Trajectories of E-Cigarette and Conventional Cigarette Use Among Youth

Bold, Krysten W.; Kong, Grace; Camenga, Deepa R.; Simon, Patricia; Cavallo, Dana A.; Morean, Meghan E.; Krishnan‐Sarin, Suchitra

doi:10.1542/peds.2017-1832

Cited by 171 publications

(123 citation statements)

References 24 publications

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“…Since the time that we published our earlier analysis [8] and our paper on general considerations relating to vaping as a possible gateway into cigarette smoking [7] a number of other authors have presented evidence from prospective studies [9][10][11][12][13][14][15]. The studies vary in the extent to which potential confounding variables have been adjusted for, with large OR estimates tending to be reported in studies with more limited control.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, a study in the Netherlands [15], which adjusted only for sex, age education and a single indicator of propensity to smoke, reported an OR of 11.90 (95% CI 3.36-42.11) for the relationship between ever use of e-cigarettes with nicotine and initiation of cigarette smoking during follow-up. Also, a study in the US [9], which adjusted only for demographic variables and use of other tobacco products, reported ORs of 7.08 (2.34-21.42) and 3.87 (1.86-2.06) depending on the follow-up period studied, while another US study [13], with limited control for confounding variables, reported an OR of 3.57 (1.96-6.45). Apart from a US study [14] ,which reported an OR of 6.8 (1.7-28.3), following adjustment for ten covariates independently associated with initiation of smoking, most of the other studies which appear to have better control for confounding gave lower estimates.…”

Section: Discussionmentioning

confidence: 99%

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Further investigations of gateway effects using the PATH study

Lee¹,

Fry²

2020

Preprint

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Background: Considerable interest exists in whether e-cigarette use (“vaping”) by youths increases the risk of initiating cigarette smoking. Based on Waves 1 and 2 of the Population Assessment of Tobacco and Health study we reported that adjustment for propensity for vaping using Wave 1 variables explained about 80% of the unadjusted relationship. This analysis may be over-adjusted had vaping at Wave 1 affected some variables recorded then. Here we present analyses using Waves 1 to 3 to avoid this possibility. Methods: Our main analysis M1 concerned those who had never smoked by Wave 2 and never vaped by Wave 1. Wave 2 vaping was linked to smoking initiation by Wave 3, adjusting for Wave 1 predictors. Sensitivity analyses excluded other tobacco product users at Wave 1, included other tobacco product use as an additional predictor, or were based on propensity for ever smoking or ever any tobacco use, rather than ever vaping. Other analyses adjusted for propensity as derived originally, or ignored Wave 1 data. Other analyses used grouped age (only available originally) or exact age (available now) as a confounder variable, attempted residual confounding adjustment by modifying values of predictor variables using data later recorded, or considered interactions with age. Results: In M1, propensity adjustment removed about 50% of the excess odds ratio (i.e. OR–1), the unadjusted OR, 5.60 (95% CI 4.52-6.93) becoming 3.37 (2.65-4.28), 3.11 (2.47-3.92) or 3.27 (2.57-4.16) depending whether adjustment was for propensity as a continuous variable, as quintiles, or for the 16 variables making up the propensity score. Many factors studied hardly affected the results, including using grouped or exact age, consideration of other tobacco products, including interactions, or using predictors of smoking or tobacco use rather than vaping. The clearest conclusion was that analyses avoiding over-adjustment only explained about 50% of the excess OR whereas analyses subject to over-adjustment explained about 80%. Conclusions: Although much of the unadjusted gateway effect results from uncontrolled confounding, our current analysis provides stronger evidence of a causal effect of vaping than did our earlier analysis. However, some doubts remain about the completeness of confounder adjustment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Further investigations of gateway effects using the PATH study

Lee¹,

Fry²

2020

Preprint

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“…19 In contrast, according to large-scale surveys and cross-sectional analyses of randomised controlled trials, the majority of electronic cigarette users perceive these devices as a tool to quit regular tobacco smoking. 20,21…”

Section: Epidemiology Of Electronic Cigarette Usagementioning

confidence: 99%

Electronic Cigarettes and Cardiovascular Risk: Caution Waiting for Evidence

D’Amario

Migliaro²,

Borovac

et al. 2019

Eur Cardiol

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Electronic cigarettes use is a growing trend in contemporary societies, with the propensity to compete with traditional tobacco smoking. Some preclinical studies demonstrated the toxic and detrimental effects of electronic cigarettes liquid components. Its impact on human health remains unknown and insufficiently studied. While some studies suggest that electronic cigarettes use might be associated with endothelial dysfunction, impaired platelet function and increased risk of adverse clinical events, other studies did not confirm these findings and epidemiological data mostly suggest that the use of electronic cigarettes appears to be safer than that of traditional tobacco cigarettes. This article provides an up-to-date overview of the current state of knowledge regarding electronic cigarettes and their impact on human health, with special emphasis on their effect on cardiovascular diseases.

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“…13 Exclusive e-cigarette users are at high risk of beginning combustible cigarette use within 2 years of initiating vaping. 14,15 Currently, 27.5% of United States youth report using an electronic cigarette within the past 30 days and rates of use in children have increased by over 100% in the past 2 years. 16 Though popularly conceived as a safer alternative to combustible cigarettes, these products contain toxicants such as formaldehyde, propylene glycol, acetylaldehyde, vegetable glycerin and acrolein.…”

mentioning

confidence: 99%

“…53,54 Further, teens who use these products are twice as likely to graduate to long-term combustible tobacco and up to three times more likely to use marijuana. 14,55,56 The balance of public health harm resulting from a generation of potential, sustained nicotine addiction beginning in childhood clearly outweighs any, as yet, unproven benefit to adult combustible tobacco smokers.…”

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confidence: 99%