scholarly journals Exploring the gateway hypothesis of e-cigarettes and tobacco: a prospective replication study among adolescents in the Netherlands and Flanders

2021 ◽  
pp. tobaccocontrol-2021-056528
Author(s):  
Thomas Martinelli ◽  
Math J J M Candel ◽  
Hein de Vries ◽  
Reinskje Talhout ◽  
Vera Knapen ◽  
...  
Keyword(s):  
The Netherlands ◽  
Tobacco Use ◽  
Tobacco Smoking ◽  
Longitudinal Design ◽  
Positive Association ◽  
Cigarette Use ◽  
Convenience Sample ◽  
Frequent Use ◽  
Never Smokers

BackgroundStudies demonstrated that adolescent e-cigarette use is associated with subsequent tobacco smoking, commonly referred to as the gateway effect. However, most studies only investigated gateways from e-cigarettes to tobacco smoking. This study replicates a cornerstone study revealing a positive association between both adolescent e-cigarette use and subsequent tobacco use; and tobacco and subsequent e-cigarette use in the Netherlands and Flanders.DesignThe longitudinal design included baseline (n=2839) and 6-month (n=1276) and 12-month (n=1025) follow-up surveys among a school-based cohort (mean age: 13.62). Ten high schools were recruited as a convenience sample. The analyses involved (1) associations of baseline e-cigarette use and subsequent tobacco smoking among never smokers; (2) associations of e-cigarette use frequency at baseline and tobacco smoking frequency at follow-up; and (3) the association of baseline tobacco smoking and subsequent e-cigarette use among non-users of e-cigarettes.FindingsConsistent with prior findings, baseline e-cigarette use was associated with higher odds of tobacco smoking at 6-month (OR=1.89; 95% CI 1.05 to 3.37) and 12-month (OR=5.63; 95% CI 3.04 to 10.42) follow-ups. More frequent use of e-cigarettes at baseline was associated with more frequent smoking at follow-ups. Baseline tobacco smoking was associated with subsequent e-cigarette use (OR=3.10; 95% CI 1.58 to 6.06 at both follow-ups).ConclusionOur study replicated the positive relation between e-cigarette use and tobacco smoking in both directions for adolescents. This may mean that the gateway works in two directions, that e-cigarette and tobacco use share common risk factors, or that both mechanisms apply.

scholarly journals Evidence that an intervention weakens the relationship between adolescent electronic cigarette use and tobacco smoking: a 24-month prospective study

2019 ◽  
pp. tobaccocontrol-2018-054905
Author(s):  
Mark Conner ◽  
Sarah Grogan ◽  
Ruth Simms-Ellis ◽  
Keira Flett ◽  
Bianca Sykes-Muskett ◽  
...  
Keyword(s):  
Tobacco Use ◽  
Tobacco Smoking ◽  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Electronic Cigarette ◽  
Self Report ◽  
Cigarette Use ◽  
The Impact ◽  
The Relationship

BackgroundThe electronic cigarette (e-cigarette) use to subsequent smoking relationship in adolescents has received much attention. Whether an intervention to reduce smoking initiation attenuated this relationship was assessed.MethodData were from 3994 adolescent never smokers (aged 13–14 years at baseline) as part of a cluster randomised controlled trial. Self-report measures of smoking, e-cigarette use and covariates were assessed and used to predict ever smoked cigarettes, any recent tobacco smoking and regularly smoked cigarettes at 24-month follow-up.ResultsBaseline ever use of e-cigarettes was associated with ever smoked cigarettes (OR=4.03, 95% CI 3.33 to 4.88; controlling for covariates, OR=2.78, 95% CI 2.20 to 3.51), any recent tobacco smoking (OR=3.38, 95% CI 2.72 to 4.21; controlling for covariates, OR=2.17, 95% CI 1.76 to 2.69) and regularly smoked cigarettes (OR=3.60, 95% CI 2.35 to 5.51; controlling for covariates, OR=1.27, 95% CI 1.17 to 1.39) at follow-up. For ever smoked cigarettes only, the impact of e-cigarette use was attenuated in the intervention (OR=1.83) compared with control (OR=4.53) condition. For ever smoked cigarettes and any recent tobacco smoking, the impact of e-cigarette use was attenuated among those with friends who smoked (OR=2.05 (ever smoked); 1·53 (any tobacco use)) compared with those without friends who smoked (OR=3.32 (ever smoked); 2·17 (any tobacco use)).ConclusionsThis is one of the first studies to show that e-cigarette use was robustly associated with measures of smoking over 24 months and the first to show an intervention to attenuate the relationship. Further research with a broader age range of adolescents is required.

scholarly journals Tobacco Use Changes and Perceived Health Risks among Current Tobacco Users during the COVID-19 Pandemic

2021 ◽  
Vol 18 (4) ◽  
pp. 1795
Author(s):  
Jessica M. Yingst ◽  
Nicolle M. Krebs ◽  
Candace R. Bordner ◽  
Andrea L. Hobkirk ◽  
Sophia I. Allen ◽  
...  
Keyword(s):  
Tobacco Use ◽  
Cigarette Use ◽  
User Research ◽  
Convenience Sample ◽  
State College ◽  
Quit Attempt ◽  
Global Pandemic ◽  
Penn State ◽  
Penn State College ◽  
Current Tobacco

COVID-19 has become a global pandemic, with over 81 million cases worldwide. To assess changes in tobacco use as a result of the pandemic, we surveyed a convenience sample of current tobacco users between April and June 2020. The sample was taken from a tobacco user research registry (n = 3396) from the Penn State College of Medicine in Hershey, Pennsylvania, USA. Participants who responded to the survey and were eligible for this study (n = 291) were 25.6% male, 93% white, and had a mean age of 47.3 (SD = 11.6) years. There were no reports of participants testing positive for COVID-19, but 21.7% reported experiencing symptoms associated with the virus. Most participants (67%) believed that their risk of contracting COVID-19 was the same as non-tobacco users, but 57.7% believed that their risk of serious complications, if infected, was greater compared to non-tobacco users. A total of 28% reported increasing their cigarette use during the pandemic. The most common reasons for increased use were increased stress, more time at home, and boredom while quarantined. Nearly 15% reported decreasing their tobacco use. The most common reasons for reduced use were health concerns and more time around non-smokers (including children). A total of 71 (24.5%) users reported making a quit attempt. Characterizing these pandemic-related changes in tobacco use may be important to understanding the full scope of subsequent health outcomes resulting from the pandemic. Tobacco cessation resources should be tailored to allow for safe, appropriate access for those interested in quitting.

scholarly journals Sex Difference in the Association between Electronic Cigarette Use and Subsequent Cigarette Smoking among U.S. Adolescents: Findings from the PATH Study Waves 1–4

2021 ◽  
Vol 18 (4) ◽  
pp. 1695
Author(s):  
Zongshuan Duan ◽  
Yu Wang ◽  
Jidong Huang
Keyword(s):  
Mental Health ◽  
Cigarette Smoking ◽  
Tobacco Use ◽  
Mental Health Problems ◽  
Cigarette Use ◽  
Tobacco Products ◽  
Estimation Equations ◽  
Nationally Representative ◽  
Prospective Association

E-cigarettes are the most-used tobacco products among U.S. adolescents. Emerging evidence suggests that adolescents using e-cigarettes are at elevated risk for initiating cigarette smoking. However, whether this risk may differ by sex remains unknown. This study analyzed data from Wave 1 to 4 of the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative longitudinal survey. Generalized estimation equations (GEE) were performed to estimate the associations between baseline e-cigarette use and subsequent cigarette smoking, controlling for sociodemographic characteristics, mental health conditions, and other tobacco use. Effect modifications by sex were examined. Multivariate analyses showed that, among baseline never cigarette smokers, past-30-day e-cigarette use at baseline waves was significantly associated with past-30-day cigarette smoking at follow-up waves (aOR = 3.90, 95% CI: 2.51–6.08). This association was significantly stronger for boys (aOR = 6.17, 95% CI: 2.43–15.68) than for girls (aOR = 1.10, 95% CI: 0.14–8.33). Additionally, using other tobacco products, older age, and having severe externalizing mental health problems at baseline were significantly associated with an increased likelihood of cigarette smoking at follow-up. The prospective association between e-cigarette use and cigarette smoking differs by sex among U.S. adolescents. Sex-specific tobacco control interventions may be warranted to curb the youth tobacco use epidemic.

scholarly journals Perception and Current Use of E-cigarettes Among Youth in China

2018 ◽  
Vol 21 (10) ◽  
pp. 1401-1407 ◽  
Author(s):  
Lin Xiao ◽  
Mark Parascandola ◽  
Congxiao Wang ◽  
Yuan Jiang
Keyword(s):  
Middle School ◽  
Middle School Students ◽  
Tobacco Use ◽  
Tobacco Product ◽  
Cigarette Use ◽  
School Students ◽  
Factors Associated ◽  
Nationally Representative ◽  
Never Smokers ◽  
The Relationship

Abstract Introduction This study provides nationally representative estimates of electronic cigarette (e-cigarette) use among youth in China and explores the factors associated with awareness and use of e-cigarettes and the relationship between e-cigarette and conventional tobacco use. Methods This study examined data from the Global Youth Tobacco Survey, which was completed by 155 117 middle school students (51.8% boys and 48.2% girls) in China, and employed a multistage stratified cluster sampling design. For data analysis, SAS 9.3 complex survey procedures were used, and logistic regression was used to explore factors associated with e-cigarette use and the relationship between e-cigarette and conventional tobacco use. Results About 45.0% of middle school students had heard of e-cigarettes, but only 1.2% reported using e-cigarettes in the last 30 days. Among never-smokers, e-cigarette users were more likely to intend to use a tobacco product in the next 12 months than nonusers (adjusted odds ratio [OR] = 6.970, 95% confidence interval [CI] = 4.474% to 10.857%), and more likely to say that they would enjoy smoking a cigarette (adjusted OR = 14.633, 95% CI = 11.328% to 18.902%). E-cigarette use was associated with previous experimentation with cigarette smoking (OR = 3.2), having noticed tobacco advertising in the past 30 days (OR = 2.7), having close friends who smoke (OR = 1.4), and thinking tobacco helps people feel more comfortable in social situations (OR = 3.3) and makes young people look more attractive (OR = 1.3). Conclusions E-cigarette use among youth in China remains low but awareness is high. E-cigarette use was associated with increased intentions to use tobacco. Enhanced prevention efforts are needed targeting e-cigarette use among youth. Implications This study is the first nationally representative survey of e-cigarette use among youth in China. It found that among middle school students, prevalence of e-cigarette use is 1.2% and prevalence of e-cigarette awareness is 45.0%. Chinese youths use e-cigarettes as a tobacco product rather than an aid to quitting. Among never-smokers, e-cigarette users were more likely to have intentions to use a tobacco product in the next 12 months, more likely to use a tobacco product offered by their best friends and enjoy smoking a cigarette than nonusers.

scholarly journals E-Cigarette Use and Future Cigarette Initiation Among Never Smokers and Relapse Among Former Smokers in the PATH Study

2019 ◽  
Vol 134 (5) ◽  
pp. 528-536 ◽  
Author(s):  
Robert McMillen ◽  
Jonathan D. Klein ◽  
Karen Wilson ◽  
Jonathan P. Winickoff ◽  
Susanne Tanski
Keyword(s):  
Cigarette Smoking ◽  
Harm Reduction ◽  
Electronic Cigarettes ◽  
Computer Assisted ◽  
Cigarette Use ◽  
Cigarette Smokers ◽  
Potential Harm ◽  
Increased Risk ◽  
Never Smokers

Objectives: Any potential harm-reduction benefit of electronic cigarettes (e-cigarettes) could be offset by nonsmokers who initiate e-cigarette use and then smoke combustible cigarettes. We examined correlates of e-cigarette use at baseline with combustible cigarette smoking at 1-year follow-up among adult distant former combustible cigarette smokers (ie, quit smoking ≥5 years ago) and never smokers. Methods: The Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal study, surveyed 26 446 US adults during 2 waves: 2013-2014 (baseline) and 2014-2015 (1-year follow-up). Participants completed an audio computer-assisted interview in English or Spanish. We compared combustible cigarette smoking at 1-year follow-up by e-cigarette use at baseline among distant former combustible cigarette smokers and never smokers. Results: Distant former combustible cigarette smokers who reported e-cigarette past 30-day use (9.3%) and ever use (6.7%) were significantly more likely than those who had never used e-cigarettes (1.3%) to have relapsed to current combustible cigarette smoking at follow-up ( P < .001). Never smokers who reported e-cigarette past 30-day use (25.6%) and ever use (13.9%) were significantly more likely than those who had never used e-cigarettes (2.1%) to have initiated combustible cigarette smoking ( P < .001). Adults who reported past 30-day e-cigarette use (7.0%) and ever e-cigarette use (1.7%) were more likely than those who had never used e-cigarettes (0.3%) to have transitioned from never smokers to current combustible cigarette smokers ( P < .001). E-cigarette use predicted combustible cigarette smoking in multivariable analyses controlling for covariates. Conclusions: Policies and counseling should consider the increased risk for nonsmokers of future combustible cigarette smoking use as a result of using e-cigarettes and any potential harm-reduction benefits e-cigarettes might bring to current combustible cigarette smokers.

scholarly journals Co-use and Mixing Tobacco With Cannabis Among Ontario Adults

2019 ◽  
Author(s):  
Navitha Jayakumar ◽  
Michael Chaiton ◽  
Renee Goodwin ◽  
Robert Schwartz ◽  
Shawn O’Connor ◽  
...  
Keyword(s):  
Health Effects ◽  
Tobacco Use ◽  
Tobacco Smoking ◽  
Evidence Base ◽  
Health Concern ◽  
Cigarette Use ◽  
User Characteristics ◽  
Considerable Effort ◽  
The Past ◽  
Health Monitor

Abstract Introduction The legalization of nonmedical cannabis in 2018 may have important implications for tobacco use in Canada. There is a risk of renormalizing tobacco use with co-use of tobacco and cannabis introducing nontobacco users to tobacco. Co-use is the use of both substances by the same individual at the same time or on different occasions, as well as mixed together. This study assessed the prevalence of co-use and mixing of tobacco and cannabis among Ontario adults and the characteristics of the users. Aims and Methods Data from the 1996 to 2017 cycles of the Centre for Addiction and Mental Health Monitor (n = 4481) were used to examine trends in prevalence and the proportion of Ontario adults co-using and mixing tobacco and cannabis. Logistic regression was used to study associations between user characteristics and co-use and mixing. Results Co-use of cigarettes and cannabis among cannabis users declined from 59.8% in 1996 to 41.7% in 2017. Past-year e-cigarette use was the only predictor of co-use. From 2015 to 2017, 31.1% (95% confidence interval 27.0, 35.9) of Ontario adults who used cannabis reported mixing it with tobacco in the past year. Being white, past-year e-cigarette use, having moderate or high nicotine dependence, and having moderate or high risk for cannabis problems were significant predictors of mixing among cannabis users. Conclusion Given the well-established negative health effects associated with tobacco use, alongside a growing evidence base for negative health effects of cannabis smoking, co-use and mixing could pose a considerable public health concern in the context of legalization. Implications Considerable effort has been expended to reduce tobacco smoking. However, current efforts to reduce tobacco smoking may be diminished since this study found the prevalence of mixing tobacco and cannabis among cannabis users in Ontario to be higher than expected. Mixing tobacco and cannabis may introduce nontobacco smokers to tobacco, exposing them to health risks associated with both cannabis and tobacco smoke. Therefore, there is a need to monitor changes in tobacco use and understanding implications for tobacco control and cessation programs within the changing environment of cannabis legalization in Canada and other jurisdictions.

scholarly journals Prospective association between use of electronic cigarettes and use of conventional cigarettes - a systematic review and meta-analysis

2021 ◽  
pp. 00976-2020
Author(s):  
Louise Adermark ◽  
Maria Rosaria Galanti ◽  
Charlotta Ryk ◽  
Hans Gilljam ◽  
Linnea Hedman
Keyword(s):  
Systematic Review ◽  
Cigarette Smoking ◽  
Electronic Cigarettes ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Cigarette Use ◽  
Study Selection ◽  
Prospective Association ◽  
Never Smokers

ObjectiveThe aim of this systematic review and meta-analysis was to assess the association between e-cigarette use and subsequent initiation or recurrence of cigarette smoking.Data sourcesA systematic literature search was finalised November 11, 2019 using PubMed incl. Medline, EMBASE, Cochrane Library, Scopus, PubMed Health, NICE evidence search, PROSPERO, CRD, and PsycInfo.Study selectionStudies were included if meeting the following criteria: reporting empirical results; longitudinal observational design with a minimum of 3 months of follow-up; including general population samples; allowing for the comparison between users and non-users of e-cigarettes. Studies rated as having high risk of bias were excluded. Studies were independently assessed by at least two authors. The procedures described by PRISMA were followed, and the quality of evidence was rated using GRADE.Data synthesisThirty longitudinal studies from 22 different cohorts assessing e-cigarette use among non- or never-smokers at baseline, and subsequent use of cigarette smoking at follow-up, were included in this review. A random-effects meta-analysis based on 89 076 participants showed a pooled unadjusted odds ratio (OR) of cigarette smoking among baseline non-smokers e-cigarette users compared with non-users of 4.68 (CI 3.64–6.02), while the adjusted OR was 3.37 (CI 2.68–4.24). These results were consistent irrespective of whether the outcome was measured as ever smoking or as past 30-day smoking. The evidence was graded as moderate.ConclusionsUse of e-cigarettes may predict the initiation or recurrence of cigarette smoking.

scholarly journals Relationship between trying an electronic cigarette and subsequent cigarette experimentation in Scottish adolescents: a cohort study

2017 ◽  
Vol 27 (4) ◽  
pp. 373-378 ◽  
Author(s):  
Catherine Best ◽  
Farhana Haseen ◽  
Dorothy Currie ◽  
Gozde Ozakinci ◽  
Anne Marie MacKintosh ◽  
...  
Keyword(s):  
Young People ◽  
Smoking Status ◽  
Close Monitoring ◽  
Cigarette Use ◽  
Survey Analysis ◽  
Original Cohort ◽  
Friendship Group ◽  
Never Smokers ◽  
Smoking Susceptibility

BackgroundThis study examines whether young never smokers in Scotland, UK, who have tried an e-cigarette are more likely than those who have not, to try a cigarette during the following year.MethodsProspective cohort survey conducted in four high schools in Scotland, UK during February/March 2015 (n=3807) with follow-up 1 year later. All pupils (age 11–18) were surveyed. Response rates were high in both years (87% in 2015) and 2680/3807 (70.4%) of the original cohort completed the follow-up survey. Analysis was restricted to baseline ‘never smokers’ (n=3001/3807), 2125 of whom were available to follow-up (70.8%).ResultsAt baseline, 183 of 2125 (8.6%) never smokers had tried an e-cigarette and 1942 had not. Of the young people who had not tried an e-cigarette at baseline, 249 (12.8%) went on to try smoking a cigarette by follow-up. This compares with 74 (40.4%) of those who had tried an e-cigarette at baseline. This effect remained significant in a logistic regression model adjusted for smoking susceptibility, having friends who smoke, family members’ smoking status, age, sex, family affluence score, ethnic group and school (adjusted OR 2.42 (95% CI 1.63 to 3.60)). There was a significant interaction between e-cigarette use and smoking susceptibility and between e-cigarette use and smoking within the friendship group.ConclusionsYoung never smokers are more likely to experiment with cigarettes if they have tried an e-cigarette. Causality cannot be inferred, but continued close monitoring of e-cigarette use in young people is warranted.

scholarly journals Meat consumption and cancer of unknown primary (CUP) risk: results from The Netherlands cohort study on diet and cancer

2021 ◽  
Author(s):  
Karlijn E. P. E. Hermans ◽  
Piet A. van den Brandt ◽  
Caroline Loef ◽  
Rob L. H. Jansen ◽  
Leo J. Schouten
Keyword(s):  
Cohort Study ◽  
The Netherlands ◽  
Positive Association ◽  
Meat Consumption ◽  
Cancer Of Unknown Primary ◽  
Unknown Primary ◽  
Processed Meat ◽  
Significant Positive Association ◽  
Processed Meat Consumption

Abstract Purpose Cancer of unknown primary (CUP) is a metastasised cancer for which no primary lesion could be identified during life. Research into CUP aetiology with respect to dietary factors is particularly scarce. This study investigates whether meat consumption is associated with CUP risk. Methods Data was utilised from the prospective Netherlands cohort study that includes 1,20,852 participants aged 55–69 years. All participants completed a self-administered questionnaire on diet and other cancer risk factors at baseline. Cancer follow-up was established through record linkage to the Netherlands Cancer Registry and the Dutch Pathology Registry. A total of 899 CUP cases and 4111 subcohort members with complete and consistent dietary data were available for case–cohort analyses after 20.3 years of follow-up. Multivariable adjusted hazard ratios (HRs) were calculated using proportional hazards models. Results We found a statistically significant positive association with beef and processed meat consumption and CUP risk in women (multivariable adjusted HR Q4 vs. Q1 1.47, 95% CI 1.04–2.07, Ptrend = 0.004 and Q4 vs. Q1 1.53, 95% CI 1.08–2.16, Ptrend = 0.001, respectively), and a non-significant positive association with processed meat consumption and CUP risk in men (multivariable adjusted HR Q4 vs. Q1 1.33, 95% CI 0.99–1.79, Ptrend = 0.15). No associations were observed between red meat (overall), poultry or fish consumption and CUP risk. Conclusion In this cohort, beef and processed meat consumption were positively associated with increased CUP risk in women, whereas a non-significant positive association was observed between processed meat consumption and CUP risk in men.

scholarly journals Factors Associated with Cigarette Use During Airmen’s First Year of Service in the United States Air Force

2019 ◽  
Vol 185 (1-2) ◽  
pp. e212-e220 ◽  
Author(s):  
Melissa Little ◽  
Jon O Ebbert ◽  
Rebecca A Krukowski ◽  
Jennifer Halbert ◽  
Maj Ryan Kalpinski ◽  
...  
Keyword(s):  
Cigarette Smoking ◽  
Air Force ◽  
Tobacco Use ◽  
Smoking Initiation ◽  
The United States ◽  
First Year ◽  
Cigarette Use ◽  
Factors Associated ◽  
Never Smokers ◽  
One Year

Abstract Introduction Despite declines of cigarette use in the civilian population, military personnel report alarmingly high rates of cigarette use. Enlisted Air Force recruits are required to remain tobacco-free for the first 12 weeks of training, and the majority express confidence they will not use tobacco after the ban; however, most previous smokers return to smoking and many nonsmokers initiate. Understanding the factors associated with cigarette-smoking initiation among non-users and re-initiation among former users is critical for the development of successful tobacco control efforts. Materials and Methods The current study examines predictors of cigarette smoking among a sample of 2,188 USAF personnel after their first year of service. Logistic regression analyses examined associations between baseline predictors and initiation and re-initiation of cigarette smoking at a one-year follow-up. Results Compared to never smokers at both time points, the strongest predictor of smoking initiation over the past 12 months was having owned cigarette-branded merchandise (OR 3.81, 95% CI 1.67, 8.71). Compared to former smokers who remained abstinent, the strongest predictor of re-initiation was intention to use tobacco (OR 2.08, 95% CI 1.53, 2.83). Compared to individuals who initiate, the strongest predictors of re-initiation were prior use of other tobacco products and tobacco use intentions (ORs range 1.85 to 4.63). Conclusions Multiple risk factors are associated with tobacco use. Given that Airmen are tobacco-free for the first 12 weeks of training, tobacco interventions during this period might be more effective. Our findings can be used to tailor interventions to prevent tobacco use in the U.S. military.

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