Trends in electronic cigarette use and conventional smoking: quantifying a possible ‘diversion’ effect among US adolescents

Selya, Arielle; Foxon, Floe

doi:10.1111/add.15385

Cited by 38 publications

(27 citation statements)

References 30 publications

(48 reference statements)

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“…Figures 6 and 7 do not conclusively prove a diversion effect, but they do show that population-level trends are much better explained by a net diversion effect, and are very inconsistent with a net catalyst effect. Recently, this was also observed for the trends in e-cigarette use among young persons in the US (Selya & Foxon, 2021).…”

Section: User Pattern Of Snussupporting

confidence: 58%

A conceptual framework for assessing the public health effects from snus and novel non-combustible nicotine products

Lund

Vedøy

2021

Nordic Studies on Alcohol and Drugs

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Objective: The tobacco industry plans to base their future earnings on the production of non-combustible nicotine products. These might replace or come in addition to the more harmful cigarettes that historically have dominated the nicotine market in the Nordic countries. The authorities in each country must decide whether the products should have market access and, in that case, how strictly they should be regulated. Our aim is to present a framework that can assist the health authorities to make a regulation where benefits will outweigh the harms. Method: In a public health perspective, health gains from substitution must be weighed against the health loss from additional use. The main elements of the weighing will be based on the information about the absolute risk of the products, their relative risk compared to conventional cigarettes and how the users are composed according to smoking status. We apply the framework on snus as used in Norway – a product with an established usage pattern and epidemiologically assessed health risks. Results: The framework consists of (i) a comprehensive set of specific user patterns that may result in health deterioration and user patterns that may result in health benefits, (ii) an estimation of the number of people with health-augmenting and health-impairing user patterns, respectively, and (iii) an estimation of the degree of health deterioration or health benefit that will affect the persons with the different user patterns. Conclusion: The net effect on public health will appear as an overall result of the number of people with positive and negative user patterns, respectively, in combination with the magnitude of the change in health status these people will experience. The use of an explicit framework highlights how a political decision may affect nicotine use and health-related outcomes. The framework breaks open a large and complex question into smaller pieces and requires the authorities to expose and explain the kind of evidence and reasoning behind regulations of novel nicotine products.

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Section: User Pattern Of Snussupporting

confidence: 58%

A conceptual framework for assessing the public health effects from snus and novel non-combustible nicotine products

Lund

Vedøy

2021

Nordic Studies on Alcohol and Drugs

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“…[118][119][120][121] smoke. [122][123][124] Conversely, some prospective studies have found the vaping-smoking relationship strongest in youths at low risk of smoking. [125][126][127] Obvious plausible correlates are often not considered, however.…”

Section: Vaping Causing Smoking Initiationmentioning

confidence: 99%

Balancing Consideration of the Risks and Benefits of E-Cigarettes

et al. 2021

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The topic of e-cigarettes is controversial. Opponents focus on e-cigarettes’ risks for young people, while supporters emphasize the potential for e-cigarettes to assist smokers in quitting smoking. Most US health organizations, media coverage, and policymakers have focused primarily on risks to youths. Because of their messaging, much of the public—including most smokers—now consider e-cigarette use as dangerous as or more dangerous than smoking. By contrast, the National Academies of Science, Engineering, and Medicine concluded that e-cigarette use is likely far less hazardous than smoking. Policies intended to reduce adolescent vaping may also reduce adult smokers’ use of e-cigarettes in quit attempts. Because evidence indicates that e-cigarette use can increase the odds of quitting smoking, many scientists, including this essay’s authors, encourage the health community, media, and policymakers to more carefully weigh vaping’s potential to reduce adult smoking-attributable mortality. We review the health risks of e-cigarette use, the likelihood that vaping increases smoking cessation, concerns about youth vaping, and the need to balance valid concerns about risks to youths with the potential benefits of increasing adult smoking cessation.

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“…The potential role of e‐cigarette trends in explaining the current findings is unclear. It remains a matter of active debate whether e‐cigarette use causes later cigarette smoking, 26 whether both behaviors originate from a common liability for tobacco use, 27 or whether e‐cigarette use diverts youth away from cigarette smoking 28 . Even less is certain about this question in the context of rurality, and this a critical topic for ongoing research.…”

Section: Discussionmentioning

confidence: 99%

Rural disparities in adolescent smoking prevalence

Kim

Selya

2021

The Journal of Rural Health

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Introduction Rural residence is a well‐established risk factor for risk behaviors and subsequent morbidity and mortality in the United States. Smoking is the primary cause of preventable death and is more prevalent in rural America. As chronic smoking habits typically develop during adolescence, the discrepancy in smoking rates between rural and urban youth likely contributes to a significant geographic disparity in the long‐term health of adults. Methods Data were extracted from 12th‐grader surveys of the US Monitoring the Future study from 1998 to 2018. The historic trends of smoking initiation, ever‐regular and current‐regular smoking rates of rural and urban adolescents were estimated with intercept‐only time‐varying effect models. Differences in prevalence between rural and urban youth were calculated for each smoking behavior. Results Though overall smoking prevalence continues to decline, this trend is significantly attenuated among rural adolescents compared to urban youth. The absolute difference in lifetime smoking prevalence between rural and urban youth has markedly increased from 6.9% in 1998 to 13.5% in 2018, which is among the highest in the past 20 years and is a potentially alarming upward trend. However, the absolute differences in ever‐regular and current‐regular smoking prevalence have shown an overall net decline, decreasing from 6.4 to 4.8%, and from 5.5 to 3.0%, respectively. Conclusions This geographic disparity between rural and urban adolescents represents a potentially modifiable cause of increased morbidity and mortality in rural areas. Interventions and regulatory efforts should be tailored for rural adolescents to reduce the narrowing but persistent disparity in regular smoking.

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Trends in electronic cigarette use and conventional smoking: quantifying a possible ‘diversion’ effect among US adolescents

Cited by 38 publications

References 30 publications

A conceptual framework for assessing the public health effects from snus and novel non-combustible nicotine products

A conceptual framework for assessing the public health effects from snus and novel non-combustible nicotine products

Balancing Consideration of the Risks and Benefits of E-Cigarettes

Rural disparities in adolescent smoking prevalence

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