[E-Cigarette Use and Later Use of Conventional Cigarettes - Results of a Prospective Observational Study over 2...

The aim was to investigate whether e-cigarette use predicts later experimentation with conventional cigarettes.

During the 2016/2017 school year, 2,388 children and adolescents from Baden-Württemberg, Mecklenburg-Western Pomerania, North Rhine-Westphalia, Rhineland-Palatinate, Schleswig-Holstein and Saxony who had never smoked conventional cigarettes before took part in a survey over a 2-year period (mean age 11.8 years, SD = 1.21; 49.6 % female).

At baseline, 85 pupils (3.6 %) reported that they had already tried e-cigarettes at least once. By the end of the observational period, 430 of the sample had tried conventional cigarettes (18.0 %). After statistical control for age, sex, migration background, type of school, socioeconomic status, sensation-seeking, alcohol use, and school performance, the adjusted relative risk of experimentation with conventional cigarettes was 85 % higher (adjusted relative risk = 1.85, 95 % CI [1.34 - 2.56]) for pupils who had used e-cigarettes at baseline. Further analyses revealed that the risk was higher among adolescents with low sensation-seeking scores.

Among young never-smokers, experimentation with conventional cigarettes is more common in those who used e-cigarettes before than among those who have not tried e-cigarettes before. This effect seems to be stronger among adolescents who, in general, have a lower risk of starting to smoke.