Article Text
Abstract
Introduction This study quantifies the longitudinal association between e-cigarette use and subsequent conventional cigarette initiation and vice versa among Thai youths.
Methods Data from a longitudinal survey of 6045 Thai seventh grade students with baseline in 2019 and the 12-month follow-up in 2020 were analysed using complex survey multivariate logistic regressions to assess whether e-cigarette use was associated with subsequent cigarette smoking (ever, current and dual product users at follow-up) among baseline never smokers.
Results Consistent with prior findings from other countries, among those who had never smoked cigarettes at baseline, ever e-cigarette users were more likely to try cigarette smoking (adjusted OR 4.44; 95% CI 2.23 to 8.86; p<0.001), or become dual users (adjusted OR 5.31; 95% CI 2.63 to 10.74; p<0.001) 1 year later. Baseline current e-cigarette users were more likely to become ever smokers (adjusted OR 5.37; 95% CI 1.82 to 15.90; p=0.005), current smokers (OR 3.92; 95% CI 1.69 to 9.14; p=0.003) and dual product users (adjusted OR 6.96; 95% CI 1.54 to 31.38; p=0.015) at the 12-month follow-up than non-e-cigarette users. Similarly, among never e-cigarette users at baseline, ever cigarette smoking were more likely to try e-cigarettes (adjusted OR 3.38; 95% CI 1.66 to 6.88; p=0.002), currently use e-cigarettes (adjusted OR 2.75; 95% CI 1.47 to 5.13; p=0.003) and currently use both e-cigarettes and cigarettes (adjusted OR 4.87; 95% CI 2.92 to 8.13; p<0.001) at the follow-up than never smokers. Among never e-cigarette users at baseline, current-cigarette smoking were more likely to try e-cigarettes (adjusted OR 6.21; 95% CI 2.58 to 14.95; p<0.001), currently use e-cigarettes (adjusted OR 2.80; 95% CI 1.27 to 6.14; p=0.014) and currently use both e-cigarettes and cigarettes (adjusted OR 7.70; 95% CI 3.45 to 17.19; p<0.001) at the follow-up than never smokers.
Conclusions This longitudinal study in Asian low-income and middle-income countries supports the prospective association of youth e-cigarette use with subsequent smoking initiation and youth cigarette use with subsequent e-cigarette initiation that is similar to that observed in high-income Western countries.
- electronic nicotine delivery devices
- low/middle income country
- addiction
Data availability statement
Data are available on reasonable request. All data used to prepare this paper are available from the cited sources. The Thailand Parental Supply and Use of Alcohol, Cigarettes & Drugs Longitudinal Study dataset can be requested directly from the Thailand Parental Supply and Use of Alcohol, Cigarettes & Drugs Longitudinal Study Cohort in Secondary School Students’ Project, Department of Psychiatry, Faculty of Medicine Chulalongkorn University, Bangkok, Thailand.
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Data availability statement
Data are available on reasonable request. All data used to prepare this paper are available from the cited sources. The Thailand Parental Supply and Use of Alcohol, Cigarettes & Drugs Longitudinal Study dataset can be requested directly from the Thailand Parental Supply and Use of Alcohol, Cigarettes & Drugs Longitudinal Study Cohort in Secondary School Students’ Project, Department of Psychiatry, Faculty of Medicine Chulalongkorn University, Bangkok, Thailand.
Footnotes
X @ProfGlantz
Contributors RP (guarantor) developed the idea for the study, analysed the data and wrote the first draft of the manuscript. MW assisted with data preparation. SG assisted with revising and refining the analysis and manuscript.
Funding This work was supported by the Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand. The funding agencies played no role in study design; collection, analysis, and interpretation of data; writing the report; or the decision to submit for publication.
Competing interests SG serves as a consultant to the World Health Organization. The other authors declare that there are no competing interests.
Provenance and peer review Not commissioned; externally peer reviewed.
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