Electronic cigarette use and risk of cigarette and smokeless tobacco initiation among adolescent boys: a propensity score matched analysis.

Introduction:
This text is a summary of a scientific study examining the relationship between electronic cigarette (e-cigarette) use and the risk of initiating cigarette and smokeless tobacco (SLT) use among adolescent boys. The study uses a propensity score matching design, multiple imputation, and long-term follow-ups to determine whether e-cigarette use is causally related to ever and current (i.e., past 30-day) cigarette or SLT initiation in a cohort of adolescent males.

Key Points:

* The study uses a propensity score matching design, multiple imputation, and long-term follow-ups to determine the causal relationship between e-cigarette use and cigarette or SLT initiation.
* The study finds that adolescent boys who used e-cigarettes had increased risk of later initiating traditional tobacco products when compared to similar boys who had never used e-cigarettes.
* The study controls for potential confounding variables, such as birth year, race, region, parental education, living with an adult tobacco user, impulsivity, and ever use of other substances prior to initiation of e-cigarette use.
* The study has a large pre-match sample size, which supports the ability to match every e-cigarette user to two non-users in all 25 imputed datasets and achieve good post-match covariate balance.
* The study acknowledges limitations, such as the exclusion of girls, sampling from Ohio, coarseness of measuring age of product use, and the inability to control unmeasured confounders.
* The study concludes that e-cigarette use increases the risk of initiating both cigarettes and SLT in a cohort of adolescent boys who were balanced on risk factors for e-cigarette use.

Main Message:
This study provides evidence for the causal relationship between e-cigarette use and the risk of initiating cigarette and SLT use among adolescent boys. The study's rigorous design and control for potential confounding variables strengthen the evidence base for the negative health impacts of e-cigarette use among youth. The findings highlight the need for policymakers and regulators to consider the potential risks associated with e-cigarette use, particularly among adolescents.

Keller-hamilton B, Lu B, Roberts ME, Berman ML, Root ED, Ferketich aK. Electronic cigarette use and risk of cigarette and smokeless tobacco initiation among adolescent boys: a propensity score matched analysis. addictive behaviors. 2021;114:106770. doi:10.1016/j.addbeh.2020.106770