Predictors of electronic cigarette use among Swedish teenagers: a population-based cohort study

Abstract

ObjectivesThe aim was to identify predictors of electronic cigarette (e-cigarette) use among teenagers.Design and settingA prospective population-based cohort study of schoolchildren in northern Sweden.ParticipantsIn 2006, a cohort study about asthma and allergic diseases among schoolchildren started within the Obstructive Lung Disease in Northern Sweden studies. The study sample (n=2185) was recruited at age 7–8 years, and participated in questionnaire surveys at age 14–15 and 19 years. The questionnaire included questions about respiratory symptoms, living conditions, upper secondary education, physical activity, diet, health-related quality of life, parental smoking and parental occupation. Questions about tobacco use were included at age 14–15 and 19 years.Primary outcomeE-cigarette use at age 19 years.ResultsAt age 19 years, 21.4% had ever tried e-cigarettes and 4.2% were current users. Among those who were daily tobacco smokers at age 14–15 years, 60.9% had tried e-cigarettes at age 19 years compared with 19.1% of never-smokers and 34.0% of occasional smokers (p<0.001). Among those who had tried e-cigarettes, 28.1% were never smokers both at age 14–15 and 19 years, and 14.4% were never smokers among the current e-cigarette users. In unadjusted analyses, e-cigarette use was associated with daily smoking, use of snus and having a smoking father at age 14–15 years, as well as with attending vocational education, physical inactivity and unhealthy diet. In adjusted analyses, current e-cigarette use was associated with daily tobacco smoking at age 14–15 years (OR 6.27; 95% CI 3.12 to 12.58), attending a vocational art programme (OR 2.22; 95% CI 1.04 to 4.77) and inversely associated with eating a healthy diet (OR 0.74; 95% CI 0.59 to 0.92).ConclusionsE-cigarette use was associated with personal and parental tobacco use, as well as with physical inactivity, unhealthy diet and attending vocational upper secondary education. Importantly, almost one-third of those who had tried e-cigarettes at age 19 years had never been tobacco smokers.

Electronic Cigarettes and Asthma: What Do We Know So Far?

“…Twenty-five observational studies involving 966,376 participants, three case studies, one opinion article, eight reviews, and four systematic reviews with three meta-analyses were identified for this query ( Table 3 ). Several researchers have pointed out that EC might lead previously “nicotine naïve youths” to tobacco cigarette use [ 18 , 62 , 63 , 64 , 114 ]. Tobacco cigarette use and asthma were found to be associated with lifetime EC use and young adults who used ECs persisted with smoking tobacco cigarettes [ 84 ].…”

“…It has been pointed out that ECs could serve as a gateway to tobacco cigarette smoking or illicit drugs (the “gateway effect”) [ 19 , 63 ]. One cohort study and two large cross-sectional studies—including more than 670,000 participants, with many asthmatics among them—have demonstrated the association between EC and tobacco smoking, snus, alcohol, and other substance use [ 68 , 75 , 114 ]. EC devices can contain cannabis-based products including tetrahydrocannabinol (THC), the psychoactive component of cannabis (marijuana) [ 18 ].…”

Alcohol use, cigarette smoking, vaping and number of sexual partners: A cross‐sectional study of sexually active, ethnically diverse, inner city adolescents

“…Our participants were younger and more ethnically diverse, and 90% were adolescents. A Swedish study of 2185 teenagers found reported e‐cigarette use was associated with personal and parental tobacco use, physical inactivity and an unhealthy diet 8 . We did not collect data on all these variables.…”

“…4 However, there are few UK data on the extent of clustering of risky behaviours, specifically in inner-city, ethnically diverse adolescents 6,7 ; there have been calls for more studies of substance use and sexual behaviour in teenagers. 2,5,8 Adolescence is a key stage in life when unhealthy habits are most often established, 9 and these can lead to health inequalities later in life. 1,10 Using cross-sectional, baseline data from the 'Test and treat' (TnT) feasibility trial (which explored the uptake of rapid chlamydia tests and same-day on-site treatment 11 ), we examined the prevalence of reported alcohol use, smoking (including heavy smoking defined as ≥10 cigarettes daily) and vaping, and explored possible associations with numbers of sexual partners (≥2 versus 0-1) within the past year.…”

“…Similarly in Italian adolescents, lifetime cannabis use, high alcohol intake and early sexual intercourse were more frequent among heavy smokers 4 . However, there are few UK data on the extent of clustering of risky behaviours, specifically in inner‐city, ethnically diverse adolescents 6,7 ; there have been calls for more studies of substance use and sexual behaviour in teenagers 2,5,8 . Adolescence is a key stage in life when unhealthy habits are most often established, 9 and these can lead to health inequalities later in life 1,10 …”