Home > Association of electronic nicotine delivery system use with cigarette smoking progression or reduction among young adults.

Pearson, Jennifer L and Sharma, Eva and Rui, Ning and Halenar, Michael J and Johnson, Amanda L and Cummings, K Michael and Hammad, Hoda T and Kaufman, Annette R and Tworek, Cindy and Goniewicz, Maciej L and Kimmel, Heather L and Tanski, Susanne and Compton, Wilson M and Day, Hannah and Ambrose, Bridget K and Bansal-Travers, Maansi and Silveira, Marushka L and Abrams, David and Limpert, Jeannie and Travers, Mark J and Borek, Nicolette and Hyland, Andrew J and Stanton, Cassandra A (2020) Association of electronic nicotine delivery system use with cigarette smoking progression or reduction among young adults. JAMA Network Open, 3, (11), e2015893. doi: 10.1001/jamanetworkopen.2020.15893.

External website: https://jamanetwork.com/journals/jamanetworkopen/f...

Importance: The prevalence of electronic nicotine delivery systems (ENDS) use, including e-cigarettes, among US young adults (YAs) has raised questions about how these products may affect future tobacco and nicotine use among YAs. Given this prevalence and that young adulthood is a critical period for the establishment of tobacco and nicotine use, it is important to consider the association between ENDS use and cigarette smoking specifically in this age group.

Objective: To examine whether ENDS use frequency or intensity is associated with changes in cigarette smoking among US YA ever smokers during 1 year.

Design, Setting, and Participants: This cohort study used 3 waves of data (2013-2014, 2014-2015, and 2015-2016) from the Population Assessment of Tobacco and Health (PATH) Study, an ongoing longitudinal cohort study of adults and youth. Unweighted 1:6 propensity score matching was used to match participants on wave 1 risk factors for ENDS use at wave 2. The changes in smoking between wave 2 and wave 3 were assessed using the matched sample. In total, 1096 ENDS-naive, ever cigarette-smoking YAs (18-24 years of age) at wave 1 who participated in wave 2 and wave 3 and who had complete data in the PATH Study were included in the analyses, which were conducted from August 2018 to October 2019.

Exposures: Never ENDS use (n = 987), any previous 30-day ENDS use (n = 109), 1 to 5 days of ENDS use in the previous 30 days (n = 75), and 6 or more days ENDS use in the previous 30 days at wave 2 (n = 34).

Main Outcomes and Measures: The analytic sample was selected using multiple variables based on peer-reviewed literature supporting associations with ENDS use. The main outcomes-changes in cigarette smoking behavior between wave 2 and wave 3-were defined using 2 measures: (1) change in smoking frequency, defined as the number of smoking days in the previous 30 days at wave 3 vs wave 2, and (2) change in smoking intensity, defined as the number smoking days in the previous 30 days multiplied by the mean number of cigarettes consumed on smoking days at wave 3 vs wave 2.

Results: The present cohort analyses included 1096 YA ever smokers who were ENDS naive at wave 1. The majority of the sample were women (609 [55.6%]) and White individuals (698 [63.7%]), and the mean (SD) age was 21.4 (1.9) years. In wave 1, 161 YAs (14.7%) were daily smokers in the previous 30 days. After propensity score matching, no statistically significant associations were observed between any definition of wave 2 ENDS use and changes in either the frequency or intensity of smoking at wave 3.

Conclusions and Relevance: In this cohort study of US YA ever smokers, ENDS use was not associated with either decreased or increased cigarette smoking during a 1-year period. However, it is possible that the rapidly evolving marketplace of vaping products may lead to different trajectories of YA cigarette and ENDS use in the future.

Item Type
Publication Type
International, Open Access, Article
Drug Type
Tobacco / Nicotine
Intervention Type
Harm reduction, Screening / Assessment
2 November 2020
Identification #
doi: 10.1001/jamanetworkopen.2020.15893
Page Range

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