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

Mark Conner; Sarah Grogan; Ruth Simms-Ellis; Keira Flett; Bianca Sykes-Muskett; Lisa Cowap; Rebecca Lawton; Christopher J Armitage; David Meads; Carole Torgerson; Robert West; Kamran Siddiqi

doi:10.1136/tobaccocontrol-2016-053539

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

Mark Conner, Sarah Grogan, Ruth Simms-Ellis, Keira Flett, Bianca Sykes-Muskett, Lisa Cowap, Rebecca Lawton, Christopher J Armitage, David Meads, Carole Torgerson, Robert West, Kamran Siddiqi

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: In 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.

METHODS: Data 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.

RESULTS: At 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.

CONCLUSIONS: This 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.

Original language	English
Pages (from-to)	1-9
Number of pages	9
Journal	Tobacco Control
DOIs	https://doi.org/10.1136/tobaccocontrol-2016-053539
Publication status	Published - 17 Aug 2017

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Journal Article

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10.1136/tobaccocontrol-2016-053539

tobaccocontrol-2016-053539.full
© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
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Cite this

@article{90c002a740044ca19eb975d84ee58598,

title = "Do electronic cigarettes increase cigarette smoking in UK adolescents?: Evidence from a 12-month prospective study",

abstract = "BACKGROUND: In 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.METHODS: Data 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.RESULTS: At 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.CONCLUSIONS: This 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.",

keywords = "Journal Article",

author = "Mark Conner and Sarah Grogan and Ruth Simms-Ellis and Keira Flett and Bianca Sykes-Muskett and Lisa Cowap and Rebecca Lawton and Armitage, {Christopher J} and David Meads and Carole Torgerson and Robert West and Kamran Siddiqi",

note = "{\textcopyright} Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.",

year = "2017",

month = aug,

day = "17",

doi = "10.1136/tobaccocontrol-2016-053539",

language = "English",

pages = "1--9",

journal = "Tobacco Control",

issn = "1468-3318",

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TY - JOUR

T1 - Do electronic cigarettes increase cigarette smoking in UK adolescents?

T2 - Evidence from a 12-month prospective study

AU - Conner, Mark

AU - Grogan, Sarah

AU - Simms-Ellis, Ruth

AU - Flett, Keira

AU - Sykes-Muskett, Bianca

AU - Cowap, Lisa

AU - Lawton, Rebecca

AU - Armitage, Christopher J

AU - Meads, David

AU - Torgerson, Carole

AU - West, Robert

AU - Siddiqi, Kamran

PY - 2017/8/17

Y1 - 2017/8/17

N2 - BACKGROUND: In 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.METHODS: Data 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.RESULTS: At 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.CONCLUSIONS: This 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.

AB - BACKGROUND: In 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.METHODS: Data 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.RESULTS: At 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.CONCLUSIONS: This 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.

KW - Journal Article

U2 - 10.1136/tobaccocontrol-2016-053539

DO - 10.1136/tobaccocontrol-2016-053539

M3 - Article

C2 - 28818839

SP - 1

EP - 9

JO - Tobacco Control

JF - Tobacco Control

SN - 1468-3318

ER -