E-cigarette use among young people increases risk for cigarette smoking

  • Berry KM & al.
  • JAMA Netw Open
  • 1 Feb 2019

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • E-cigarette use among young people is tied to increased risk for taking up conventional cigarette smoking.
  • Those who use e-cigarettes first are 4-fold likelier than those who do not to start conventional cigarettes within 2 years.

Why this matters

  • E-cigarette use is on the increase among young people, presenting a public health challenge.

Key results

  • Among choices of nicotine/tobacco exposure, young people were most likely to turn to e-cigarettes.
  • Using e-cigarettes increased overall odds of cigarette smoking:
    • OR, 4.09 (95% CI, 2.97-5.63).
  • Using e-cigarettes especially increased the likelihood that an otherwise low-risk young person (who does not engage in risky behaviors generally) would turn to cigarettes:
    • OR, 8.57 (95% CI, 3.87-18.97).

Study design

  • Prospective cohort study, 3 waves in the Population Assessment of Tobacco and Health Study (2013-2016); young people, 12-15 years, starting as never-users of these tobacco products.
  • Funding: NIH.

Limitations

  • Observational, no causation established.

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