BACKGROUND: In 2015, 12.1% of 12- to 17-year-olds in Germany had reportedly already tried e-cigarette smoking at least once. We carried out a study of the "gateway" hypothesis, according to which the use of e-cigarettes can motivate adolescents to start smoking conventional cigarettes. METHODS: During the 2015/2016 school year, 2186 tenth-graders in the German states of Lower Saxony and Schleswig-Holstein who had never smoked conventional cigarettes before took part in a survey over a 6-month period (mean age 15.5 years, standard deviation 0.65; 53.6% female). RESULTS: 14.3% of the survey population (313 adolescents) said at the start of the survey period that they had already tried e-cigarettes at least once. By the end of the survey period, 12.3% (268) of those who had never smoked before had begun to experiment with conventional cigarettes. The risk of beginning such experimentation was 2.2 times higher among e-cigarette users. This association remained (relative risk = 2.18 [1.65; 2.83]) after statistical control for age, sex, state, immigrant background, type of school, socioeconomic status, various personality traits (sensation-seeking, impulsivity, anxiety, hopelessness, extraversion, agreeableness, conscientiousness, neuroticism, openness), and the use of alcohol, cannabis, and other illicit drugs. Further analysis revealed that the association between the use of e-cigarettes and the onset of conventional cigarette smoking was stronger among adolescents with low sensation-seeking scores and without any experience of alcohol intoxication. CONCLUSION: Among adolescents who have never smoked, experimentation with conventional cigarettes is more common in those who have used e-cigarettes. This effect seems to be stronger among adolescents who, in general, have a lower risk of starting to smoke. The 6-month observation period of this study is too short to allow any inference regarding a connection between e-cigarette use and the development of tobacco dependence.
BACKGROUND: In 2015, 12.1% of 12- to 17-year-olds in Germany had reportedly already tried e-cigarette smoking at least once. We carried out a study of the "gateway" hypothesis, according to which the use of e-cigarettes can motivate adolescents to start smoking conventional cigarettes. METHODS: During the 2015/2016 school year, 2186 tenth-graders in the German states of Lower Saxony and Schleswig-Holstein who had never smoked conventional cigarettes before took part in a survey over a 6-month period (mean age 15.5 years, standard deviation 0.65; 53.6% female). RESULTS: 14.3% of the survey population (313 adolescents) said at the start of the survey period that they had already tried e-cigarettes at least once. By the end of the survey period, 12.3% (268) of those who had never smoked before had begun to experiment with conventional cigarettes. The risk of beginning such experimentation was 2.2 times higher among e-cigarette users. This association remained (relative risk = 2.18 [1.65; 2.83]) after statistical control for age, sex, state, immigrant background, type of school, socioeconomic status, various personality traits (sensation-seeking, impulsivity, anxiety, hopelessness, extraversion, agreeableness, conscientiousness, neuroticism, openness), and the use of alcohol, cannabis, and other illicit drugs. Further analysis revealed that the association between the use of e-cigarettes and the onset of conventional cigarette smoking was stronger among adolescents with low sensation-seeking scores and without any experience of alcohol intoxication. CONCLUSION: Among adolescents who have never smoked, experimentation with conventional cigarettes is more common in those who have used e-cigarettes. This effect seems to be stronger among adolescents who, in general, have a lower risk of starting to smoke. The 6-month observation period of this study is too short to allow any inference regarding a connection between e-cigarette use and the development of tobacco dependence.
Authors: Samir Soneji; Jessica L Barrington-Trimis; Thomas A Wills; Adam M Leventhal; Jennifer B Unger; Laura A Gibson; JaeWon Yang; Brian A Primack; Judy A Andrews; Richard A Miech; Tory R Spindle; Danielle M Dick; Thomas Eissenberg; Robert C Hornik; Rui Dang; James D Sargent Journal: JAMA Pediatr Date: 2017-08-01 Impact factor: 16.193
Authors: Brian A Primack; Ariel Shensa; Jaime E Sidani; Beth L Hoffman; Samir Soneji; James D Sargent; Robert M Hoffman; Michael J Fine Journal: Am J Med Date: 2017-12-11 Impact factor: 4.965
Authors: Thomas A Wills; Rebecca Knight; James D Sargent; Frederick X Gibbons; Ian Pagano; Rebecca J Williams Journal: Tob Control Date: 2016-01-25 Impact factor: 7.552
Authors: Ahmed Jamal; Andrea Gentzke; S Sean Hu; Karen A Cullen; Benjamin J Apelberg; David M Homa; Brian A King Journal: MMWR Morb Mortal Wkly Rep Date: 2017-06-16 Impact factor: 17.586
Authors: Mark Conner; Sarah Grogan; Ruth Simms-Ellis; Keira Flett; Bianca Sykes-Muskett; Lisa Cowap; Rebecca Lawton; Christopher J Armitage; David Meads; Carole Torgerson; Robert West; Kamran Siddiqi Journal: Tob Control Date: 2017-08-17 Impact factor: 7.552
Authors: Jessica L Barrington-Trimis; Zhi Yang; Sara Schiff; Jennifer Unger; Tess Boley Cruz; Robert Urman; Junhan Cho; Jonathan M Samet; Adam M Leventhal; Kiros Berhane; Rob McConnell Journal: Pediatrics Date: 2020-04-06 Impact factor: 7.124