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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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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: Primack, Brian A.
Soneji, Samir
Fine, Michael J.
Sargent, James D.
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
FWCI: 58.44
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
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 › Public Health, Environmental and Occupational Health › 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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Progression to Traditional Cigarette Smoking After Electronic Cigarette Use Among US Adolescents and Young Adults

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