Associations Between Early Onset of E-cigarette Use and Cigarette Smoking and Other Substance Use Among US Adolescents: A National Study

McCabe, Sean Esteban; West, Brady T.; McCabe, Vita V.

doi:10.1093/ntr/ntx231

Cited by 80 publications

(53 citation statements)

References 45 publications

(94 reference statements)

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“…Due to the lack of studies on the dual use of illicit drugs and e-cigarettes in Canada, it is not possible to compare these results to previous Canadian data to assess trends. However, some international studies have shown findings similar to those in the present study [15][16][17]34]. Additionally, even fewer studies have explored the potential use of ecigarettes as illicit drug delivery systems.…”

Section: Discussionsupporting

confidence: 81%

The association between alcohol, marijuana, illegal drug use and current use of E-cigarette among youth and young adults in Canada: results from Canadian Tobacco, Alcohol and Drugs Survey 2017

et al. 2019

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Background: E-cigarettes have grown in popularity around the world since 2003. Although marketed as a smoking cessation tool, e-cigarettes can lead to tobacco cigarette smoking in youth. In Canada, among all age groups, youth and young adults have the highest prevalence of e-cigarette use. The objective of this study was to assess the factors associated with e-cigarette use among youth and young adults in Canada, and to specifically examine the association between alcohol, marijuana and illicit drug use. Methods: Data from the 2017 Canadian Tobacco, Alcohol and Drugs Survey were used. The sample was restricted to those aged 15-24 years (n = 10,322), and main outcome defined as 'E-cigarette use in the past 30-days'. Multivariable logistic regression was performed to assess the association between the main outcome and substance use variables (illicit drug, marijuana and alcohol use), tobacco exposure variables, and demographic and healthrelated factors. Results: 6.2% Canadians aged 15-24 reported using e-cigarettes in the past 30-days, while 23.9% reported having ever tried e-cigarettes. Twenty-three percent of the past 30-day users reported using e-cigarettes every day and 72.5% of the past 30-day users reported having nicotine in their last e-cigarette. Additionally, youth aged 15-17 were 4.95 times more likely to be e-cigarette users as compared to those aged 22-24 (OR: 4.95, 95% CI: 3.1-7.9). Moreover, e-cigarette use was significantly associated with marijuana use (OR:4.17, 95% CI: 2.6-6.7) and alcohol use (OR: 5.08, 95% CI: 2.9-9.0), and approached significance with illicit drug use (OR: 1.68, 95% CI: 1.0-2.9). Furthermore, being a current smoker (OR: 2.93, 95% CI: 1.8-4.7) and male (OR: 2.28, 95% CI: 1.5-3.4) was significantly associated with the outcome. Conclusion: This study is nationally representative and provides insight into e-cigarette use among youth and young adults aged 15-24 years. Given that e-cigarettes can be used as illicit drug delivery systems, more studies are needed to understand how Canadian youth and young adults are using e-cigarettes. Stricter restrictions on public e-cigarette smoking, and awareness campaigns informing youth of risks of e-cigarette smoking should be implemented.

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Section: Discussionsupporting

confidence: 81%

The association between alcohol, marijuana, illegal drug use and current use of E-cigarette among youth and young adults in Canada: results from Canadian Tobacco, Alcohol and Drugs Survey 2017

et al. 2019

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“…Other studies show that adolescents who engage in e-cigarette use only are at greater risk for other types of substance use, however, these studies have not fully considered the role of early onset vs late onset of e-cigarettes relative to dual users across multiple age groups. 10,11,22,23,28 The results from this study extend prior work and suggest that earlier initiation of e-cigarette use remains a substantial risk factor for other types of substance use-even for this lower risk group of e-cigarette only users. Taken together, these findings indicate that adolescents who engage in early onset of e-cigarette use (ecigarette use only or dual use) should be assessed for substance-related problems based on their increased risk for polysubstance use.…”

Section: Discussionsupporting

confidence: 78%

Initiation Sequence of E‐Cigarette and Cigarette Smoking Among US Adolescents: A National Study

et al. 2019

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Background and Objectives: The primary objectives were to: (1) examine the initiation sequence of e-cigarette use and cigarette smoking; (2) assess other substance use as a function of the initiation sequence of e-cigarettes and cigarettes; and (3) investigate the role of early e-cigarette initiation among US secondary school students. Methods: Data were collected via self-administered questionnaires from independent 2015 and 2016 nationally representative cross-sectional samples of 8th grade, 10th grade, and 12th grade students (N = 36 410). Results: The lifetime initiation sequence included: (1) e-cigarette use before cigarette smoking (1.7%); (2) e-cigarette use and cigarette smoking in same grade (4.2%); (3) cigarette smoking before e-cigarette use (6.1%); (4) e-cigarette use only (12.6%); (5) cigarette smoking only (3.6%); and (6) no e-cigarette use or cigarette smoking (71.8%). The risk of substance use was highest among dual users (regardless of initiation sequence), followed by cigarette smokers, e-cigarette users, and no e-cigarette use or cigarette smoking. The most prevalent initiation sequence of e-cigarette use involved initiating other substances before e-cigarettes, especially among older adolescents. Early initiation of e-cigarette use was associated with increased odds of substance use behaviors for all three age groups. Discussion and Conclusions: Adolescents who report a history of both e-cigarette use and cigarette smoking should be considered at high risk for substance-related problems. Early initiation of e-cigarette use is a signal for other substance use. Scientific Significance: Youth substance use prevention programs and prospective studies must take into account polysubstance use when addressing the relationships between e-cigarette use and cigarette smoking.

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“…JUUL’s high nicotine concentration raises concern that it is serving as a gateway to nicotine addiction among a sizeable number of adolescents. Studies show that nicotine-addicted teen vapers often adopt use of more dangerous combustible tobacco types 52–56. The rising use of vapour devices in schools may portend use of other substances.…”

Section: Discussionmentioning

confidence: 99%

JUUL and other stealth vaporisers: hiding the habit from parents and teachers

2018

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Associations Between Early Onset of E-cigarette Use and Cigarette Smoking and Other Substance Use Among US Adolescents: A National Study

Cited by 80 publications

References 45 publications

The association between alcohol, marijuana, illegal drug use and current use of E-cigarette among youth and young adults in Canada: results from Canadian Tobacco, Alcohol and Drugs Survey 2017

The association between alcohol, marijuana, illegal drug use and current use of E-cigarette among youth and young adults in Canada: results from Canadian Tobacco, Alcohol and Drugs Survey 2017

Initiation Sequence of E‐Cigarette and Cigarette Smoking Among US Adolescents: A National Study

JUUL and other stealth vaporisers: hiding the habit from parents and teachers

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