2014.410089
- FDA's New Regulations for E-Cigarettes, Cigars, and All Other Tobacco Products.(Available at)https://www.fda.gov/tobaccoproducts/labeling/rulesregulationsguidance/ucm394909.htmDate accessed: April 24, 2017
- Waterpipe smoking and regulation in the United States: a comprehensive review of the literature.Int J Environ Res Public Health. 2015; 12: 6115-6135https://doi.org/10.3390/ijerph120606115
- Social cognitive theory: an agentic perspective.Annu Rev Psychol. 2001; 52: 1-26https://doi.org/10.1146/annurev.psych.52.1.1
- Validation of susceptibility as a predictor of which adolescents take up smoking in the United States.Health Psychol. 1996; 15: 355-361https://doi.org/10.1037/0278-6133.15.5.355
- What fraction of young adults are at risk for future smoking, and who are they?.Nicotine Tob Res. 2005; 7: 747-759https://doi.org/10.1080/14622200500259796
- Electronic cigarettes and conventional cigarette use among U.S. adolescents: a cross-sectional study.JAMA Pediatr. 2014; 168: 610-617https://doi.org/10.1001/jamapediatrics.2013.5488
- Association between electronic cigarette use and openness to cigarette smoking among US young adults.Nicotine Tob Res. 2015; 17: 212-218https://doi.org/10.1093/ntr/ntu211
- E-cigarette use as a predictor of cigarette smoking: results from a 1-year follow-up of a national sample of 12th grade students.Tob Control. 2017; https://doi.org/10.1136/tobaccocontrol-2016-053291
- E-cigarettes and future cigarette use.Pediatrics. 2016; 138https://doi.org/10.1542/peds.2016-0379
- Electronic cigarette use and uptake of cigarette smoking: a longitudinal examination of U.S. college students.Addict Behav. 2017; 67: 66-72https://doi.org/10.1016/j.addbeh.2016.12.009
- Association of electronic cigarette use with initiation of combustible tobacco product smoking in early adolescence.JAMA. 2015; 314: 700https://doi.org/10.1001/jama.2015.8950
- Progression to traditional cigarette smoking after electronic cigarette use among US adolescents and young adults.JAMA Pediatr. 2015; 169: 1018https://doi.org/10.1001/jamapediatrics.2015.1742
- Longitudinal study of e-cigarette use and onset of cigarette smoking among high school students in Hawaii.Tob Control. 2016; (Epub before print)https://doi.org/10.1136/tobaccocontrol-2015-052705
- US college students' use of tobacco products: results of a national survey.JAMA. 2000; 284: 699-705
- The next generation of users: prevalence and longitudinal patterns of tobacco use among US young adults.Am J Public Health. 2014; 104: 1429-1436https://doi.org/10.2105/AJPH.2013.301802
- Differential trends in cigarette smoking in the USA: is menthol slowing progress?.Tob Control. 2015; 24: 28-37https://doi.org/10.1136/tobaccocontrol-2013-051159
- KnowledgePanel Design Summary.(Available at)
- Viewing tobacco use in movies: does it shape attitudes that mediate adolescent smoking?.Am J Prev Med. 2002; 22 (Available at): 137-145http://www.ncbi.nlm.nih.gov/pubmed/11897456Date accessed: April 24, 2017
- Associations between initial water pipe tobacco smoking and snus use and subsequent cigarette smoking: results from a longitudinal study of US adolescents and young adults.JAMA Pediatr. 2015; 169: 129-136https://doi.org/10.1001/jamapediatrics.2014.2697
- Exposure to smoking in movies and smoking initiation among black youth.Am J Prev Med. 2013; 44: 345-350https://doi.org/10.1016/j.amepre.2012.12.008
- Association of established smoking among adolescents with timing of exposure to smoking depicted in movies.J Natl Cancer Inst. 2012; 104: 549-555https://doi.org/10.1093/jnci/djs138
- Smoking initiation and smoking patterns among US college students.J Am Coll Health. 1999; 48: 55-60https://doi.org/10.1080/07448489909595674
- Measuring global self-esteem: construct validation of a single-item measure and the Rosenberg Self-Esteem Scale.Pers Soc Psychol Bull. 2001; 27: 151-161https://doi.org/10.1177/0146167201272002
- Brief measures of sensation seeking for screening and large-scale surveys.Drug Alcohol Depend. 2003; 72: 279-286
- Psychological antecedents of teenage drug use.in: Research in Community and Mental Health: An Annual Compilation of Research. Vol. 1. JAI, Greenwich, CT1979: 87-102
- Effect of viewing smoking in movies on adolescent smoking initiation: a cohort study.Lancet. 2003; 362: 281-285https://doi.org/10.1016/S0140-6736(03)13970-0
- A comparison of different tests for trend. Stata Resources and Support.(Available at)
- Stata Statistical Software: Version 12.(College Station, TX)2015
- Increasing prevalence of electronic cigarette use among smokers hospitalized in 5 US cities, 2010-2013.Nicotine Tob Res. 2015; 17: 236-244https://doi.org/10.1093/ntr/ntu138
- The Health Consequences of Smoking — 50 Years of Progress: A Report of the Surgeon General.(Atlanta, GA)2014 (Available at)http://www.webcitation.org/6dJFmoRUaDate accessed: April 24, 2017
- Nicotine absorption from electronic cigarette use: comparison between first and new-generation devices.Sci Rep. 2014; 4: 4133https://doi.org/10.1038/srep04133
- Development of symptoms of tobacco dependence in youths: 30 month follow up data from the DANDY study.Tob Control. 2002; 11: 228-235
- Is use of smokeless tobacco a risk factor for cigarette smoking? The U.S. experience.Nicotine Tob Res. 2003; 5: 561-569
- The environment and disease: association or causation?.Proc R Soc Med. 1965; 58 (Available at): 295-300http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1898525/Date accessed: April 24, 2017
- A review of the current geographic distribution of and debate surrounding electronic cigarette clean air regulations in the United States.Health Place. 2015; 31: 75-82https://doi.org/10.1016/j.healthplace.2014.11.003
- A baseline understanding of state laws governing e-cigarettes.Tob Control. 2014; 23: iii37-iii40https://doi.org/10.1136/tobaccocontrol-2013-051459
- Portrayal of electronic cigarettes on YouTube.BMC Public Health. 2014; 14: 1028https://doi.org/10.1186/1471-2458-14-1028
- Exposure to electronic nicotine delivery systems (ENDS) visual imagery increases smoking urge and desire.Psychol Addict Behav. 2015; https://doi.org/10.1037/adb0000123
- Deeming Tobacco Products To Be Subject to the Federal Food, Drug, and Cosmetic Act, as Amended by the Family Smoking Prevention and Tobacco Control Act.(Washington, DC)2014
- Multiple tobacco product use among US adolescents and young adults.Tob Control. 2016; 25: 174-180https://doi.org/10.1136/tobaccocontrol-2014-051638
- Electronic Cigarette Use among Adults: United States, 2014. Vol. 217. National Center for Health Statistics, Hyattsville, MD2015
Article Info
Publication History
Published online: December 10, 2017
Footnotes
Funding: National Cancer Institute ( R01-CA140150 ).
Conflicts of Interest: None.
Authorship: All authors had access to the data and played a role in writing this manuscript.
Identification
Copyright
© 2018 Published by Elsevier Inc.
