Relationship between trying an electronic cigarette and subsequent cigarette experimentation in Scottish adolescents: a cohort study

Abstract

BackgroundThis study examines whether young never smokers in Scotland, UK, who have tried an e-cigarette are more likely than those who have not, to try a cigarette during the following year.MethodsProspective cohort survey conducted in four high schools in Scotland, UK during February/March 2015 (n=3807) with follow-up 1 year later. All pupils (age 11–18) were surveyed. Response rates were high in both years (87% in 2015) and 2680/3807 (70.4%) of the original cohort completed the follow-up survey. Analysis was restricted to baseline ‘never smokers’ (n=3001/3807), 2125 of whom were available to follow-up (70.8%).ResultsAt baseline, 183 of 2125 (8.6%) never smokers had tried an e-cigarette and 1942 had not. Of the young people who had not tried an e-cigarette at baseline, 249 (12.8%) went on to try smoking a cigarette by follow-up. This compares with 74 (40.4%) of those who had tried an e-cigarette at baseline. This effect remained significant in a logistic regression model adjusted for smoking susceptibility, having friends who smoke, family members’ smoking status, age, sex, family affluence score, ethnic group and school (adjusted OR 2.42 (95% CI 1.63 to 3.60)). There was a significant interaction between e-cigarette use and smoking susceptibility and between e-cigarette use and smoking within the friendship group.ConclusionsYoung never smokers are more likely to experiment with cigarettes if they have tried an e-cigarette. Causality cannot be inferred, but continued close monitoring of e-cigarette use in young people is warranted.

Is adolescent e-cigarette use associated with smoking in the United Kingdom?: A systematic review with meta-analysis

“…Using parameters from the CASP tool for cohort studies, the included studies were generally of good quality ( Table 1) while risk of bias was mainly low ( Table 2). Over all of the eight included studies 20,[42][43][44][45][46][47][48] there were a total of 73076 adolescents aged 10-19 years ( Table 3). Five of the studies used a crosssectional survey design 20,45-48 while three [42][43][44] were longitudinal (prospective) designs and were able to be included in a meta-analysis.…”

“…Smoking initiation does not mean regular use, however it can be taken as a potential starting point that could easily progress to regular use of a substance 49 . Three longitudinal studies [42][43][44] Almost half of those who had tried smoking had tried an e-cigarette. 42.8% of young people who had used e-cigarettes reported that they had never smoked tobacco.…”

Adolescents’ perceptions of tobacco accessibility and smoking norms and attitudes in response to the tobacco point-of-sale display ban in Scotland: results from the DISPLAY Study

“…22 Using principal component analysis, FAS scores were transformed into a single-dimensional score which was then divided into tertiles of high, medium and low FAS. 23 Smoking status was measured with the question 'Have you ever smoked cigarettes or hand-rolled cigarettes (roll-ups), even if it is just one or two puffs?' and among those answering 'yes', those who indicated 'I currently smoke cigarettes or hand-rolled cigarettes (roll-ups)' were considered smokers.…”

E-cigarettes and youth smoking: be alert but not alarmed

“…Conner et al 1 and Best et al 2 report the results of two longitudinal studies of teenagers in the UK that examined the relationship between vaping an e-cigarette and smoking a cigarette. Similar to studies conducted in the USA,3 4 they both report an association between experimentation with vaping and subsequent experimentation with smoking.…”

“…The baseline waves of these longitudinal studies were conducted in locations and at times when there were no age restrictions on sales of vaping products 2. In such a regulatory context, it is not surprising that young people may have tried the product with less restrictions first 5.…”