RT Journal Article
SR Electronic
T1 Do electronic cigarettes increase cigarette smoking in UK adolescents? Evidence from a 12-month prospective study
JF Tobacco Control
JO Tob Control
FD BMJ Publishing Group Ltd
SP 365
OP 372
DO 10.1136/tobaccocontrol-2016-053539
VO 27
IS 4
A1 Mark Conner
A1 Sarah Grogan
A1 Ruth Simms-Ellis
A1 Keira Flett
A1 Bianca Sykes-Muskett
A1 Lisa Cowap
A1 Rebecca Lawton
A1 Christopher J Armitage
A1 David Meads
A1 Carole Torgerson
A1 Robert West
A1 Kamran Siddiqi
YR 2018
UL http://tobaccocontrol.bmj.com/content/27/4/365.abstract
AB 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.