E-Cigarette Use and Regular Cigarette Smoking Among Youth: Population Assessment of Tobacco and Health Study (2013–2016)

Abstract

This study examines the association between current e-cigarette use at baseline and regular cigarette smoking at follow-up among U.S. youth. A longitudinal analysis of youth (aged 12-17 years) data from Waves 1-3 of the Population Assessment of Tobacco and Health Study (2013-2016) was conducted between January 2019 and December 2019. Youth who reported past-30-day current e-cigarette use at baseline were identified and followed for regular cigarette smoking (≥20 days) at follow-up. Compared with noncurrent e-cigarette users at baseline, current e-cigarette users (cigarette nonsmokers) had 5.0 (95% CI=1.9, 12.8) times higher odds of becoming regular cigarette smokers 1 year later. Additionally, there was a direct linear relationship between the number of days of e-cigarette use at baseline and the number of days of cigarette smoking 1 year later. Current e-cigarette use among U.S. youth is associated with higher odds of transitioning to regular cigarette smoking, likely reflecting robust transitions rather than experimentation. These results suggest that promoting e-cigarettes as the current practice for tobacco harm reduction will likely have the unintended consequence of initiating youth cigarette smokers.