Premium
Initiation Sequence of E‐Cigarette and Cigarette Smoking Among US Adolescents: A National Study
Author(s) -
McCabe Sean Esteban,
Veliz Philip,
McCabe Vita V.,
Boyd Carol J.
Publication year - 2019
Publication title -
the american journal on addictions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.997
H-Index - 76
eISSN - 1521-0391
pISSN - 1055-0496
DOI - 10.1111/ajad.12886
Subject(s) - cigarette smoking , medicine , polysubstance dependence , electronic cigarette , odds ratio , monitoring the future , environmental health , substance abuse , demography , psychiatry , pathology , sociology
Background and Objectives The primary objectives were to: (1) examine the initiation sequence of e‐cigarette use and cigarette smoking; (2) assess other substance use as a function of the initiation sequence of e‐cigarettes and cigarettes; and (3) investigate the role of early e‐cigarette initiation among US secondary school students. Methods Data were collected via self‐administered questionnaires from independent 2015 and 2016 nationally representative cross‐sectional samples of 8th grade, 10th grade, and 12th grade students ( N = 36 410). Results The lifetime initiation sequence included: (1) e‐cigarette use before cigarette smoking (1.7%); (2) e‐cigarette use and cigarette smoking in same grade (4.2%); (3) cigarette smoking before e‐cigarette use (6.1%); (4) e‐cigarette use only (12.6%); (5) cigarette smoking only (3.6%); and (6) no e‐cigarette use or cigarette smoking (71.8%). The risk of substance use was highest among dual users (regardless of initiation sequence), followed by cigarette smokers, e‐cigarette users, and no e‐cigarette use or cigarette smoking. The most prevalent initiation sequence of e‐cigarette use involved initiating other substances before e‐cigarettes, especially among older adolescents. Early initiation of e‐cigarette use was associated with increased odds of substance use behaviors for all three age groups. Discussion and Conclusions Adolescents who report a history of both e‐cigarette use and cigarette smoking should be considered at high risk for substance‐related problems. Early initiation of e‐cigarette use is a signal for other substance use. Scientific Significance Youth substance use prevention programs and prospective studies must take into account polysubstance use when addressing the relationships between e‐cigarette use and cigarette smoking. (Am J Addict 2019;28:285–294)