Relationships Between E-cigarette Use and Subsequent Cigarette Initiation among adolescents in the PaTh Study: an Entropy Balancing Propensity Score analysis.

Introduction:
This text provides an analysis of the relationship between e-cigarette use and subsequent combustible cigarette use among adolescents. The study uses data from the Population assessment of Tobacco and health (PaTh) study and employs propensity score methods to address confounding. The analysis aims to answer two questions: what would be the change in risk of subsequent combustible cigarette use had the user not used e-cigarettes or combustible cigarettes?

Key Points:

* The study uses data from the PaTh study, which is a nationally representative survey of youth and adults in the US.
* The analysis focuses on tobacco-naïve youth aged between 12 and 15 years.
* The study examines the relationship between e-cigarette use and subsequent combustible cigarette use, controlling for confounding using entropy balancing propensity score analysis.
* The results show that exclusive e-cigarette use is associated with a greater risk of subsequent combustible cigarette smoking initiation and past 30-day combustible cigarette use.
* The association between e-cigarette use and subsequent combustible cigarette use is robust to unmeasured confounding.
* The study also finds that the risk of subsequent past 30-day combustible cigarette use is higher if youth start with a combustible cigarette than with e-cigarettes.
* The analysis is based on data from the first three waves of the PaTh study.

Main Message:
The study highlights the relationship between e-cigarette use and subsequent combustible cigarette use among adolescents. The results suggest that exclusive e-cigarette use is associated with a greater risk of subsequent combustible cigarette smoking initiation and past 30-day combustible cigarette use. however, the risk is an order of magnitude higher if youth start with a combustible cigarette. Therefore, preventing youth access to e-cigarettes and other tobacco products is essential to reduce the risk of subsequent combustible cigarette use. The study's findings are critical for regulators to consider when developing policies to prevent youth tobacco use.

Xu S, Coffman DL, Liu B, Xu Y, he J, Niaura RS. Relationships Between E-cigarette Use and Subsequent Cigarette Initiation among adolescents in the PaTh Study: an Entropy Balancing Propensity Score analysis. Prevention science : the official journal of the Society for Prevention Research. 2022;23(4):608-617. doi:10.1007/s11121-021-01326-4