Electronic cigarette use by youths doubles likelihood of going on to smoke tobacco

29 August 2014

Youths who have used e-cigarettes are more likely to report that they may try conventional cigarettes, according to a study by Georgia State University and the US Centers for Disease Control and Prevention.

 The study found that among youths who had never tried tobacco but had used e-cigarettes, 43.9% said they intended to smoke conventional cigarettes within the next year, compared with 21.5% of those who had never used e-cigarettes. The data comes from the 2011, 2012 and 2013 National Youth Tobacco surveys of middle and high school students.

"Preventing youth from initiating tobacco use and becoming nicotine dependence requires taking an upstream approach — that’s why understanding the factors that influence intention to use cigarettes among youth who have never smoked cigarettes is critical in preventing the onset of tobacco use," said lead author Shanta Dube, Associate Professor of Epidemiology and Biostatistics at Georgia State's School of Public Health.

In addition, exposure to pro-tobacco advertising was associated with the intention to smoke among US middle and high school students who reported never smoking.

"We have to continue to focus on the fact that youth are still developing and therefore they are a vulnerable population; they are prone to experimenting and engaging in risk taking behaviors," Dube said. "Currently e-cigarettes are unregulated and they are sold in flavors such as Skittles, cotton candy, and the like, which can attract youth.

"Most importantly we know that e-cigarettes and conventional tobacco cigarettes are used exactly the same way, making it difficult for children and youth to tell them apart," she continued. "Youth exposure to e-cigarette use and pro-tobacco messaging creates an environment that can potentially undermine a half-century long effort to change social norms, thereby making youth susceptible to use cigarettes."


Intentions to smoke cigarettes among never-smoking US middle and high school electronic cigarette users, National Youth Tobacco Survey, 2011-2013. Nicotine and Tobacco Research. DOI: 10.1093/ntr/ntu166.


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