Abstract
BackgroundConcerns remain about potential negative impacts of e-cigarettes including possibilities that: youth e-cigarette use (vaping) increases risk of youth smoking; and vaping by parents may have impacts on their children’s vaping and smoking behaviour.MethodsWith panel data from 3291 youth aged 10–15 years from the 7th wave of the UK Understanding Society Survey (2015–2017), we estimated effects of youth vaping on youth smoking (ever, current and past year initiation), and of parental vaping on youth smoking and vaping, and examined whether the latter differed by parental smoking status. Propensity weighting was used to adjust for measured confounders and estimate average effects of vaping for all youth, and among youth who vaped. E-values were calculated to assess the strength of unmeasured confounding influences needed to negate our estimates.ResultsAssociations between youth vaping and youth smoking were attenuated considerably by adjustment for measured confounders. Estimated average effects of youth vaping on youth smoking were stronger for all youth (e.g. OR for smoking initiation: 32.5; 95% CI: 9.8–107.1) than among youth who vaped (OR: 4.4; 0.6–30.9). Relatively strong unmeasured confounding would be needed to explain these effects. Associations between parental vaping and youth vaping were explained by measured confounders. Estimates indicated effects of parental vaping on youth smoking, especially for youth with ex-smoking parents (e.g. OR for smoking initiation: 11.3; 2.7–46.4) rather than youth with currently smoking parents (OR: 1.0; 0.2–6.4), but these could be explained by relatively weak unmeasured confounding.ConclusionsWhile measured confounding accounted for much of the associations between youth vaping and youth smoking, indicating support for underlying propensities, our estimates suggested residual effects that could only be explained away by considerable unmeasured confounding or by smoking leading to vaping. Estimated effects of youth vaping on youth smoking were stronger among the general youth population than among the small group of youth who actually vaped. Associations of parental vaping with youth smoking and vaping were either explained by measured confounding or could be relatively easily explained by unmeasured confounding.
Highlights
Concerns remain about potential negative impacts of e-cigarettes including possibilities that: youth e-cigarette use increases risk of youth smoking; and vaping by parents may have impacts on their children’s vaping and smoking behaviour
As vaping prevalence has risen among adults, it is important to understand the impacts this may have on young people who live with those adults, for example, the impacts on the children if a smoking parent were to switch to vaping
Mounting evidence supports the view that e-cigarettes are substantially less harmful than traditional cigarettes [1, 16, 43,44,45,46], and that they can aid successful smoking cessation [3, 16, 35, 47,48,49]
Summary
Concerns remain about potential negative impacts of e-cigarettes including possibilities that: youth e-cigarette use (vaping) increases risk of youth smoking; and vaping by parents may have impacts on their children’s vaping and smoking behaviour. The notion that vaping increases risk for smoking can be contrasted with that of common liabilities [8, 9]: that underlying propensities for both behaviours account for their close association among youth [2, 6, 11,12,13,14,15,16]. Common liabilities and vaping increasing smoking risk (or smoking increasing vaping risk [22]) are not mutually exclusive explanations for associations between vaping and smoking among youth. It is more important to establish the relative contribution of each in explaining associations between youth smoking and vaping, than to try and establish any one as the ‘true’ explanation
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
