Earlier this spring, we provided a review of studies into the relationship between young people using e-cigarettes and their subsequent use of tobacco. This post reports on four more large studies which support the general conclusion that young e-cigarette users are three to four times more likely to become tobacco cigarette smokers
Smoking Intention and Progression From E-Cigarette Use to Cigarette Smoking was published in the journal Paediatrics in November 2020. Olusegun Owotomo and his colleagues at the University of Texas used data from the Population Assessment of Tobacco and Health (PATH) study to look at changes in adolescent behaviour from 2014-15 to 2015-16. They used a US nationally representative population of adolescents who were 12 to 17 years old at the beginning of the study period to find out whether the teenager's stated intention to smoke cigarettes or their use of e-cigarettes predicted actual cigarette smoking one year later. There were four previous analyses of PATH data that examined the relationship between e-cigarette use and subsequent smoking, but this was the first to also examine the effect of intention to smoke. References to these previous studies can be found in the Australian study by Olivia Baenziger and her colleagues.
It turned out that both intention to smoke and e-cigarette use predicted later smoking.. "Among adolescents who had expressed intention to smoke conventional cigarettes at baseline, e-cigarette use did not predict cigarette smoking at follow-up. However, among adolescents without previous intention to smoke conventional cigarettes, e-cigarette use predicted cigarette smoking."
If teens said they intended to smoke, they were three times more likely to actually become cigarette smokers. Children who smoked e-cigarettes in 2014-15 were 4.6 times more likely to become cigarette smokers by 2015-16, even if they earlier had no intention of becoming cigarette smokers. This latter finding is very much in line with most other studies of same phenomenon, as we shall see in the following sections.
Evidence from meta-analyses performed by the Irish Health Research Board
Electronic cigarette use and tobacco cigarette smoking initiation in adolescents: An evidence review was made public by the Irish Health Research Board in October. It was prepared to respond to Ireland's Department of Health's request for an answer to the question "Does e-cigarette use by adolescents who are cigarette naïve at baseline lead to subsequent cigarette smoking?"
- Multiple studies and multiple meta-analyses from many countries show remarkably consistent results. Young people who take up using e-cigarettes are 3-4 times more likely to progress to becoming cigarettes smokers than their peers who do not use e-cigarettes.
- This risk of becoming a smoker also applies to those young e-cigarette users who declare they have have no intention of becoming smokers. Despite their intentions, they are over four times more likely to become cigarette smokers.
- Former smokers who take up e-cigarettes are over twice as likely to relapse to cigarette smoking.