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E-cigarette use among adolescents leads to traditional cigarette use

In a sample of adolescents and young adults, e-cigarette use was associated with progression to traditional cigarette smoking.

“Our study identified a longitudinal association between baseline e-cigarette use and progression to traditional cigarette smoking among adolescents and young adults,” Brian A. Primack, MD, PhD, associate professor of medicine, pediatrics, and clinical and translational science at the University of Pittsburgh School of Medicine, and colleagues wrote.

In the longitudinal cohort study, a national sample of 694 participants aged 16 to 26 years — who never smoked cigarettes and were considered nonsusceptible to smoking — completed surveys from Oct. 1, 2012 to May 1, 2014 about smoking and were reassessed 1 year later. The researchers looked for association between “baseline e-cigarette use and cigarette smoking, controlling for sex, age, race/ethnicity, maternal educational level, sensation seeking tendency, parental cigarette smoking, and cigarette smoking among friends,” according to the study.

In the first survey, 2.3% of participants used e-cigarettes. In the 1-year follow-up survey, 18.9% of those who had not used e-cigarettes, and 68.8% of those who had, progressed towards cigarette smoking. Initial e-cigarette use was associated with progression to smoking (adjusted odds ratio [AOR] =  8.3; 95% CI, 1.2-58.6) and to susceptibility among nonsmokers (AOR = 8.5; 95% CI, 1.3-57.2).

“The article by Primack et al  is one more piece of evidence that the effect of e-cigarettes on youth is happening now in real time and that these products harm nonsmokers and result in a net harm to society and public health,” Jonathan D. Klein, MD, MPH, of the American Academy of Pediatrics, wrote in an editorial accompanying the study. “We do not need more research on this question. … What we still need is the political will to act on the evidence and protect our youth.” – by Will Offit

Disclosures: The researchers report no relevant financial disclosures.