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Cited by 496Smoking Behavior and CessationSubstance Abuse Treatment and OutcomesImpact of Technology on Adolescents

Electronic Cigarettes and Conventional Cigarette Use Among US Adolescents: A Cross-sectional Study

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Dutra, Lauren M., Glantz, Stanton A.·2014·JAMA Pediatrics
DOI 10.1001/jamapediatrics.2013.5488PMC PMC4142115
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Abstract

OBJECTIVE: To examine e-cigarette use and conventional cigarette smoking. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional analyses of survey data from a representative sample of US middle and high school students in 2011 (n = 17 353) and 2012 (n = 22 529) who completed the 2011 and 2012 National Youth Tobacco Survey. EXPOSURES: Ever and current e-cigarette use. MAIN OUTCOMES AND MEASURES: Experimentation with, ever, and current smoking, and smoking abstinence. RESULTS: Among cigarette experimenters (1 puff), ever e-cigarette use was associated with higher odds of ever smoking cigarettes (100 cigarettes; odds ratio [OR] = 6.31; 95% CI, 5.39-7.39) and current cigarette smoking (OR = 5.96; 95% CI, 5.67-6.27). Current e-cigarette use was positively associated with ever smoking cigarettes (OR = 7.42; 95% CI, 5.63-9.79) and current cigarette smoking (OR = 7.88; 95% CI, 6.01-10.32). In 2011, current cigarette smokers who had ever used e-cigarettes were more likely to intend to quit smoking within the next year (OR = 1.53; 95% CI, 1.03-2.28). Among experimenters with conventional cigarettes, ever use of e-cigarettes was associated with lower 30-day (OR = 0.24; 95% CI, 0.21-0.28), 6-month (OR = 0.24; 95% CI, 0.21-0.28), and 1-year (OR = 0.25; 95% CI, 0.21-0.30) abstinence from cigarettes. Current e-cigarette use was also associated with lower 30-day (OR = 0.11; 95% CI, 0.08-0.15), 6-month (OR = 0.11; 95% CI, 0.08-0.15), and 1-year (OR = 0.12; 95% CI, 0.07-0.18) abstinence. Among ever smokers of cigarettes (100 cigarettes), ever e-cigarette use was negatively associated with 30-day (OR = 0.61; 95% CI, 0.42-0.89), 6-month (OR = 0.53; 95% CI, 0.33-0.83), and 1-year (OR = 0.32; 95% CI, 0.18-0.56) abstinence from conventional cigarettes. Current e-cigarette use was also negatively associated with 30-day (OR = 0.35; 95% CI, 0.18-0.69), 6-month (OR = 0.30; 95% CI, 0.13-0.68), and 1-year (OR = 0.34; 95% CI, 0.13-0.87) abstinence. CONCLUSIONS AND RELEVANCE: Use of e-cigarettes was associated with higher odds of ever or current cigarette smoking, higher odds of established smoking, higher odds of planning to quit smoking among current smokers, and, among experimenters, lower odds of abstinence from conventional cigarettes. Use of e-cigarettes does not discourage, and may encourage, conventional cigarette use among U.S. adolescents.

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  • Teenagers who use e-cigarettes are more likely to escalate to smoking tobacco.

    “Teenagers who use e-cigarettes are also more likely to escalate to smoking tobacco (Dutra & Glantz, 2014; Wills et al. 2015).”

    From <scp>N</scp> icotine and the adolescent brain (2015) · cites this paper as Dutra & Glantz, 2014

    The Comment reports that adolescents who had experimented with cigarettes and used e-cigarettes were more likely to be established or current smokers. But the Comment’s conclusion explicitly says the cross-sectional study cannot determine which product youth used first, so it does not establish that e-cigarette users subsequently escalated to tobacco smoking. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Even amongst current adolescent smokers, e-cigarettes increase the likelihood of perpetuating and increasing tobacco use.

    “Even amongst current adolescent smokers, e-cigarettes increase the likelihood of perpetuating and increasing tobacco use (Dutra & Glantz, 2014; Lee et al. 2014).”

    From <scp>N</scp> icotine and the adolescent brain (2015) · cites this paper as Dutra & Glantz, 2014

    The Results (page unavailable) report that, among current adolescent smokers, current e-cigarette use was associated with higher cigarette consumption; they also report lower odds of abstinence among ever smokers who used e-cigarettes. But the Conclusion (page unavailable) says the cross-sectional study cannot establish the direction of smoking and e-cigarette use, so it does not show that e-cigarettes increase or perpetuate tobacco use over time. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • More teenagers currently use e-cigarettes than tobacco.

    “Indeed, emerging clinical evidence reveals that more teenagers currently use e-cigarettes than tobacco (Dutra & Glantz, 2014; Wills et al. 2015).”

    From <scp>N</scp> icotine and the adolescent brain (2015) · cites this paper as Dutra & Glantz, 2014

    The Results (page unavailable) report current e-cigarette use of 1.1% in 2011 and 2.0% in 2012 among the students studied. I searched for a comparable prevalence of current conventional-cigarette use, but the passages in our copy do not establish that more teenagers used e-cigarettes than tobacco. (LLM, conf=0.72)

    Experimental — accuracy not yet measured

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Cites

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Research works printed but not linked: 31

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Authors
Dutra, L. M., & Glantz, S. A.
Affiliations
University of California, San Francisco (US)
Corresponding author
Glantz, Stanton A.
ORCID
Venue
JAMA Pediatrics
Publisher
American Medical Association (AMA)
Published
2014-07-01
Volume
168
Issue
7
Pages
610
ISSN
  • 1072-4710 (ISSN-L)
  • 2168-6203
DOI
10.1001/jamapediatrics.2013.5488
PMC
PMC4142115
OpenAlex
W2167228587
Cited by
496
References
3
Citations by year
2026: 4 · 2025: 11 · 2024: 6 · 2023: 8 · 2022: 25 · 2021: 18 · 2020: 31 · 2019: 39 · 2018: 54 · 2017: 57 · 2016: 95 · 2015: 96 · 2014: 50 · 2013: 1 · 2012: 1
FWCI
66.23
Type
journal article
Language
en
Open access
Locations
  • Archives of Pediatrics and Adolescent Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Cancer Institute (CA113710, CA-060121, R01CA061021, R25CA113710, T32CA113710)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
Keywords
electronic cigarettes, adolescent smoking, conventional cigarette smoking, vaping, smoking abstinence, smoking cessation intentions, tobacco use prevention, youth tobacco use, National Youth Tobacco Survey, smoking initiation, dual use of e-cigarettes and cigarettes, tobacco control, school-based prevention, youth tobacco marketing, tobacco product pricing, tobacco product availability
MeSH terms
Adolescent, Cross-Sectional Studies, Female, Humans, Male, Risk Factors, Smoking, United States, Smoking Cessation, Electrical Equipment and Supplies, Tobacco Products

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