Patterns and predictors of e‐cigarette, cigarette and dual use uptake in UK adolescents: evidence from a 24‐month prospective study

Abstract

Background and AimsTo assess prevalence and predictors of e‐cigarettes/cigarettes patterns of use in adolescents in England.DesignProspective study with 24‐month follow‐up of e‐cigarette/cigarette ever/regular use with data from an intervention evaluation.SettingForty‐five schools in England (Staffordshire and Yorkshire).ParticipantsA total of 3210 adolescents who, at baseline, were aged 13–14 years and had never used e‐cigarettes/cigarettes.MeasurementsBased on e‐cigarette/cigarette ever use at follow‐up, six groups were created: (a) never user, (b) e‐cigarette only, (c) cigarette only, (d) dual use—order of use unclear, (e) dual use—e‐cigarettes used first and (f) dual use—cigarettes used first. Baseline measures were: gender, ethnicity, socio‐economic status, impulsivity, family plus friend smoking and smoking‐related beliefs (attitude and perceived behavioural control).FindingsIn groups (a) to (f), there were 71.5, 13.3, 3.3, 5.7, 2.9 and 3.4% adolescents, respectively. Among groups using cigarettes, regular smoking was more prevalent in group (f) (dual use—cigarettes used first) [17.6%, 95% confidence interval (CI) = 10.4, 24.8] than in groups (c), (d) and (e) combined (7.3%, 95% CI = 4.7, 9.9). Among groups using e‐cigarettes, regular use was less prevalent in group (b) (e‐cigarette only) (1.9%, 95% CI = 0.6, 3.2) than in groups (d), (e) and (f) combined (12.2%, 95% CI = 8.9, 15.5). Higher impulsivity plus friends and family smoking were predictive of being in groups (b) to (f) compared with group (a) (never users). Males were more likely to be in group (b) compared to group (a); females were more likely to be in groups (c) to (f) compared to group (a).ConclusionsRegular use of e‐cigarettes/cigarettes varies across groups defined by ever use of e‐cigarettes/cigarettes. Interventions targeted at tackling impulsivity or adolescents whose friends and family members smoke may represent fruitful avenues for future research.

Exploring the gateway hypothesis of e-cigarettes and tobacco: a prospective replication study among adolescents in the Netherlands and Flanders

“…32 Dual users of e-cigarettes and cigarettes, for example, share similar characteristics (eg, impulsivity) regardless of which product is used first. 64 It remains uncertain whether the found associations are causal, which the gateway hypothesis suggests, or an indication of shared risk factors for e-cigarette and tobacco use. While multiple predictors linked to tobacco smoking were addressed in our study, it remains uncertain whether all common liability risks were controlled for.…”

Effects of electronic cigarette aerosol exposure on oral and systemic health

“…The UK places limits on the amount of nicotine allowed in their e-cigarettes (up to 20 mg/mL of nicotine [ 53 ], whereas the U.S. has no limit (some brands currently have up to 87 mg/mL [ 54 ]). These different approaches to e-cigarettes have resulted in a dramatically different teenage e-cigarette rate in the UK, which is only 2% [ 55 , 56 ] compared to 20% in the US [ 57 ]. These differences raise obvious questions for the US: Should nicotine levels in e-cigarettes be regulated?…”

Prevalence of Electronic Cigarette Use and Its Determinants among 13-to-15-Year-Old Students in Greece: Results from the 2013 Global Youth Tobacco Survey (GYTS)

“…Many studies, mentioned in the introduction, have investigated whether e-cigarette use increases the risk of students' taking up tobacco smoking. In addition to those studies, a prospective observational cohort study [43] in the United Kingdom was carried out among students aged 13-14 in 2014 who had never used either conventional or electronic cigarettes. Two years later, 25.2% of them had ever used e-cigarette and 15.3% of them had ever used conventional cigarettes.…”