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- Title
High School Seniors Who Used E-Cigarettes May Have Otherwise Been Cigarette Smokers: Evidence From Monitoring the Future (United States, 2009-2018).
- Authors
Sokol, Natasha A; Feldman, Justin M
- Abstract
<bold>Introduction: </bold>Studies have indicated that youth who use e-cigarettes are more likely to progress to cigarette smoking; however, the likelihood that these youth would have used tobacco products in the pre-vaping era is unclear.<bold>Aims and Methods: </bold>This study sought to determine whether youth who used e-cigarettes in 2014-2018 would have likely been smokers in the period preceding e-cigarette availability. Analyzing Monitoring the Future 12th grade data (United States, 2009-2018), we forecasted the prevalence of current smoking with logistic regression-derived propensity scores. Models predicted smoking for all subsequent years, incorporating sociodemographic, family, alcohol, and school-related variables, and a linear time trend. We compared forecasted to observed smoking prevalence annually, and prevalence of current e-cigarette use among nonsmokers across smoking propensity tertiles.<bold>Results: </bold>Until 2014, observed smoking prevalence mirrored forecasted prevalence. Afterward, forecasted rates consistently overestimated prevalence. Among nonsmoking youth, e-cigarette use was lowest among those with lowest predicted probability of cigarette smoking (3.8%; 95% confidence interval [CI]: 3.3, 4.4) and highest among those with highest probability (23.5%; 95% CI: 22.2, 24.9).<bold>Conclusions: </bold>Youth e-cigarette use has increased rapidly, with high prevalence among nonsmoking youth. However, the decline in current smoking among 12th graders has accelerated since e-cigarettes have become available. E-cigarette use is largely concentrated among youth who share characteristics with smokers of the pre-vaping era, suggesting e-cigarettes may have replaced cigarette smoking.<bold>Implications: </bold>Among nonsmoking youth, vaping is largely concentrated among those who would have likely smoked prior to the introduction of e-cigarettes, and the introduction of e-cigarettes has coincided with an acceleration in the decline in youth smoking rates. E-cigarettes may be an important tool for population-level harm reduction, even considering their impact on youth.
- Subjects
UNITED States; ELECTRONIC cigarettes; CIGARETTE smokers; HIGH school seniors; TOBACCO products; SMOKING; CROSS-sectional method; SCHOOLS; RESEARCH funding
- Publication
Nicotine & Tobacco Research, 2021, Vol 23, Issue 11, p1958
- ISSN
1462-2203
- Publication type
journal article
- DOI
10.1093/ntr/ntab102