Chaffee BW, Watkins SL, Glantz SA. Electronic Cigarette Use and Progression From Experimentation to Established Smoking. Pediatrics. 2018;141(4):e20173594
In prior research, among youth never-smokers, e-cigarette use has shown to be associated with subsequent use of conventional cigarettes. In this prospective study, US adolescents between 12-17 years who had tried conventional cigarettes (³1 cigarette puffs) but were not yet established smokers (³100 cigarettes) were evaluated for additional use of e-cigarettes. At a year follow-up, using e-cigarettes was associated with approximately a two-fold increased odds of progressing to established smoking of conventional cigarettes.
In the Population Assessment of Tobacco and Health (PATH) Youth survey, participants were asked questions about use of tobacco and nicotine-containing products in 2013-2014 (baseline) and then in 2014-15. Among 1295 youth who had tried conventional cigarettes at baseline (so-called “cigarettes experimenters”), ever using e-cigarettes at baseline was associated with being an established conventional cigarette smoker at follow-up compared with never-users of e-cigarettes at baseline (19.3% vs 9.7%; p<.001). E-cigarette ever-users were also more likely to report conventional cigarettes smoking in the past 30 days (38.8% vs 26.6%), compared with e-cigarette never-users. . In regression models adjusted for age, sex, and race/ethnicity, e-cigarette ever-use was associated with significantly higher odds of established conventional cigarette smoking by follow-up (odds ratio [OR] = 2.07; 95% confidence interval = 1.41-3.04) and past 30-day conventional cigarette smoking (OR = 1.65; 1.26-2.15). There was also evidence of stepwise increase in risk of subsequent conventional cigarette use with progressive more frequent use of e-cigarettes. This study contributes to growing evidence that e-cigarette use is a meaningful risk for advancing conventional cigarette use among youth who are currently experimenting with cigarettes.