Longitudinal transitions in e-cigarette and cigarette use among US adults: prospective cohort study.

Introduction:
This article summarizes a study on the transitions in e-cigarette and cigarette use among US adults. The study used data from the Population Assessment of Tobacco and Health (PATH) Study and examined behavioral transitions in ENDS and cigarette use across waves. The study also identified predictors of these behavioral transitions.

Key Points:

* The study found high changeability in ENDS and cigarette use among US adults.
* Discontinuing ENDS use was common among US adults, but in absolute terms, ENDS use was growing, while smoking was falling.
* Current established ENDS use did not discourage relapse to cigarette smoking among former smokers, nor smoking initiation among never smokers.
* Adults aged 18 -24, Hispanics, and past 12-month cannabis users were more likely to initiate ENDS or cigarettes.
* Internalizing mental health symptoms increased the odds of ENDS initiation, while externalizing symptoms increased the odds of cigarette initiation.
* Those who perceived nicotine as very harmful were more likely to discontinue ENDS.
* Current cigarette users (vs. non-users) at baseline were more likely to initiate, relapse, or discontinue ENDS, and current ENDS users (vs. non-users) at baseline were more likely to initiate, relapse, or discontinue cigarettes.

Main Message:
The study highlights the importance of monitoring transitions in ENDS and cigarette use among US adults, particularly among vulnerable populations such as young adults, people with mental health conditions, and cannabis users. The findings suggest that ENDS may play a role in the decline in cigarette use, but further research is needed. The study also emphasizes the need for tobacco control programs to focus on priority populations and to consider mental health burdens in regulatory implications for novel tobacco products.

Ebrahimi Kalan M, Brewer NT. Longitudinal transitions in e-cigarette and cigarette use among US adults: prospective cohort study. Lancet regional health Americas. 2023;22:100508. doi:10.1016/j.lana.2023.100508