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Cited by 514Smoking Behavior and CessationSubstance Abuse Treatment and OutcomesImpact of Technology on Adolescents

Progression to Traditional Cigarette Smoking After Electronic Cigarette Use Among US Adolescents and Young Adults

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Primack, Brian A., Soneji, Samir, Stoolmiller, Michael, Fine, Michael J., Sargent, James D.·2015·JAMA Pediatrics
DOI 10.1001/jamapediatrics.2015.1742PMC PMC4800740
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Abstract

IMPORTANCE: Electronic cigarettes (e-cigarettes) may help smokers reduce the use of traditional combustible cigarettes. However, adolescents and young adults who have never smoked traditional cigarettes are now using e-cigarettes, and these individuals may be at risk for subsequent progression to traditional cigarette smoking. OBJECTIVE: To determine whether baseline use of e-cigarettes among nonsmoking and nonsusceptible adolescents and young adults is associated with subsequent progression along an established trajectory to traditional cigarette smoking. DESIGN, SETTING, AND PARTICIPANTS: In this longitudinal cohort study, a national US sample of 694 participants aged 16 to 26 years who were never cigarette smokers and were attitudinally nonsusceptible to smoking cigarettes completed baseline surveys from October 1, 2012, to May 1, 2014, regarding smoking in 2012-2013. They were reassessed 1 year later. Analysis was conducted from July 1, 2014, to March 1, 2015. Multinomial logistic regression was used to assess the independent 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. Sensitivity analyses were performed, with varying approaches to missing data and recanting. EXPOSURES: Use of e-cigarettes at baseline. MAIN OUTCOMES AND MEASURES: Progression to cigarette smoking, defined using 3 specific states along a trajectory: nonsusceptible nonsmokers, susceptible nonsmokers, and smokers. Individuals who could not rule out smoking in the future were defined as susceptible. RESULTS: Among the 694 respondents, 374 (53.9%) were female and 531 (76.5%) were non-Hispanic white. At baseline, 16 participants (2.3%) used e-cigarettes. Over the 1-year follow-up, 11 of 16 e-cigarette users and 128 of 678 of those who had not used e-cigarettes (18.9%) progressed toward cigarette smoking. In the primary fully adjusted models, baseline e-cigarette use was independently 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). Sensitivity analyses showed consistent results in the level of significance and slightly larger magnitude of AORs. CONCLUSIONS AND RELEVANCE: In this national sample of US adolescents and young adults, use of e-cigarettes at baseline was associated with progression to traditional cigarette smoking. These findings support regulations to limit sales and decrease the appeal of e-cigarettes to adolescents and young adults.

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  • ANE is associated with long-lasting effects on attention, risky sexual behavior, and progression to traditional cigarettes.

    “ANE is associated with long-lasting effects on attention [210], risky sexual behavior [211], and progression to traditional cigarettes [212].”

    From Consequences of adolescent drug use (2023) · cites this paper as [212]

    The Results and Discussion report that baseline e-cigarette use was associated with progression toward traditional cigarette smoking over one year. The study does not establish a long-lasting causal effect of nicotine exposure, and the Discussion notes that it did not assess frequent or established smoking. (LLM, conf=0.82)

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  • Several longitudinal studies found that electronic cigarette use at baseline is associated with increased risk of later combustible tobacco use.

    “Several longitudinal studies have found that electronic cigarette use at baseline is associated with increased risk of future use of combustible tobacco products.”

    From Developmental toxicity of nicotine: A transdisciplinary synthesis and implications for emerging tobacco products (2017) · cites this paper as [9]

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Authors
Primack, B. A., Soneji, S., Stoolmiller, M., Fine, M. J., & Sargent, J. D.
Affiliations
  • University of Pittsburgh (US)
  • Dartmouth College (US)
  • University of Oregon (US)
ORCID
Venue
JAMA Pediatrics
Publisher
American Medical Association (AMA)
Published
2015-11-01
Volume
169
Issue
11
Pages
1018
ISSN
  • 1072-4710 (ISSN-L)
  • 2168-6203
DOI
10.1001/jamapediatrics.2015.1742
PMC
PMC4800740
OpenAlex
W1830229799
Cited by
514
References
41
Citations by year
2026: 6 · 2025: 10 · 2024: 17 · 2023: 15 · 2022: 31 · 2021: 43 · 2020: 77 · 2019: 71 · 2018: 67 · 2017: 80 · 2016: 81 · 2015: 10 · 2014: 2
FWCI
58.44
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 Institutes of Health (KL2TR001088, 5r01ca077026-18, UL1TR001086)
  • National Cancer Institute (R01CA140150, R01-CA077026, R21CA185767, P30CA023108)
  • National Center for Advancing Translational Sciences
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, never smokers, smoking susceptibility, adolescents, young adults, vaping, smoking initiation, sensation seeking, parental smoking, peer smoking, harm reduction, nicotine dependence, nicotine withdrawal symptoms, nicotine sensitivity
MeSH terms
Adolescent, Adolescent Behavior, Adult, Female, Health Surveys, Humans, Longitudinal Studies, Male, Risk Factors, Smoking, United States, Cohort Studies, Logistic Models, Smoking Cessation, Disease Progression, Risk Assessment, Young Adult, Electronic Nicotine Delivery Systems

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