Summary
Introduction:
This text is a summary of a research study published in JAMA Pediatrics that explores the relationship between non-cigarette tobacco product use and subsequent cigarette smoking among youth. The study uses data from the Population Assessment of Tobacco and Health (PATH) study, a nationally representative longitudinal cohort of youth aged 12 to 17 years. The study examines the association between ever and past 30-day use of e-cigarettes, hookah, non-cigarette combustible tobacco, and smokeless tobacco at baseline and cigarette smoking initiation within 1 year.
Key Points:
* The study is based on data from the PATH study, a nationally representative longitudinal cohort of youth aged 12 to 17 years.
* The study examines the association between ever and past 30-day use of e-cigarettes, hookah, non-cigarette combustible tobacco, and smokeless tobacco at baseline and cigarette smoking initiation within 1 year.
* After adjusting for sociodemographic, environmental, and behavioral smoking risk factors, the study finds that any use of e-cigarettes, hookah, non-cigarette combustible tobacco, or smokeless tobacco is independently associated with cigarette smoking initiation within 1 year.
* The odds of past 30-day cigarette use at follow-up are approximately twice as high among baseline ever users of e-cigarettes, hookah, non-cigarette combustible tobacco, and smokeless tobacco.
* Youths who had tried more than one type of tobacco product at baseline had 3.81 times greater adjusted odds of past 30-day cigarette smoking at follow-up than did baseline never tobacco users.
* The study controls for potential confounding factors such as sex, age, race/ethnicity, parental educational level, urban residence, sensation seeking, alcohol use, living with a tobacco user, noticing health warning labels, and tobacco advertising receptivity.
* The study has a large sample size and uses multiple imputation to account for missing data in independent variables.
Main Message:
The main message of this study is that any use of e-cigarettes, hookah, non-cigarette combustible tobacco, or smokeless tobacco is independently associated with cigarette smoking initiation among youth. The study highlights the importance of preventing youth from initiating tobacco use in any form, as use of one type of tobacco product may increase the risk of progressing to cigarette use. The findings provide evidence for regulators to consider treating alternative cigarette products as a group and potentially extending policies that work for one product to the others, such as a ban on flavoring.
Citation
Watkins, Shannon Lea, Stanton A. Glantz, and Benjamin W. Chaffee. “Association of Noncigarette Tobacco Product Use With Future Cigarette Smoking Among Youth in the Population Assessment of Tobacco and Health (PATH) Study, 2013-2015.” JAMA Pediatrics 172, no. 2 (February 1, 2018): 181. https://doi.org/10.1001/jamapediatrics.2017.4173.
