Do Electronic Cigarettes Increase Cigarette Smoking in UK Adolescents? Evidence from a 12-month Prospective Study

Conner, M.; Grogan, S.; Simms-Ellis, R.; Flett, K.; Sykes-Muskett, B.; Cowap, L.; Lawton, R.; Armitage, C.J.; Meads, D.; Torgerson, C.; West, R.; Siddiqi, K.

Abstract

Background In cross-sectional surveys, increasing numbers of adolescents report using both electronic cigarettes (e-cigarettes) and cigarettes. This study assessed whether adolescent e-cigarette use was associated prospectively with initiation or escalation of cigarette use. Methods Data were from 2836 adolescents (aged 13–14 years at baseline) in 20 schools in England. At baseline, breath carbon monoxide levels, self-reported e-cigarette and cigarette use, sex, age, friends and family smoking, beliefs about cigarette use and percentage receiving free school meals (measure of socioeconomic status) were assessed. At 12-month follow-up, self-reported cigarette use was assessed and validated by breath carbon monoxide levels. Results At baseline, 34.2% of adolescents reported ever using e-cigarettes (16.0% used only e-cigarettes). Baseline ever use of e-cigarettes was strongly associated with subsequent initiation (n=1726; OR 5.38, 95% CI 4.02 to 7.22; controlling for covariates, OR 4.06, 95% CI 2.94 to 5.60) and escalation (n=318; OR 1.91, 95% CI 1.14 to 3.21; controlling for covariates, this effect became non-significant, OR 1.39, 95% CI 0.97 to 1.82) of cigarette use. Conclusions This is the first study to report prospective relationships between ever use of e-cigarettes and initiation and escalation of cigarette use among UK adolescents. Ever use of e-cigarettes was robustly associated with initiation but more modestly related to escalation of cigarette use. Further research with longer follow-up in a broader age range of adolescents is required.

Citation

Conner, M., Grogan, S., Simms-Ellis, R., Flett, K., Sykes-Muskett, B., Cowap, L., …Siddiqi, K. (2018). Do Electronic Cigarettes Increase Cigarette Smoking in UK Adolescents? Evidence from a 12-month Prospective Study. Tobacco Control, 27(4), 365-372. https://doi.org/10.1136/tobaccocontrol-2016-053539

• Journal Article Type: Article
• Acceptance Date: Jun 9, 2017
• Online Publication Date: Aug 17, 2017
• Publication Date: Jul 1, 2018
• Deposit Date: Jun 9, 2017
• Publicly Available Date: Jun 9, 2017
• Journal: Tobacco Control
• Print ISSN: 0964-4563
• Electronic ISSN: 1468-3318
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 27
• Issue: 4
• Pages: 365-372
• DOI: https://doi.org/10.1136/tobaccocontrol-2016-053539
• Public URL: https://durham-repository.worktribe.com/output/1377246