Hongying Dai1,2,3, Delwyn Catley4,3, Kimber P Richter5, Kathy Goggin4,3,6, Edward F Ellerbeck5. 1. The Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, Kansas City, Missouri; hdai@cmh.edu. 2. Departments of Biomedical and Health Informatics and. 3. Pediatrics, and. 4. The Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, Kansas City, Missouri. 5. Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kansas. 6. School of Pharmacy, University of Missouri-Kansas City, Kansas City, Missouri; and.
Abstract
BACKGROUND: Cigarettes have been strongly associated with subsequent marijuana use among adolescents, but electronic cigarettes (e-cigarettes) are now rapidly replacing traditional cigarettes among youth. This study examines associations between youth e-cigarette use and subsequent marijuana use in a national sample. METHODS: Youth (aged 12-17 years) never marijuana users at wave 1 (n = 10 364; 2013-2014) from the Population Assessment of Tobacco and Health study were followed-up in 1 year (wave 2, 2014-2015). Multivariable logistic regressions were performed to evaluate associations between e-cigarette use at wave 1 and ever/heavy marijuana use in the past 12 months (P12M) and at wave 2. RESULTS: Among never marijuana users, e-cigarette ever use (versus never use) at wave 1 was associated with increased likelihood of marijuana P12M use (adjusted odds ratio [aOR] = 1.9; 95% confidence interval [CI]: 1.4-2.5) at wave 2. There was a significant interaction between e-cigarette use and age (P < .05) with aOR = 2.7 (95% CI: 1.7-4.3) for adolescents aged 12 to 14 and aOR = 1.6 (95% CI: 1.2-2.3) for adolescents aged 15 to 17. The association with heavy marijuana use was significant among younger adolescents (aOR = 2.5; 95% CI: 1.2-5.3) but was not among older adolescents. Heavier e-cigarette use at wave 1 yielded higher odds of P12M and heavy marijuana use at wave 2 for younger adolescents. CONCLUSIONS: E-cigarette use predicts subsequent marijuana use among youth, with a stronger associations among young adolescents. Reducing youth access to e-cigarettes may decrease downstream marijuana use.
BACKGROUND: Cigarettes have been strongly associated with subsequent marijuana use among adolescents, but electronic cigarettes (e-cigarettes) are now rapidly replacing traditional cigarettes among youth. This study examines associations between youth e-cigarette use and subsequent marijuana use in a national sample. METHODS: Youth (aged 12-17 years) never marijuana users at wave 1 (n = 10 364; 2013-2014) from the Population Assessment of Tobacco and Health study were followed-up in 1 year (wave 2, 2014-2015). Multivariable logistic regressions were performed to evaluate associations between e-cigarette use at wave 1 and ever/heavy marijuana use in the past 12 months (P12M) and at wave 2. RESULTS: Among never marijuana users, e-cigarette ever use (versus never use) at wave 1 was associated with increased likelihood of marijuanaP12M use (adjusted odds ratio [aOR] = 1.9; 95% confidence interval [CI]: 1.4-2.5) at wave 2. There was a significant interaction between e-cigarette use and age (P < .05) with aOR = 2.7 (95% CI: 1.7-4.3) for adolescents aged 12 to 14 and aOR = 1.6 (95% CI: 1.2-2.3) for adolescents aged 15 to 17. The association with heavy marijuana use was significant among younger adolescents (aOR = 2.5; 95% CI: 1.2-5.3) but was not among older adolescents. Heavier e-cigarette use at wave 1 yielded higher odds of P12M and heavy marijuana use at wave 2 for younger adolescents. CONCLUSIONS: E-cigarette use predicts subsequent marijuana use among youth, with a stronger associations among young adolescents. Reducing youth access to e-cigarettes may decrease downstream marijuana use.
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