Youth e-cigarette use foreshadows combustible cigarette use
Youths who used e-cigarettes were at increased risk for starting and using combustible cigarettes, according to findings recently published in JAMA Network Open.
“Although prior studies have shown a significant association between e-cigarette use and subsequent cigarette initiation, they may be subject to methodological limitations,” Kaitlyn M. Berry, MPH, of the department of global health at Boston University School of Public Health and colleagues wrote.
Data from 6,123 youth (mean age, 13.4 years) who had never used cigarettes, e-cigarettes, or other tobacco products in 2013 were collected and then compared to whether they were using any of these products in 2016.
Berry and colleagues found that of those who began using tobacco products by 2016, 8.6% used e-cigarettes first, 3.3% used cigarettes first and 5% used other noncigarette tobacco products first.
Researchers also found that by 2016, 6.1% of youth had ever used cigarettes. Youths who reported e-cigarette use in the 2013 survey had more than four times the odds of ever using cigarettes than those who reported never using tobacco at all in the 2013 survey (OR = 4.09; 95% CI, 2.97-5.63). Prior use of other tobacco products was also linked to increased odds of ever cigarette use (OR = 3.84; 95% CI, 2.63-5.63).
“These findings strengthen the rationale for aggressive regulation of youth access to and marketing of e-cigarettes to achieve future decreases in the prevalence of cigarette use among youths,” Berry and colleagues concluded.
Federal regulators have been increasing their attention on the e-cigarette industry in recent months. CDC and FDA data indicated a 75% increase in the number of youths who used e-cigarettes in the past 30 days between 2017 and 2018.
In November, 1 month after the FDA seized hundreds of JUUL-related documents, the agency announced it would revisit policies that extend the premarket application compliance date for newly regulated non-combustible tobacco products, electronic nicotine delivery systems (ENDS), and e-cigarettes to August 2022, and oversee most flavored ENDS that are sold online without additional, heightened age verification and other restrictions in place. One month later, Phillip Morris’ parent company Altria invested $12.8B in JUUL. At the time of that announcement, both companies stated they are against youth using any tobacco products and are “committed to solving” the increase in youth use. – by Janel Miller
Disclosures: Berry reports receiving grant support from the National Heart, Lung, and Blood Institute of the National Institutes of Health and Center for Tobacco Products. Please see the study for all other relevant financial disclosures.