E-cigarette use in early adolescents who also smoke tends to raise the risk of future smoking, according to a new analysis of the issue.
Dr Jeremy Staff of Pennsylvania State University, USA, and colleagues have looked at the influence of e-cigarettes, using figures from two large cohorts in the UK and USA, including 1,893 young people. This showed that 57% of UK and 58% of US young cigarette smokers had also used e-cigarettes.
“The odds of later adolescent smoking among early smoking youth were significantly higher among e-cigarette users relative to those who had not used e-cigarettes,” state the authors in Tobacco Control today.
It was estimated that this group were 45% more likely to smoke cigarettes by age 18. The link was strongest for those who started smoking before the age of 15 years.
They suggest the pathway could either be via ‘disruption’ in which e-cigarette use steers them towards exclusive use of e-cigarettes, or as these results indicate, via ‘entrenchment’ in which e-cigarette use increases the odds of tobacco cigarette smoking.
“Despite national differences in e-cigarette regulation and marketing, there is evidence e-cigarette use among early adolescent smokers in the UK and USA leads to higher odds of any smoking and more frequent tobacco cigarette use later in adolescence,” they write.
“Cross-national support for the entrenchment hypothesis supports further UK, and especially US, e-cigarette regulations targeting early smoking youth.”
The researchers call for more work looking at the precise ways in which e-cigarette use affects tobacco use over time.
Kelly, B. C. et al. E-cigarette use among early adolescent tobacco cigarette smokers: testing the disruption and entrenchment hypotheses in two longitudinal cohorts. Tobacco Control 19 April 2023 doi: 10.1136/tc-2022-057717
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