E-cigarette device type and combustible tobacco use: Results from a pooled analysis of 10,482 youth

To understand whether using a certain e-cigarette device is more strongly associated with risk of combustible tobacco use among youth.

We conducted multivariable logistic regression analyses using cross-sectional data from 4 samples of youth in Connecticut and California (N = 10,482; ages 13-24), separately for each study using the total sample and the sample of past-month e-cigarette users, to understand the association between e-cigarette device type and past-month combustible tobacco use, while controlling for age, sex, race/ethnicity, socioeconomic status, school, and past-month marijuana use. Then, we conducted meta-analyses to calculate pooled associations for adolescents, young adults, and all individuals combined.

Among the total sample, combustible tobacco use was associated with any e-cigarette device use (vs. no e-cigarette use) in the pooled analysis across all studies. Among past-month e-cigarette users, combustible tobacco use across all studies was 15.8%- 61.5%. Pooled associations among past-month e-cigarette users showed that using disposable devices (vs. pods; AOR=2.83, 95% CI: 1.73-4.61) and multiple devices most frequently (vs. pods; AOR=2.13, 95% CI: 1.16-3.90) was associated with greater odds of combustible tobacco use. Pooled associations also found that using multiple devices (vs. a single device) in the past month was associated with greater odds of combustible tobacco use (AOR 2.33, 95% CI: 1.74, 3.14).

Using disposable e-cigarettes and multiple devices is associated with greater likelihood of combustible tobacco use among e-cigarette using youth. Future research should elucidate the trajectory of e-cigarette device used and combustible tobacco use among youth to inform prevention and product regulation.