E-cigarette Use and Subsequent Smoking Frequency Among Adolescents.

Area of Science:

• Adolescent health
• Tobacco control
• Public health policy

Background:

• Electronic cigarette (e-cigarette) use is linked to adolescent cigarette initiation.
• The association between e-cigarette use and increased cigarette consumption post-initiation is not well understood.
• Transitions between exclusive e-cigarette use, exclusive cigarette use, dual use, and nonuse among adolescents require further investigation.

Purpose of the Study:

• To determine if adolescent e-cigarette use is associated with more frequent cigarette use after initiation.
• To examine the transition patterns between exclusive and dual use of e-cigarettes and combustible cigarettes among adolescents.

Main Methods:

• Pooled data from three prospective cohort studies in California and Connecticut (N=6258, baseline 2013-2014, follow-up 2014-2016).
• Polytomous regression models assessed the association of baseline e-cigarette use with follow-up cigarette use frequency (experimental, infrequent, frequent).
• Evaluated transitions between baseline and follow-up single or dual product use patterns.

Main Results:

• Adolescent never smokers who used e-cigarettes showed significantly higher odds of subsequent experimental, infrequent, or frequent cigarette use compared to non-users.
• Baseline past-30-day exclusive cigarette use was associated with higher odds of follow-up exclusive cigarette or dual product use.
• The odds ratios for experimental, infrequent, and frequent cigarette use following e-cigarette initiation were not significantly different from each other.

Conclusions:

• Adolescent e-cigarette use is associated with increased frequency of cigarette use, including experimental, infrequent, and frequent patterns.
• Policies targeting tobacco control are essential to prevent adolescents from progressing to more frequent tobacco use patterns.
• Reducing combustible cigarette use, whether exclusive or dual, is crucial to mitigate the adverse public health impact of e-cigarettes.