Summary
Introduction:
This article is a systematic review and meta-analysis examining the relationship between electronic cigarette (e-cigarette) use and tobacco cigarette smoking initiation among adolescents in Europe and North america. The study aimed to determine if e-cigarette use by adolescents who never smoked tobacco cigarettes at baseline was associated with subsequent initiation of cigarette smoking through a meta-analysis of longitudinal prospective studies.
Key Points:
* The study identified 14 unique longitudinal prospective studies, with a total of 21 papers, that met the inclusion criteria.
* The data in the primary studies were collected between 2013 and 2016, and the longitudinal follow-up periods ranged from 4 months to 2.5 years.
* Fifteen primary papers were completed using North american populations, and six primary papers were based on European populations.
* The studies' populations ranged from 13 to 19 years at baseline.
* The papers assessed tobacco cigarette smoking during follow-up as an outcome variable, with 18 papers studying ever use of tobacco cigarettes and 4 querying past 30-day use of tobacco cigarettes.
* The meta-analysis calculated a 4.06 times higher odds of initiating smoking tobacco cigarettes for teenagers who had ever used e-cigarettes at baseline.
* Sensitivity and subgroup analyses supported the relationship between ever using e-cigarettes and initiating smoking tobacco cigarettes.
* The longitudinal prospective study design used to evaluate the relationship between e-cigarette use and iniatiation of tobacco cigarette smoking permits researchers to start the process of establishing a causal relationship.
Main Message:
The study found that e-cigarette use was associated with initiation of tobacco cigarette smoking among teenagers in Europe and North america, identifying an important public health harm. The meta-analysis presents a more precise and generalisable estimate of the odds of tobacco cigarette smoking initiation following ever use of e-cigarettes in teenagers. Given the widespread availability and use of e-cigarettes, this study further supports urgent action by policy-makers to prevent their use by adolescents to reduce direct harms in this vulnerable population group as well as to protect gains in reducing tobacco use initiation.
Citation
O’Brien D, Long J, quigley J, Lee C, McCarthy a, Kavanagh P. association between electronic cigarette use and tobacco cigarette smoking initiation in adolescents: a systematic review and meta-analysis. BMC public health. 2021;21(1):954. doi:10.1186/s12889-021-10935-1
