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Evidence that an intervention weakens the relationship between adolescent electronic cigarette use and tobacco smoking: A 24 month prospective study

Conner, Mark and Grogan, Sarah and Simms-Ellis, Ruth and Scholtens, Keira and Sykes-Muskett, Bianca and Cowap, Lisa and Lawton, Rebecca and Armitage, Christopher J and Meads, David and Schmitt, Laetitia and Torgerson, Carole and West, Robert and Siddiqi, Kamran (2019) Evidence that an intervention weakens the relationship between adolescent electronic cigarette use and tobacco smoking: A 24 month prospective study. Tobacco Control. ISSN 0964-4563 (In Press)

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Abstract

Background: The electronic cigarette (e-cigarette) use to subsequent smoking relationship in adolescents has received much attention. Whether an intervention to reduce smoking initiation attenuated this relationship was assessed. Method: Data were from 3994 adolescent never smokers (aged 13-14 years at baseline) as part of a cluster randomised controlled trial. Self-report measures of smoking, e-cigarette use and covariates were assessed and used to predict ever smoked cigarettes, any recent tobacco smoking, and regularly smoked cigarettes at 24-month follow-up. Results: Baseline ever use of e-cigarettes was associated with ever smoked cigarettes (OR= 4·03, 95%CI 3·33—4·88; controlling for covariates, OR=2·78, 95%CI 2·20—3·51), any recent tobacco smoking (OR=3·38, 95%CI 2·72—4·21; controlling for covariates, OR=2·17, 95%CI 1·76—2·69) and regularly smoked cigarettes (OR=3·60, 95%CI 2·35—5·51; controlling for covariates, OR=1·27, 95%CI 1·17—1·39) at follow-up. For ever smoked cigarettes only, the impact of e-cigarette use was attenuated in the intervention (OR=1·83) compared to control (OR=4·53) condition. For ever smoked cigarettes and any recent tobacco smoking, the impact of e-cigarette use was attenuated among those with friends who smoked (OR=2·05 [ever smoked]; 1·53 [any tobacco use]) compared to those without friends who smoked (OR=3·32 [ever smoked]; 2·17 [any tobacco use]). Conclusions: This is one of the first studies to show that e-cigarette use was robustly associated with measures of smoking over 24 months and the first to show an intervention to attenuate the relationship. Further research with a broader age-range of adolescents is required.

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