Association between electronic cigarette use and tobacco cigarette smoking initiation in adolescents: A systematic review and meta-analysis

O’Brien, Doireann; Long, Jean; Quigley, Joan; Lee, Caitríona; McCarthy, Anne; Kavanagh, Paul

doi:10.21203/rs.3.rs-59681/v2

Cited by 4 publications

(5 citation statements)

References 59 publications

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“…The link between cigarette smoking and e-cigarette use has been well-established (15)(16)(17) and our ndings support this as, but with gender differences. Girls who had ever-smoked had higher odds (AOR 1.56, 95% CI: 1.12-2.18) of ever-using e-cigarettes.…”

Section: Gender Differences E-cigarette Use and Smokingsupporting

confidence: 78%

“…The series of risks identi ed from nicotine exposure, include altered development of cerebral cortex and hippocampus in the developing adolescent brain (12). The link between teenage e-cigarette use and increased smoking is widely accepted and supported by several reviews (15)(16)(17). The gateway theory (18), the common liability theory (19), the catalyst model (20), and the catalyst/ diversion model (whether e-cigarettes are a "catalyst" to conventional smoking or whether they divert adolescents from more harmful products (21)) have all been considered.…”

Section: Introductionmentioning

confidence: 99%

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Trend analyses suggest gender-focused, peer-aware, and parent-targeted interventions could reduce teenage e-cigarette use

Hanafin¹,

Sunday²,

Clancy³

2021

Preprint

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E-cigarette ever-use and current-use among teenagers has been increasing worldwide, including in Ireland. Boys are widely observed to have increased prevalence compared with girls.We use data from two waves of the European School Survey Project on Alcohol and other Drugs (ESPAD) in Ireland and focus on gender and teenage e-cigarette use. We examine changes in ever and current-use among 16-year-olds (n = 3,421) between 2015 and 2019. We use multivariable logistic regression analyses to explore relative and gendered effects of covariates on teenage e-cigarette use.E-cigarette ever-use increased from 23–39% and current-use from 10–18%, (in 2015 vs 2019, respectively). The rate of increase in ever-use is significantly greater for girls AOR 2.67 (C.I. 2.02, 3.54) vs 2.04 (C.I. 1.55, 2.68) for boys. Smoking and e-cigarette use are linked but never-smokers who try e-cigarettes have risen from 33–67%. Peer smoking is also significantly associated with e-cigarette ever- and current-use, particularly for boys if “Most/All friends smoke” AOR 5.90 (C.I. 3.31, 10.52) vs 3.50 (C.I. 1.79, 6.84) for girls. Less parental monitoring is associated with greater e-cigarette use, for boys AOR 5.50 (C.I. 2.85, 10.61) vs AOR 5.31 (C.I. 3.01, 9.37) for girls.Boys currently have a higher prevalence of e-cigarette use but girls are increasingly at risk. Targeting by industry through advertising, gaming and social media may contribute to use. Peer influences and parental monitoring are significant risk factors for use and provide a mechanism for intervention to prevent an increasing risk of nicotine addiction.

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Section: Gender Differences E-cigarette Use and Smokingsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Trend analyses suggest gender-focused, peer-aware, and parent-targeted interventions could reduce teenage e-cigarette use

Hanafin¹,

Sunday²,

Clancy³

2021

Preprint

View full text Add to dashboard Cite

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“…If e-cigarettes are being used in settings where smoking is prohibited, this may increase cumulative nicotine exposure and the associated adverse effects. It is possible that dual-use may represent a transition to tobacco product use, a process known as the gateway effect, and longitudinal evidence for this effect is mounting [ 36 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

E-Cigarette-Only and Dual Use among Adolescents in Ireland: Emerging Behaviours with Different Risk Profiles

Bowe

Doyle

Stanistreet

et al. 2021

IJERPH

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E-cigarette-only use and dual-use are emerging behaviours among adolescent nicotine product users which have not yet been sufficiently explored. This study examines the prevalence of, and the factors associated with, nicotine product use in adolescence. The study is a cross-sectional analysis of the 2018 Planet Youth survey completed by 15–16 year olds in the West of Ireland in 2018. The outcome of interest was current nicotine product use, defined as use at least once in the past 30 days. A main effects multinomial logistic regression model was used to examine the association between potential risk and protective factors and nicotine product use. Among 4422 adolescents 22.1% were current nicotine product users, consisting of 5.1% e-cigarette only users, 7.7% conventional cigarette only users, and 9.3% dual-users. For risk factors, the odds of association were weaker for e-cigarette only use compared to conventional cigarette and dual use. Participating in team sport four times/week or more significantly reduced the odds of conventional cigarette and dual use but had no association with e-cigarette only use (Cig: adjusted odds ratio (AOR) 0.63, 95% confidence interval (CI) 0.44–0.90; Dual-use: AOR 0.63, 95% CI 0.43–0.93). Similarly, having higher value for conventional social norms reduced the odds of conventional cigarette and dual use but not e-cigarette only use. This is the first study to show, among a generalisable sample, that dual-use is the most prevalent behaviour among adolescent nicotine product users in Ireland. Risk factor profiles differ across categories of use and prevention initiatives must be cognisant of this.

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“…A level of evidence [ 30 ] and a GRADE recommendation [ 31 ] were ascribed to the main outcome. The methods for this paper are described in detail elsewhere [ 32 ].…”

Section: Methodsmentioning

confidence: 99%

Association between electronic cigarette use and tobacco cigarette smoking initiation in adolescents: a systematic review and meta-analysis

et al. 2021

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Background This systematic review of prospective longitudinal primary studies sought to determine whether electronic cigarette (e-cigarette) use by teenagers who had never smoked conventional tobacco cigarettes (tobacco cigarettes) at baseline was associated with subsequently commencing tobacco cigarette smoking. Methods The review followed the principles of a systematic review and meta-analysis. A key word search identified peer-reviewed articles published between 1 January 2005 and 2 October 2019 from seven bibliographic databases and one search engine. Using pre-prepared inclusion/exclusion criteria two researchers independently screened abstracts, and subsequently, full text papers. Selected articles were quality assessed in duplicate. Data on study participants characteristics, exposure and outcome measures were recorded in an adapted Cochrane Data Extraction Form. Feasibility assessment was done to detect clinical heterogeneity and choose an approach to meta-analysis. Analysis comprised pairwise random effects meta-analyses, and sensitivity and subgroup analyses. Results From the 6619 studies identified, 14 one-off primary studies in 21 articles were suitable for inclusion. The participants ages ranged from 13 to 19 years and comprised teenagers based in Europe and North America. Nine of the 14 one-off studies, with follow-up periods between 4 and 24 months, met the criteria for inclusion in a meta-analysis of the association between ever use of e-cigarettes and subsequent initiation of tobacco cigarette use. Based on primary study adjusted odds ratios, our meta-analysis calculated a 4.06 (95% confidence interval (CI): 3.00–5.48, I2 68%, 9 primary studies) times higher odds of commencing tobacco cigarette smoking for teenagers who had ever used e-cigarettes at baseline, though the odds ratio were marginally lower (to 3.71 times odds, 95%CI: 2.83–4. 86, I2 35%, 4 primary studies) when only the four high-quality studies were analysed. Conclusion The systematic review found that e-cigarette use was associated with commencement of tobacco cigarette smoking among teenagers in Europe and North America, identifying an important health-related harm. Given the availability and usage of e-cigarettes, this study provides added support for urgent response by policymakers to stop their use by teenagers to decrease direct harms in this susceptible population group, as well as to conserve achievements in diminishing tobacco cigarette initiation.

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Association between electronic cigarette use and tobacco cigarette smoking initiation in adolescents: A systematic review and meta-analysis

Cited by 4 publications

References 59 publications

Trend analyses suggest gender-focused, peer-aware, and parent-targeted interventions could reduce teenage e-cigarette use

Trend analyses suggest gender-focused, peer-aware, and parent-targeted interventions could reduce teenage e-cigarette use

E-Cigarette-Only and Dual Use among Adolescents in Ireland: Emerging Behaviours with Different Risk Profiles

Association between electronic cigarette use and tobacco cigarette smoking initiation in adolescents: a systematic review and meta-analysis

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