Electronic Cigarettes and Conventional Cigarette Use Among US Adolescents

Abstract

Importance E-cigarette use is increasing rapidly among adolescents and e-cigarettes are currently unregulated. Objective Examine e-cigarette use and conventional cigarette smoking. Design Cross-sectional analyses of survey data. Setting 2011 and 2012 National Youth Tobacco Surveys (NYTS) Participants Representative sample of US middle and high school students in 2011 (n=17,353) and 2012 (n=22,529) Exposures Ever and current e-cigarette use Main outcome measures Experimentation with, ever, and current smoking; smoking abstinence Results In pooled analyses, among cigarette experimenters (≥1 puff), ever e-cigarette use was associated with higher odds of ever smoking cigarettes (≥100 cigarettes; OR= 6.31, 95% CI [5.39-7.39) and current cigarette smoking (OR=5.96 [5.67-6.27]). Current e-cigarette use was positively associated with ever smoking cigarettes (OR=7.42 [5.63-9.79]) and current cigarette smoking (OR= 7.88 [6.01-10.32]. In 2011, current cigarette smokers who had ever used e-cigarettes were more likely to intend to quit smoking within the next year (OR=1.53 [1.03-2.28]). Among experimenters with conventional cigarettes, ever use of e-cigarettes was also associated with lower 30-day (OR=0.24 [0.21-0.28]), 6-month (OR=0.24 [0.21-0.28]), and 1-year (OR=0.25 [0.21-0.30]) abstinence from cigarettes. Current e-cigarette use was also associated with lower 30-day (OR=0.11 [0.08-0.15]), 6-month (OR=0.11 [0.08-0.15]), and 1-year (OR=0.12 [0.07-0.18]) abstinence. Among ever smokers of cigarettes (≥100 cigarettes), ever e-cigarette use was negatively associated with 30-day (OR=0.61, [0.42-0.89]), 6-month (OR=0.53, [0.33-0.83]) and one-year (OR=0.32 [0.18-0.56) abstinence from conventional cigarettes. Current e-cigarette use was also negatively associated with 30-day (OR=0.35 [0.18-0.69]), 6-month (OR=0.30 [0.13-0.68]), and one-year (OR=0.34 [0.13-0.87]) abstinence. Conclusions E-cigarette use was associated with higher odds of ever or current cigarette smoking, higher odds of established smoking, higher odds of planning to quit smoking among current smokers, and, among experimenters, lower odds of abstinence from conventional cigarettes. Relevance Results suggest e-cigarette use does not discourage, and may encourage, conventional cigarette use among US adolescents.

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