Abstract
Electronic cigarettes (e-cigarettes) use is becoming increasingly common, especially among adolescents and young adults, and there is little evidence on the impact of e-cigarettes use on never-smokers. With a meta-analysis method, we explore the association between e-cigarettes use and smoking intention that predicts future cigarette smoking. Studies were identified by searching three databases up to January 2016. The meta-analysis results were presented as pooled odds ratio (OR) with 95% confidence interval (CI) calculated by a fixed-effects model. A total of six studies (91,051 participants, including 1452 with ever e-cigarettes use) were included in this meta-analysis study. We found that never-smoking adolescents and young adults who used e-cigarettes have more than 2 times increased odds of intention to cigarette smoking (OR = 2.21, 95% CI: 1.86–2.61) compared to those who never used, with low evidence of between-study heterogeneity (p = 0.28, I2 = 20.1%). Among never-smoking adolescents and young adults, e-cigarettes use was associated with increased smoking intention.
Highlights
Reductions in the smoking prevalence were observed at global level since 1980, the tobacco pandemic remains a threat to the health of the world’s population [1]
The process of study selection for this meta-analysis is shown in Figure 1. 20 articles were excluded from 31 potentially eligible studies because they were reviews, news, studies on model hypotheses, and/or published without English language
A total of six studies were included in this meta-analysis of e-cigarettes use and smoking intention [22,23,24,25,26,27]
Summary
Reductions in the smoking prevalence were observed at global level since 1980, the tobacco pandemic remains a threat to the health of the world’s population [1]. As the second most important risk factor for global disease burden, tobacco use accounted for 6.1 million deaths and. Considering that the majority of smokers begin to smoke during their adolescence [3], preventing youth initiation and transition to established smoking are critical public health issues that deserve more attention. Smoking intention, defined as the lack of a firm commitment not to smoke among never-smokers, is strongly predictive of future established smoking [4,5,6]. A growing body of literature has identified varying factors associated with smoking intention, such as parental or peer smoking, exposure to secondhand smoke inside or outside the home, pro-tobacco advertising, and school connectedness [7,8,9]. Additional studies are warranted in this direction with the advent of electronic cigarettes (e-cigarettes)
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