Consumption of e-cigarettes among adolescents is linked to possible smoking

(Reuters Health) – According to a new US study, the use of electronic cigarettes can increase the risk of smoking.

Overall, teens who used e-cigarettes before trying other tobacco products were four times more likely to smoke traditional cigarettes after a few years than those who had never tried any type of smoking device. vaping or tobacco products other than cigarettes, the study team reports in JAMA Network Open.

"Electronic cigarettes can be a way of smoking and a size solution," said Andrew Stokes, senior author of the Boston School of Public Health's School of Public Health.

Overall, smoking rates have dropped significantly, Stokes said. "This is a real success for public health and in this context, it is quite alarming that a new product on the market potentially attracts a whole generation of tobacco," he added.

Stokes and his colleagues explored the influence of the electronic cigarette as part of the Population Assessment of Tobacco and Health (PATH) study, a nationally representative sample of children ages 12 to 15 years who completed annual questionnaires between 2013 and 2016.

Along with questions about smoking and smoking, the surveys looked at children's socioeconomic background and attitudes toward smoking. They were also asked questions designed to shed light on their vulnerability to risky behavior and sensation seeking.

Those who reported using a tobacco product during the three-year survey were asked about the 12 products for which they had "tried the first", including traditional cigarettes, cigars, pipes, hookahs , chewing tobacco, snus and electronic cigarettes.

Stokes and his colleagues focused on the 6,123 children who said in the first wave of the survey that they had never used tobacco products. In the third survey, 6.1% of these children reported smoking or trying traditional cigarettes.

Just over 20% of children who had tried e-cigarettes had tried or smoked regularly before the third wave, and of the children who had tried tobacco products other than tobacco first, over 21% had tried or smoked the cigarette. This compares to only 4% of children who had not used any type of tobacco product without a cigarette.

The researchers calculated that the odds of trying traditional cigarettes or becoming regular smokers were 4.09 times higher for those who had tried the e-cigarette first and 3.84 times higher after dying. first tried other tobacco products without a cigarette.

But for children considered at low risk to start smoking – those who initially reported not being interested in smoking, were reluctant to take risks and less inclined to seek new experiences – the first use of electronic cigarettes increased risk of smoking in the future. 8.57 times. This additional risk was not found in early users of other products other than cigarettes.

Stokes suspects that there are several reasons why children who do not see themselves smoking are never at risk of smoking. First of all, he said, many people do not realize that nicotine is a highly addictive substance. "And there is also the cool factor," he said. "The flavors are very appealing and we know that they disproportionately attract young people, who are exposed to a lot of marketing aimed at them on social media."

The new findings are "quite consistent with what we have already seen in this area in terms of demonstrating that people who experiment with electronic cigarettes, even if they initially swear never to smoke ordinary cigarettes, risk much more Brian Primack , Director of the Center for Media, Technology and Health Research at the University of Pittsburgh, Pennsylvania.

The new study "reinforces earlier results in many ways," said Primack. "First of all, it's a very large and prestigious database, which is important in such a controversial area. You want to make sure your evidence is as strong as possible. On the other hand, it shows that the magnitude of the risk is even greater for people at low risk of cigarette smoking. We have seen clues about this from the beginning. And this is particularly problematic for people who would probably never have touched a cigarette to begin with. "

SOURCE: bit.ly/2MKNMJE JAMA open network, posted February 1, 2019.