Oral Nicotine Product Use and E-Cigarette Use Persistence in Adolescents and Young Adults: An Analysis Using...

Area of Science:

• Public Health
• Addiction Medicine
• Adolescent Health

Background:

• The relationship between oral nicotine product (ONP) use and e-cigarette use persistence is not well understood.
• Adolescents and young adults (AYA) are key demographics for studying emerging nicotine product use patterns.

Purpose of the Study:

• To investigate the impact of baseline ONP use on the persistence of e-cigarette use among adolescents and young adults.
• To compare these effects across different age groups within the AYA population.

Main Methods:

• Utilized augmented inverse probability weighting (AIPW) with machine learning (ML) for bias reduction and precise treatment effect estimation.
• Analyzed data from two Southern California cohorts with baseline (2022) and follow-up (2023) assessments of e-cigarette and ONP use.
• Stratified analyses by age group (adolescents vs. young adults).

Main Results:

• Among 718 AYAs, 14.2% used ONPs at baseline, and 64.3% persisted in e-cigarette use.
• Adolescents using ONPs showed a significantly lower risk of e-cigarette persistence (risk difference=-0.18, 95% CI=-0.31, -0.04).
• No significant association between ONP use and e-cigarette persistence was found among young adults.

Conclusions:

• ONPs may act as a partial substitute for e-cigarettes among adolescents, potentially reducing vaping persistence.
• This substitution effect was not observed in young adults, indicating age-specific patterns of nicotine product use.
• Regulatory strategies should consider the potential harm-reduction benefits and age-specific risks of ONPs, addressing dual use among young adults.