E-Cigarette Use and Subsequent Cigarette Initiation and Sustained Use among Youth, U.S., 2015-2017.

Introduction:
This text summarizes a study examining the relationship between e-cigarette use and subsequent initiation and sustained use of cigarettes among U.S. youth. The study uses data from the 2015-2017 National Youth Tobacco Survey and includes 52,579 youth who had never smoked cigarettes 5 years prior to the survey.

Key Points:

* The study found that e-cigarette use was significantly associated with subsequent initiation and sustained use of cigarettes among youth.
* among never cigarette smokers as of 5 years before the survey, 17.4% used e-cigarettes before first cigarette smoking or without ever smoking a cigarette.
* Youth who used e-cigarettes had higher odds of ever smoking a cigarette within the past 5 years and higher odds of sustained smoking compared to those who did not use e-cigarettes.
* The study controlled for sex, race/ethnicity, school level, use of other tobacco products, and survey year.
* The use of other tobacco products was also associated with subsequent cigarette smoking initiation.
* The study's primary independent variable did not consider behavioral differences among e-cigarette users and was measured as ever use of e-cigarettes preceding ever cigarette smoking.
* Information on the temporal sequence of tobacco product use was not available for some products such as pipes, water pipes, roll-your-own tobacco, and bidis.

Main Message:
The study highlights the importance of comprehensive tobacco prevention and control efforts aimed at reducing access to and use of all tobacco products among youth, including e-cigarettes. The findings emphasize the need for further investigation into the effects of different non-cigarette tobacco products as a predictor of smoking initiation and sustained smoking. Implementing interventions such as prohibiting use of e-cigarettes in indoor public places, preventing sales to minors, increasing e-cigarette prices, and preventing youth-targeted advertising of e-cigarettes can help prevent and reduce all forms of tobacco product use and reinforce tobacco-free norms among youth.

Odani S, armour BS, King Ba, agaku IT. E-Cigarette Use and Subsequent Cigarette Initiation and Sustained Use among Youth, U.S., 2015-2017. The Journal of adolescent health : official publication of the Society for adolescent Medicine. 2020;66(1):34-38. doi:10.1016/j.jadohealth.2019.08.021