Waterpipe smoking and subsequent cigarette and e-cigarette use: a cohort study

AimWe tested the hypothesis that waterpipe smoking increases the likelihood to try conventional and electronic cigarettes.MethodsIn 2017 and 2018, 2752 German adolescents (mean age: 14.9 years), who had never tried conventional cigarettes or e-cigarettes, took part in a longitudinal survey with a 6-month observational period. Multiple regression analyses tested the association between waterpipe use at baseline and first experimentation with e-cigarettes at follow-up. The models adjusted for risk-taking propensity (sensation seeking and experimentation with alcohol and marijuana), age, sex, migration background, type of school and peer substance use.ResultsSome 381 adolescents (12.5% of the survey population) reported waterpipe smoking at baseline. The overall initiation rate during the 6 months was 4.9% (n=134) for conventional cigarettes and 10.5% (n=288) for e-cigarettes. Prior waterpipe smoking significantly predicted cigarette use (adjusted relative risk (ARR)=1.81, 95% CI 1.19–2.76), as well as e-cigarette use (ARR=3.29, 95% CI 2.53–4.28). In addition, a significant interaction between waterpipe use and sensation seeking was found (ARR=0.56, 95% CI 0.33–0.95), with waterpipe use being more predictive of later e-cigarette initiation for lower sensation-seeking individuals.DiscussionWaterpipe use predicted both later cigarette and e-cigarette use independent of all other assessed risk factors, indicating that waterpipe use might be a risk factor on its own. The results suggest that the association was stronger for adolescents with a lower risk-taking propensity, which brings this group into focus for prevention efforts. However, further research is needed to understand whether these associations are causal.

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Effects of electronic cigarettes and hookah (waterpipe) use on home air quality

Tobacco Control ◽

10.1136/tobaccocontrol-2020-056437 ◽

2021 ◽

pp. tobaccocontrol-2020-056437

Author(s):

Jenni A Shearston ◽

James Eazor ◽

Lily Lee ◽

M J Ruzmyn Vilcassim ◽

Taylor A Reed ◽

...

Keyword(s):

New York ◽

New York City ◽

Air Quality ◽

Electronic Cigarettes ◽

Cigarette Use ◽

Major Site ◽

Passive Exposure ◽

Household Members ◽

The Impact ◽

Waterpipe Use

IntroductionA major site of secondhand smoke exposure for children and adults is the home. Few studies have evaluated the impact of e-cigarette or hookah use on home air quality, despite evidence finding toxic chemicals in secondhand e-cigarette aerosols and hookah smoke. We assessed the effect of e-cigarette and hookah use on home air quality and compared it with air quality in homes where cigarettes were smoked and where no smoking or e-cigarette use occurred.MethodsNon-smoking homes and homes where e-cigarettes, hookah or cigarettes were used were recruited in the New York City area (n=57) from 2015 to 2019. Particulate matter with diameter less than 2.5 µm (PM2.5), black carbon and carbon monoxide (CO) were measured during a smoking or vaping session, both in a ‘primary’ smoking room and in an adjacent ‘secondary’ room where no smoking or vaping occurred. Log transformed data were compared with postanalysis of variance Tukey simultaneous tests.ResultsUse of hookah significantly increased PM2.5 levels compared with non-smoking homes, in both the primary and secondary rooms, while use of e-cigarettes increased PM2.5 levels only in primary rooms. Additionally, in-home use of hookah resulted in greater CO concentrations than the use of cigarettes in primary rooms.ConclusionsUse of e-cigarettes or hookah increases air pollution in homes. For hookah, increases in PM2.5 penetrated even into rooms adjacent to where smoking occurs. Extending smoke-free rules inside homes to include e-cigarette and hookah products is needed to protect household members and visitors from passive exposure to harmful aerosols and gases.

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

Public Health Reports ◽

10.1177/0033354919864369 ◽

2019 ◽

Vol 134 (5) ◽

pp. 528-536 ◽

Cited By ~ 14

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.

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Recurrent spontaneous pneumothoraces and vaping in an 18-year-old man: a case report and review of the literature

Journal of Medical Case Reports ◽

10.1186/s13256-019-2215-4 ◽

2019 ◽

Vol 13 (1) ◽

Cited By ~ 14

Author(s):

Alex Bonilla ◽

Alexander J. Blair ◽

Suliman M. Alamro ◽

Rebecca A. Ward ◽

Michael B. Feldman ◽

...

Keyword(s):

Spontaneous Pneumothorax ◽

Electronic Cigarettes ◽

Diagnostic Testing ◽

Cigarette Use ◽

Case Presentation ◽

X Ray ◽

History Of ◽

Chest X Ray ◽

Tomography Scan

Abstract Background Primary spontaneous pneumothorax is a common disorder occurring in young adults without underlying lung disease. Although tobacco smoking is a well-documented risk factor for spontaneous pneumothorax, an association between electronic cigarette use (that is, vaping) and spontaneous pneumothorax has not been noted. We report a case of spontaneous pneumothoraces correlated with vaping. Case presentation An 18-year-old Caucasian man presented twice with recurrent right-sided spontaneous pneumothoraces within 2 weeks. He reported a history of vaping just prior to both episodes. Diagnostic testing was notable for a right-sided spontaneous pneumothorax on chest X-ray and computed tomography scan. His symptoms improved following insertion of a chest tube and drainage of air on each occasion. In the 2-week follow-up visit for the recurrent episode, he was asymptomatic and reported that he was no longer using electronic cigarettes. Conclusions Providers and patients should be aware of the potential risk of spontaneous pneumothorax associated with electronic cigarettes.

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Awareness and use of electronic cigarettes: Perceptions of health science programme students in Malaysia

Health Education Journal ◽

10.1177/0017896917732363 ◽

2017 ◽

Vol 76 (8) ◽

pp. 1000-1008 ◽

Cited By ~ 2

Author(s):

Yin Hoong Goh ◽

Juman Abdulelah Dujaili ◽

Ali Qais Blebil ◽

Syed Imran Ahmed

Keyword(s):

Young Adults ◽

Sensation Seeking ◽

Electronic Cigarettes ◽

Health Science ◽

International Medical ◽

Cigarette Use ◽

Cross Sectional ◽

Behavioural Characteristics ◽

Medical University ◽

The Impact

Objectives: In recent years, electronic nicotine delivery systems (ENDS) or e-cigarettes appear to be gaining in popularity despite controversy over their health effects and public health impacts. This paper is the first in Malaysia to assess sociodemographic and behavioural characteristics associated with ENDS awareness, perceptions and use among students enrolled in health science programmes. Design: Online self-reported use and perceptions of ENDS were assessed using a cross-sectional design. Setting: The study was conducted at the International Medical University, Malaysia. Method: An anonymous Internet-based, cross-sectional survey was conducted among a cohort of 404 undergraduate students at International Medical University, Malaysia, in September 2016. Data were collected over a period of 6 weeks. A 31-question web-based survey was developed to assess sociodemographic and behavioural characteristics associated with ENDS awareness, perceptions and use. Logistic regression analysis was performed to assess the impact of a set of predictors on e-cigarette use. Results: Almost 95% of respondents were aware of e-cigarettes, 13.8% reported ever-use and students had varied perceptions towards e-cigarettes. Characteristics associated with greater likelihood of ever-use included gender, ethnicity and parents educational level. Other correlates included prior conventional cigarette smoking, prior hookah smoking, parents’ tobacco use and higher sensation-seeking behaviour total score. Conclusion: In this sample of young adults, e-cigarette awareness was high and ever-use was evident especially among ever cigarette smokers. Nearly half of ever-users had not used an e-cigarette in the past 30 days of the survey and mostly reported flavoured over unflavoured e-cigarette use. These findings highlight the importance of e-cigarette surveillance and health promotion interventions targeting young adults.

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

ERJ Open Research ◽

10.1183/23120541.00976-2020 ◽

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.

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Electronic Cigarettes and Fecundability: Results From a Prospective Preconception Cohort Study

American Journal of Epidemiology ◽

10.1093/aje/kwaa067 ◽

2020 ◽

Author(s):

Alyssa F Harlow ◽

Elizabeth E Hatch ◽

Amelia K Wesselink ◽

Kenneth J Rothman ◽

Lauren A Wise

Keyword(s):

Cohort Study ◽

Cigarette Smoking ◽

Confidence Interval ◽

Electronic Cigarettes ◽

Smoking History ◽

Cigarette Use ◽

Web Based ◽

Joint Associations ◽

In Pregnancy

Abstract Although electronic cigarette (e-cigarette) aerosol contains similar toxicants to combustible cigarettes, few studies have examined their influence on fecundability. We assessed the association between e-cigarette use and fecundability, overall and according to combustible cigarette smoking history, in a cohort of 4,586 North American women (aged 21–45 years) enrolled during 2017–2020 in Pregnancy Study Online, a Web-based prospective preconception study. Women reported current and former e-cigarette use on baseline and follow-up questionnaires, and they completed bimonthly follow-up questionnaires until self-reported pregnancy or censoring. Fecundability ratios and 95% confidence intervals were calculated using proportional probabilities models, controlling for potential confounders. Overall, 17% of women had ever used e-cigarettes and 4% were current users. Compared with never use of e-cigarettes, current e-cigarette use was associated with slightly lower fecundability (fecundability ratio = 0.84, 95% confidence interval (CI): 0.67, 1.06). Compared with current nonusers of e-cigarettes and combustible cigarettes, fecundability ratios were 0.83 (95% CI: 0.54, 1.29) for current dual users of e-cigarettes and combustible cigarettes, 0.91 (95% CI: 0.70, 1.18) for current e-cigarette users who were nonsmokers of combustible cigarettes, and 1.01 (95% CI: 0.85, 1.20) for nonusers of e-cigarettes who were current smokers of combustible cigarettes. Current e-cigarette use was associated with slightly reduced fecundability, but estimates of its independent and joint associations with combustible cigarette smoking were inconsistent and imprecise.

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The Effects of E-Cigarette Use on Alcohol and Marijuana Abuse Symptoms in an Ethnically Diverse Sample of Young Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182413159 ◽

2021 ◽

Vol 18 (24) ◽

pp. 13159

Author(s):

Pallav Pokhrel ◽

Taha Elwir ◽

Hannah Mettias ◽

Crissy T. Kawamoto ◽

Nabin Oli ◽

...

Keyword(s):

Young Adults ◽

Sensation Seeking ◽

Ethnically Diverse ◽

Marijuana Use ◽

Cigarette Use ◽

Higher Alcohol ◽

Marijuana Abuse ◽

The Relationship ◽

Problem Alcohol

Background: We examined e-cigarette use as a prospective predictor of alcohol and marijuana abuse symptoms in a sample consisting of Native Hawaiian and Other Pacific Islander (NHPI), Filipino, Asian (i.e., Japanese, Chinese, Korean), and White young adults. NHPI represent a highly vulnerable group with regard to substance use and are severely understudied. Methods: Data were collected from 1463 young adults (M age = 22.2, SD = 3.2; 59.5% women) enrolled across community colleges in Hawai‘i at two time-points six months apart. Results: Higher frequency of e-cigarette use at baseline was predictive of higher alcohol (B = 0.06, SE = 0.02, p < 0.01) and marijuana (B = 0.06, SE = 0.02, p < 0.01) use problems at six-month follow up, adjusting for baseline cigarette smoking, problem alcohol/marijuana use, sensation seeking, and demographic variables. Ethnicity was found to significantly moderate the relationship between baseline e-cigarette use and problem marijuana use later, such that White and NHPI ethnicities were particularly vulnerable to the effects of e-cigarette use on problem marijuana use. Conclusion: NHPI are often combined with Asians in national surveys, which obfuscates the higher risks faced by NHPI compared with groups that are routinely classified as Asians (e.g., Chinese, Japanese, Filipinos). The current research highlights the NHPI’s vulnerability in terms of the effects of e-cigarette use on marijuana and alcohol abuse symptoms.

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Do electronic cigarettes increase cigarette smoking in UK adolescents? Evidence from a 12-month prospective study

Tobacco Control ◽

10.1136/tobaccocontrol-2016-053539 ◽

2017 ◽

Vol 27 (4) ◽

pp. 365-372 ◽

Cited By ~ 61

Author(s):

Mark Conner ◽

Sarah Grogan ◽

Ruth Simms-Ellis ◽

Keira Flett ◽

Bianca Sykes-Muskett ◽

...

Keyword(s):

Socioeconomic Status ◽

Carbon Monoxide ◽

Cigarette Smoking ◽

Prospective Study ◽

Electronic Cigarettes ◽

Cigarette Use ◽

School Meals ◽

Cross Sectional ◽

Age Range

BackgroundIn cross-sectional surveys, increasing numbers of adolescents report using both electronic cigarettes (e-cigarettes) and cigarettes. This study assessed whether adolescent e-cigarette use was associated prospectively with initiation or escalation of cigarette use.MethodsData were from 2836 adolescents (aged 13–14 years at baseline) in 20 schools in England. At baseline, breath carbon monoxide levels, self-reported e-cigarette and cigarette use, sex, age, friends and family smoking, beliefs about cigarette use and percentage receiving free school meals (measure of socioeconomic status) were assessed. At 12-month follow-up, self-reported cigarette use was assessed and validated by breath carbon monoxide levels.ResultsAt baseline, 34.2% of adolescents reported ever using e-cigarettes (16.0% used only e-cigarettes). Baseline ever use of e-cigarettes was strongly associated with subsequent initiation (n=1726; OR 5.38, 95% CI 4.02 to 7.22; controlling for covariates, OR 4.06, 95% CI 2.94 to 5.60) and escalation (n=318; OR 1.91, 95% CI 1.14 to 3.21; controlling for covariates, this effect became non-significant, OR 1.39, 95% CI 0.97 to 1.82) of cigarette use.ConclusionsThis is the first study to report prospective relationships between ever use of e-cigarettes and initiation and escalation of cigarette use among UK adolescents. Ever use of e-cigarettes was robustly associated with initiation but more modestly related to escalation of cigarette use. Further research with longer follow-up in a broader age range of adolescents is required.

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Changes in Use Patterns Over 1 Year Among Smokers and Dual Users of Combustible and Electronic Cigarettes

Nicotine & Tobacco Research ◽

10.1093/ntr/ntz065 ◽

2019 ◽

Vol 22 (5) ◽

pp. 672-680 ◽

Cited By ~ 14

Author(s):

Megan E Piper ◽

Timothy B Baker ◽

Neal L Benowitz ◽

Douglas E Jorenby

Keyword(s):

Electronic Cigarettes ◽

Community Sample ◽

Cigarette Use ◽

Dual Use ◽

Use Patterns ◽

Quit Smoking ◽

Longitudinal Observational Study ◽

Cigarette Dependence ◽

Point Prevalence Abstinence

Abstract Background Dual use of combustible and electronic cigarettes (e-cigarettes) is a growing use pattern; more than half of e-cigarette users are dual users. However, little is known regarding the course of dual use; for example, the likelihood of discontinuation of either combustible or e-cigarettes or both. Methods Adult daily smokers and dual users (daily smokers who also vaped at least once per week) who did not intend to quit use of either product in the next 30 days participated in a longitudinal, observational study (N = 322, 51.2% women, 62.7% white, mean age = 42.27 [SD = 14.05]). At baseline, participants completed demographics and smoking and vaping history assessments. They also reported daily cigarette and e-cigarette use via timeline follow-back assessment and provided a breath sample for carbon monoxide assay at 4-month intervals for 1 year. Results Of those who completed the year 1 follow-up, 1.9% baseline smokers and 8.0% dual users achieved biochemically confirmed seven-day point-prevalence abstinence from combustible cigarettes (χ2 = 4.57, p = .03). Of initial dual users, by 1 year 43.9% were smoking only, 48.8% continued dual use, 5.9% were vaping only, and 1.4% abstained from both products. Among baseline smokers, 92.3% continued as exclusive smokers. Baseline dual users who continued e-cigarette use were more likely to be white and report higher baseline e-cigarette dependence. Conclusions In this community sample, the majority of dual users transitioned to exclusive smoking. A higher percentage of dual users quit smoking than smokers, but attrition and baseline differences between the groups compromise strong conclusions. Sustained e-cigarette use was related to baseline e-cigarette dependence. Implications This research suggests that dual use of combustible and e-cigarettes is not a sustained pattern for the majority of dual users, but it is more likely to be a continued pattern if the user is more dependent on e-cigarettes. There was evidence that dual users were more likely to quit smoking than exclusive smokers, but this may be due to factors other than their dual use.

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Electronic cigarette use and smoking reduction – longitudinal data from CONSTANCES cohort study

European Journal of Public Health ◽

10.1093/eurpub/ckz185.473 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

R Gomajee ◽

F El-Khoury ◽

M Goldberg ◽

M Zins ◽

C Lemogne ◽

...

Keyword(s):

Smoking Cessation ◽

Regression Models ◽

Electronic Cigarettes ◽

Cox Proportional Hazards ◽

Electronic Cigarette ◽

Cigarette Use ◽

Smoking Reduction ◽

Smoking Relapse ◽

Former Smokers

Abstract Aims Electronic cigarettes are often used by smokers to stop smoking and former smokers to prevent relapse. We examined whether electronic cigarette use lead to smoking reduction and cessation among smokers, and relapse among former smokers. Design and Settings The CONSTANCES cohort, France (2012 - ongoing). Measurements Among smokers (N = 5,400, average follow-up of 23.4 months), mixed regression models were used to examine whether electronic cigarette use was linked to a decrease in the number of cigarettes smoked per day and Poisson regression models with sandwich variance estimators were used to test smoking cessation. In parallel, Cox proportional hazards regression models were used to examine the relationship between electronic cigarettes use and smoking relapse among former smokers who stopped smoking since 2010 (N = 2,025, average follow-up of 22.1 months), year in which electronic cigarettes were introduced in France. All statistical analyses were adjusted for socio-demographic characteristics, duration of follow-up, and smoking characteristics. Findings There was a significantly higher decrease in the number of cigarettes smoked/day among smokers who used electronic cigarettes (decrease of 4.4 cigarettes/day) compared to those who did not (decrease of 2.7 cigarettes/day), as well as a higher relative risk of smoking cessation (adjusted RR: 1.67 [95% CI: 1.51-1.84]). At the same time, among former smokers, EC use was associated with an increase in the rate of smoking relapse (adjusted HR = 1.70 [95% CI: 1.25-2.30]). Conclusions After a follow-up of approximately 2 years, electronic cigarettes use among smokers was associated to a decrease in smoking level and an increase in smoking cessation attempts but among former smokers it was associated to a higher risk of smoking relapse. Key messages Among smokers, electronic cigarette use was associated to smoking reduction and smoking cessation. Among former smokers who quit smoking since 2010, electronic cigarette use was associated to a higher likelihood of relapse.

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