Adolescents’ Smoking Consumption And The Progress Of E-cigarette Use

The use of electronic nicotine delivery systems by young smokers has nothing to do with the increase or decrease in smoking.

The widespread use of electronic nicotine delivery systems (ENDS, including e-cigarettes) among young people (YAs) aged 18 to 24 in the United States raises questions about how these products will affect future tobacco and nicotine users.

The National Academy of Sciences, Engineering, and Medicine (NASEM) recently published a literature review on the impact of ENDS on public health. The conclusion is that end-use harm to adult smokers may be reduced but if more non-smokers especially young people are induced to start smoking, this method may actually cause harm. In addition to that, authors of NASEM report found that there is “moderate evidence” to support the thesis that “the use of e-cigarettes increases the frequency and intensity of future smoking”.

Furthermore, between August 2018 and October 2019, a total of 1,096 YAs (18-24 years old) were included in the analysis on the ongoing longitudinal cohort study of adults and youth.

In a sample of 1096 YAs, 609 (55.6%) were young women, 698 (63.7%) were white, and 276 (25.2%) were Hispanic. The average (SD) age is 21.4 (1.9) years, and 584 (53.3%) have completed at least university studies. Among them, 214 (19.5%) were marijuana users in the first 30 days, and 161 (14.75%) smoked every day in the first 30 days. In the first wave, the average smoking frequency and intensity increased within a month until the end of the second wave. In wave 3, the average change in smoking frequency was close to zero in all groups (0.4-0.7 days). From the second wave to the third wave, the average change in smoking intensity changed more, from 5.0 cigarettes (at the end of the initial period) to 22.6 cigarettes or more (at the end of a month of use for 6 days).

Moreover, In the PSM data set the number of smoking days in the first 30 days increased by 0.33 to 1.64 days depending on the end-use definition of Wave 2. Between wave 2 and wave 3, smoking intensity also increased in the first one month, especially in YAs that used cigarette butts for 6 days or more in the first 30 days. However, these estimates are consistent with those of wave 2. Comparing with people who have never used cigarette butts for 6 days or more in the past 30 days, the number of people who smoked in the past 30 days increased by 44.4, but this increase was not statistically significant.

Therefore, the use of electronic nicotine delivery systems in YA smokers was not associated with an increase or decrease in smoking during the one-year period from 2014 to 2015. However, with the rapid development of the e-cigarette market, the use of e-cigarettes may move in different directions in the future.

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Pearson JL, Sharma E, Rui N, et al. Association of Electronic Nicotine Delivery System Use With Cigarette Smoking Progression or Reduction Among Young Adults. JAMA