E-cigarette Use and Subsequent Smoking Frequency Among Adolescents

Barrington-Trimis JL, Kong G, Leventhal AM, et al. Pediatrics. November 05, 2018. [Epub ahead of print] [CrossRef] [PubMed]

Electronic cigarette (e-cigarette) use is associated with cigarette initiation among adolescents. However, it is unclear whether e-cigarette use is associated with more frequent cigarette use after initiation. The authors pooled data from 3 prospective cohort studies in California and Connecticut (baseline: 2013–2014; follow-up: 2014–2016; N = 6258). Among baseline never smokers, e-cigarette users had greater odds of subsequent experimental (odds ratio [OR] = 4.58; 95% confidence interval [CI]: 3.56–5.88), infrequent (OR = 4.27; 95% CI: 2.75–6.62) or frequent (OR = 3.51; 95% CI: 1.97–6.24) cigarette use. Baseline past-30-day exclusive cigarette use was associated with higher odds at follow-up of exclusive cigarette or dual product use than of exclusive e-cigarette use. The authors conclude that tobacco control policy to reduce adolescent use of both e-cigarettes and cigarettes is needed to prevent progression to more frequent tobacco use patterns.