FRIDAY, Nov. 13, 2020 — Electronic cigarette use is associated with increased odds of cigarette smoking among adolescents with no previous smoking intention, according to a study published online Nov. 9 in Pediatrics.

Olusegun Owotomo, M.D., Ph.D., from Children’s National Hospital in Washington, D.C., and colleagues analyzed data from 8,661 adolescent participants in waves 2 (2014 to 2015) and 3 (2015 to 2016) of the Population Assessment of Tobacco and Health Study to evaluate the prospective association between e-cigarette use and cigarette smoking.

The researchers found that in wave 2, 12.8 percent of adolescent never-smokers of conventional cigarettes had intention to smoke and 8.5 percent had ever used an e-cigarette; at wave 3, 3.2 percent of participants had ever smoked a cigarette. Smoking intention and ever using e-cigarettes during wave 2 were positively associated with cigarette smoking at wave 3 (adjusted odds ratios [aORs], 3.03 [95 percent confidence interval (CI), 1.97 to 4.68; P < 0.001] and 4.62 [95 percent CI, 2.87 to 7.42; P < 0.001], respectively). For adolescents who in wave 2 expressed intention to smoke conventional cigarettes, the odds of cigarette smoking did not significantly differ for e-cigarette users and never-e-cigarette users in wave 3 (aOR, 1.57; 95 percent CI, 0.94 to 2.63; P = 0.08). Among adolescents with no intention to smoke in wave 2, e-cigarette users had more than four times the odds of cigarette smoking versus never-e-cigarette users in wave 3 (aOR, 4.62; 95 percent CI, 2.87 to 7.42; P < 0.0001).

“E-cigarette use may create intention to smoke and/or nicotine use disorder that lead to onset of cigarette smoking,” the authors write. “Pediatricians should continue to screen for and counsel adolescents against e-cigarette use to prevent onset of cigarette smoking.”

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