Olusegun Owotomo1, Haley Stritzel2,3, Sean Esteban McCabe4,5,6,7,8,9, Carol J Boyd4,5,6,10, Julie Maslowsky11,12,13. 1. Children's National Hospital, Washington, District of Columbia. 2. Department of Sociology and. 3. Population Research Center, College of Liberal Arts and. 4. Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing and. 5. Department of Health Behavior and Biological Sciences, School of Public Health and. 6. Institutes for Research on Women and Gender. 7. Social Research, and. 8. Healthcare Policy and Innovation and. 9. Rogel Cancer Center and. 10. Addiction Center, Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, Michigan. 11. Population Research Center, College of Liberal Arts and maslowsky@austin.utexas.edu. 12. Department of Kinesiology & Health Education, College of Education and. 13. Department of Population Health, Dell Medical School, The University of Texas at Austin, Austin, Texas; and.
Abstract
OBJECTIVES: To investigate whether the prospective association between electronic cigarette (e-cigarette) use and cigarette smoking is dependent on smoking intention status. METHODS: Waves 2 and 3 data of the Population Assessment of Tobacco and Health (PATH) Study, a US nationally representative prospective cohort study of tobacco use. Data were collected in 2014-2015 (wave 2) and 2015-2016 (wave 3) and analyzed in 2019. RESULTS: At wave 2, 12.8% of adolescent never-smokers of conventional cigarettes had intention to smoke and 8.5% had ever used an e-cigarette. At wave 3, 3.2% had ever smoked a cigarette. Both smoking intention and ever using e-cigarettes at wave 2 were positively associated with cigarette smoking at wave 3 (adjusted odds ratio [aOR] = 3.03; 95% confidence interval [CI] = 1.97-4.68, P < .001; aOR = 4.62, 95% CI = 2.87-7.42, P < .001, respectively). The interaction between smoking intention and ever using e-cigarettes was significant (aOR = 0.34, 95% CI = 0.18-0.64, P < .01). Among adolescents who had expressed intention to smoke conventional cigarettes at wave 2, the odds of cigarette smoking at wave 3 did not significantly differ for e-cigarette users and never e-cigarette users (aOR = 1.57; 95% CI 0.94-2.63; P = .08). Among adolescents who had no intention to smoke at wave 2, e-cigarette users, compared with never e-cigarette users, had >4 times the odds of cigarette smoking (aOR = 4.62; 95% CI 2.87-7.42; P < .0001). CONCLUSIONS: E-cigarette use is associated with increased odds of cigarette smoking among adolescents who had no previous smoking intention. E-cigarette use may create intention to smoke and/or nicotine use disorder that lead to onset of cigarette smoking.
OBJECTIVES: To investigate whether the prospective association between electronic cigarette (e-cigarette) use and cigarette smoking is dependent on smoking intention status. METHODS: Waves 2 and 3 data of the Population Assessment of Tobacco and Health (PATH) Study, a US nationally representative prospective cohort study of tobacco use. Data were collected in 2014-2015 (wave 2) and 2015-2016 (wave 3) and analyzed in 2019. RESULTS: At wave 2, 12.8% of adolescent never-smokers of conventional cigarettes had intention to smoke and 8.5% had ever used an e-cigarette. At wave 3, 3.2% had ever smoked a cigarette. Both smoking intention and ever using e-cigarettes at wave 2 were positively associated with cigarette smoking at wave 3 (adjusted odds ratio [aOR] = 3.03; 95% confidence interval [CI] = 1.97-4.68, P < .001; aOR = 4.62, 95% CI = 2.87-7.42, P < .001, respectively). The interaction between smoking intention and ever using e-cigarettes was significant (aOR = 0.34, 95% CI = 0.18-0.64, P < .01). Among adolescents who had expressed intention to smoke conventional cigarettes at wave 2, the odds of cigarette smoking at wave 3 did not significantly differ for e-cigarette users and never e-cigarette users (aOR = 1.57; 95% CI 0.94-2.63; P = .08). Among adolescents who had no intention to smoke at wave 2, e-cigarette users, compared with never e-cigarette users, had >4 times the odds of cigarette smoking (aOR = 4.62; 95% CI 2.87-7.42; P < .0001). CONCLUSIONS: E-cigarette use is associated with increased odds of cigarette smoking among adolescents who had no previous smoking intention. E-cigarette use may create intention to smoke and/or nicotine use disorder that lead to onset of cigarette smoking.
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