Adolescents who had tried electronic cigarettes were found to be more likely to be current smokers of conventional cigarettes compared with adolescents who had never tried e-cigarettes; and those who were current e-cigarette users were even more likely to be current cigarette smokers, according to findings published in JAMA Pediatrics (doi:10.1001/jamapediatrics.2013.5488).
“E-cigarettes are being advertised as a way to quit smoking,” study coauthor Lauren Dutra, ScD, a Postdoctoral Scholar in the Cardiovascular Research Institute at the University of California School of Medicine, explained in a telephone interview. “But, if e-cigarettes were an effective cessation method for teens, we would see that teens who are using e-cigarettes would be more likely to say no, that they hadn't smoked recently.' But we found the opposite of that—kids who used e-cigarettes were more likely to say ‘yes, I have smoked recently.’”
The study—her coauthor was Stanton A. Glantz, PhD—analyzed the odds of smoking among adolescents based on their e-cigarette use, using survey data from 39,882 middle school and high school students who completed the National Youth Tobacco Survey in 2011.
The data showed that the adolescents who said they had tried an e-cigarette at some point in their lifetime were about six times as likely to be current smokers of conventional cigarettes than the reference group (adolescents who have never used e-cigarettes, with an odds ratio of 1); and that adolescents who reported being current e-cigarette users were almost eight times as likely to be current smokers of conventional cigarettes than the reference group. The data also showed that the adolescents who said they had used e-cigarettes were more likely to say they had not smoked in the past 30 days, the past six months, or the past year.
“The article highlights some of the concerns about the potential public health harms from electronic nicotine delivery systems (ENDS)—documenting the more than doubling of ever use among teenagers between 2011 and 2012, the associations of ENDS use with more established smoking, and, among experimenters, reduced likelihood of abstinence from conventional cigarettes,” Frank J. Chaloupka, PhD, Distinguished Professor of Economics and Director of the Institute for Health Research and Policy's Health Policy Center at the University of Illinois at Chicago, said in an accompanying editorial.
Dutra noted that because the findings are cross-sectional, they do not confirm whether youths are initiating smoking with conventional cigarettes and moving on to use e-cigarettes, or vice versa—but the results do suggest that e-cigarette use does not discourage the use of conventional cigarettes.
The next step, she added, is analyzing the longitudinal data (which is currently being collected) that follows the same sample of teens and/or adults over time.