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The Association Between Smoking and Electronic Cigarette Use in a Cohort of Young People

Research output: Contribution to journalArticlepeer-review

Katherine East, Sara C. Hitchman, Ioannis Bakolis, Sarah Williams, Hazel Cheeseman, Deborah Arnott, Ann McNeill

Original languageEnglish
JournalJournal of Adolescent Health
Early online date2 Mar 2018
DOIs
Accepted/In press28 Nov 2017
E-pub ahead of print2 Mar 2018
Published2018

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Abstract

Purpose: Electronic cigarette (e-cigarette) use is associated with smoking initiation among young people; however it is also possible that smoking is associated with e-cigarette initiation. This study explores these associations among young people in Great Britain.

Methods: A longitudinal survey of 1,128 11-18 year olds was conducted with baseline in April 2016 and follow-up between August and October 2016. Logistic regression models and causal mediation analyses assessed whether (a) ever e-cigarette use and escalation were associated with smoking initiation (ever smoking at follow-up) among baseline never smokers (n=923), and (b) ever smoking and escalation were associated with e-cigarette initiation (ever e-cigarette use at follow-up) among baseline never e-cigarette users (n=1,020).

Results: At baseline, 19.8% were ever smokers and 11.4% were ever e-cigarette users. Respondents who were ever e-cigarette users (vs. never users, 53% vs. 8%, OR=11.89, 95% CI=3.56-39.72) and escalated their e-cigarette use (vs. did not, 41% vs. 8%, OR=7.89, 95% CI=3.06-20.38) were more likely to initiate smoking. Respondents who were ever smokers (vs. never smokers, 32% vs. 4%,OR=3.54, 95% CI=1.68-7.45) and escalated their smoking (vs. did not, 34% vs. 6%, OR=5.79, 95% CI=2.55-13.15) were more likely to initiate e-cigarette use. There was a direct effect of ever e-cigarette use on smoking initiation (OR=1.34, 95% CI=1.05-1.72), and ever smoking on e-cigarette initiation (OR=1.08, 95% CI=1.01-1.17); e-cigarette and smoking escalation, respectively, did not mediate these effects.

Conclusions: Among young people in Great Britain, ever e-cigarette use is associated with smoking initiation, and ever smoking is associated with e-cigarette initiation.

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