Study reveals e-cigarettes can be ‘gateway’ to cigarettes for teens with no prior intention to smoke

29/11/2020

E-cigarette use is associated with a higher risk of cigarette smoking among adolescents who had no prior intention of taking up conventional smoking, suggest the findings of a new study. These findings have strong implications for practice & policy, resear-ches say. Cigarette smoking remains a leading preventable cause of morbidity and mortality in the United States. And while adolescent cigarette smoking has declined over the past several decades, e-cigarette use presents a new risk for nicotine use disorder.
"Research is showing us that adolescent e-cigarette users who progress to cigarette smoking are not simply those who would have ended up smoking cigarette anyway," says Olusegun Owotomo, M.D., PhD, M.P.H., the study's lead author and a pediatric resident at Children's National Hospital. "Our study shows that e-cigarettes can predispose adolescents to cigarette smoking, even when they have no prior intentions to do so."
In one of the first theory-guided nationally representative studies to identify which adolescent e-cigarette users are at most risk of progressing to cigarette smoking, Researchers looked at data of more than 8,000 U.S. adolescents, ages 12-17, who had never smoked. The data was collected by the Population Assessment of Tobacco & Health (PATH) study, an NIH and FDA collaborative nationally representative prospective cohort study of tobacco use, from 2014-2016. Among adolescents who did not intend to smoke cigarettes in the future, those who used e-cigarettes were more than four times more likely to start smoking cigarettes one year later compared to those who did not use e-cigarettes. E-cigarette use constitutes a relatively new risk factor for nicotine use disorder among U.S. adolescents.
A 2019 study from the Centers for Diseases Control & Prevention found that 28% of high school students and 11% of middle school students were current e-cigarette users. With the recent emergence of newer and potentially highly addictive e-cigarette products, adolescents who use e-cigarettes are at increased risk of developing nicotine use disorder & progressing to smoke conventional cigarettes. "Abstinence from e-cigarettes can protect teens from becoming future smokers and should be framed as a smoking prevention strategy by all concerned stakeholders," says Dr Owotomo.
"Pediatricians are best positioned to educate patients and families on the clinical and psychosocial consequences of e-cigarette use and should support education campaigns and advocacy efforts geared to discourage adolescent e-cigarette use."

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