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Do electronic cigarettes increase cigarette smoking in UK adolescents? Evidence from a 12-month prospective study.

Conner, M. and Grogan, S. and Simms-Ellis, R. and Flett, K. and Sykes-Muskett, B. and Cowap, L. and Lawton, R. and Armitage, C.J. and Meads, D. and Torgerson, C. and West, R. and Siddiqi, K. (2018) 'Do electronic cigarettes increase cigarette smoking in UK adolescents? Evidence from a 12-month prospective study.', Tobacco control., 27 (4). pp. 365-372.

Abstract

Background In cross-sectional surveys, increasing numbers of adolescents report using both electronic cigarettes (e-cigarettes) and cigarettes. This study assessed whether adolescent e-cigarette use was associated prospectively with initiation or escalation of cigarette use. Methods Data were from 2836 adolescents (aged 13–14 years at baseline) in 20 schools in England. At baseline, breath carbon monoxide levels, self-reported e-cigarette and cigarette use, sex, age, friends and family smoking, beliefs about cigarette use and percentage receiving free school meals (measure of socioeconomic status) were assessed. At 12-month follow-up, self-reported cigarette use was assessed and validated by breath carbon monoxide levels. Results At baseline, 34.2% of adolescents reported ever using e-cigarettes (16.0% used only e-cigarettes). Baseline ever use of e-cigarettes was strongly associated with subsequent initiation (n=1726; OR 5.38, 95% CI 4.02 to 7.22; controlling for covariates, OR 4.06, 95% CI 2.94 to 5.60) and escalation (n=318; OR 1.91, 95% CI 1.14 to 3.21; controlling for covariates, this effect became non-significant, OR 1.39, 95% CI 0.97 to 1.82) of cigarette use. Conclusions This is the first study to report prospective relationships between ever use of e-cigarettes and initiation and escalation of cigarette use among UK adolescents. Ever use of e-cigarettes was robustly associated with initiation but more modestly related to escalation of cigarette use. Further research with longer follow-up in a broader age range of adolescents is required.

Item Type:Article
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Status:Peer-reviewed
Publisher Web site:https://doi.org/10.1136/tobaccocontrol-2016-053539
Publisher statement:© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
Record Created:09 Jun 2017 15:43
Last Modified:25 Jun 2018 10:10

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