Predicting Who Will Use E-Cigarettes, Combustible Cigarettes, or Both

Since e-cigarettes came into the market, they have become popular among adolescents. That in itself is an important public health concern; additionally, many e-cigarette users go on to use regular, combustible cigarettes.

Is there a way that we can predict who will begin to use e-cigarettes, combustible cigarettes, or both? If so, then perhaps we could develop more appropriately timed and tailored prevention interventions.

Dr. Janet Audrain-McGovern and her colleagues at the University of Pennsylvania and LaSalle University conducted a study to answer this very question. This week, Pediatrics is early releasing the article with their study results, entitled “Conjoint developmental trajectories of adolescent e-cigarette and combustible cigarette use” (10.1542/peds.2021-051828).

The authors conducted a longitudinal study, in which they surveyed 1,800 ninth-graders in Philadelphia public schools every 6 months for 3 years. The students were asked about e-cigarette and combustible cigarette use by them, friends, and household members; other substance use; demographics; perception of the risk of e-cigarette/combustible cigarette use; and behavioral/psychological risk factors (e.g., depression symptoms, sensation seeking behavior).

There were 4 distinct patterns of adolescents with regards to beginning cigarette use:

1. Later (usually after age 16 years), rapid e-cigarette uptake
2. No use of e-cigarettes or combustible cigarettes
3. Earlier (already starting use at time of first survey), steady e-cigarette uptake
4. Dual-use of e-cigarettes and combustible cigarettes.

Each pattern had a distinct profile with regards to peer and family use, ease of access to e-cigarettes and cigarettes, risk perception, and behavioral/psychological risk factors. There is too much detail to include in this blog, so you should definitely check out the article to learn more about these 4 distinct profiles.

Now that these different patterns have been identified, I look forward to seeing trials of more nuanced interventions targeting adolescents who are at risk for using e-cigarettes or combustible cigarettes based on these patterns.

Related Links:

• Rural-Urban Differences in Changes and Effects of Tobacco 21 in Youth E-cigarette Use
• Smoking Intention and Progression From E-Cigarette Use to Cigarette Smoking
• E-cigarette Product Characteristics and Subsequent Frequency of Cigarette Smoking
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