Purpose
This study evaluated whether e-cigarette trials among adolescents in Mexico who had not previously smoked cigarettes or used marijuana increased the likelihood of trial and use of conventional cigarettes or marijuana use at follow-up.
Method
A school-based longitudinal survey was conducted in 60 public middle schools from the three largest cities in Mexico. Students (12–13 years old) were surveyed in 2015 and followed up 20 months later (n= 6,574). Generalized estimating equations models were used to evaluate the association between e-cigarette trial at baseline and conventional cigarettes smoking and marijuana use at follow-up.
Result
Our findings suggest that early adolescents who have tried e-cigarettes but not cigarettes, were more likely to try conventional cigarettes, 20 months later (43% vs. 24%, respectively; RR 1.41, 95% CI 1.18–1.70). We also found that dual trial of conventional cigarettes and e-cigarettes at baseline was associated with marijuana use at follow-up (20% vs. 4%, respectively; RR 2.67, 95% CI 1.78–4.02), whereas trial of only e-cigarettes was not independently associated.
Conclusions
Although the importation, distribution, and marketing of e-cigarettes have been banned in Mexico, adolescents who had tried e-cigarettes were more likely to have tried conventional cigarette and marijuana 20 months later. Policies and public health campaigns that promote information about the dangers and risk of e-cigarette use may be important to reduce adolescent use of e-cigarettes.