Starting with e-cigs triples odds of starting cigarettes among college students; the evidence just keeps piling up

Tory Spindle and colleagues at VCU recently published a study, “Electronic cigarette use and uptake of cigarette smoking: A longitudinal examination of U.S. college students,” that followed 3757 students at Virginia Commonwealth University for a year to examine the relationship between e-cigarette use among never cigarette smokers at the beginning and whether they were smoking conventional cigarettes a year later.  They found, controlling for a wide range of demographic and behavioral variables, that e-cigarette users at baseline were about 3.4 times as likely to be smoking cigarettes a year later as young adults who were not using e-cigarettes.
 
This effect is consistent with a similar study of young adult males in Switzerland as well as all the studies of adolescents.
 
Here are the highlights and the abstract:
 
HIGHLIGHTS
• E-cig and cigarette use has not been studied in college students longitudinally.
• Ever and current e-cig use increased non-smokers chances of trying cigarettes.
• Historically internalizing/externalizing factors predict cigarette uptake strongly.
• Most internalizing/externalizing factors examined did not predict e-cig uptake.
• Males and marijuana users were more likely to initiate e-cig use.
 
ABSTRACT
Introduction: Electronic cigarette (e-cigarette) use prevalence is increasing among U.S. adolescents and adults but recent longitudinal data for college/university students are scarce. Furthermore, the extent that e-cigarette use is associated with the onset of cigarette smoking and the factors that lead to the uptake of e-cigarettes in college students has not been explored.
Methods: 3757 participants from a Mid-Atlantic university (women: 66%; White: 45%; Black: 21%; Asian: 19%; Hispanic/Latino: 6%) were surveyed in 2014 and again in 2015.
Results: Among participants reporting never smoking at time 1, those who had ever tried e-cigarettes or were currently using e-cigarettes (at least one use in past 30 days) were more likely to have ever tried cigarettes by time 2 relative to individuals who had not used e-cigarettes. Ever use of e-cigarettes (but not current use) also increased participants' likelihood of being current cigarette smokers at time 2. Among initial never users of e-cigarettes or cigarettes, males and ever marijuana users had an increased probability of trying e-cigarettes by time 2. Furthermore, less perseverance (an index of impulsivity) and ever use of other tobacco products increased initial never users' chances of trying both cigarettes and e-cigarettes by time 2.
Conclusions: Given that never-smoking participants who had tried e-cigarettes were more likely to initiate cigarette use later, limiting young adults' access to these products may be beneficial. As the long-term health implications of e-cigarette use become clearer, predictors of e-cigarette use could help identify future populations likely to use and abuse these products.
 
Here is the full citation:  Spindle, et al.  Electronic cigarette use and uptake of cigarette smoking: A longitudinal examination of U.S. college students.  Addictive Behaviors 2017; 67:66-72.  http://dx.doi.org/10.1016/j.addbeh.2016.12.009
Tory Spindle and colleagues at VCU recently published a study, “Electronic cigarette use and uptake of cigarette smoking: A longitudinal examination of U.S. college students,” that followed 3757 students at Virginia Commonwealth University for a year to examine the relationship between e-cigarette use among never cigarette smokers at the beginning and whether they were smoking conventional cigarettes a year later.  They found, controlling for a wide range of demographic and behavioral variables, that e-cigarette users at baseline were about 3.4 times as likely to be smoking cigarettes a year later as young adults who were not using e-cigarettes.
 
This effect is consistent with a similar study of young adult males in Switzerland as well as all the studies of adolescents.
 
Here are the highlights and the abstract:
 
HIGHLIGHTS
• E-cig and cigarette use has not been studied in college students longitudinally.
• Ever and current e-cig use increased non-smokers chances of trying cigarettes.
• Historically internalizing/externalizing factors predict cigarette uptake strongly.
• Most internalizing/externalizing factors examined did not predict e-cig uptake.
• Males and marijuana users were more likely to initiate e-cig use.
 
ABSTRACT
Introduction: Electronic cigarette (e-cigarette) use prevalence is increasing among U.S. adolescents and adults but recent longitudinal data for college/university students are scarce. Furthermore, the extent that e-cigarette use is associated with the onset of cigarette smoking and the factors that lead to the uptake of e-cigarettes in college students has not been explored.
Methods: 3757 participants from a Mid-Atlantic university (women: 66%; White: 45%; Black: 21%; Asian: 19%; Hispanic/Latino: 6%) were surveyed in 2014 and again in 2015.
Results: Among participants reporting never smoking at time 1, those who had ever tried e-cigarettes or were currently using e-cigarettes (at least one use in past 30 days) were more likely to have ever tried cigarettes by time 2 relative to individuals who had not used e-cigarettes. Ever use of e-cigarettes (but not current use) also increased participants' likelihood of being current cigarette smokers at time 2. Among initial never users of e-cigarettes or cigarettes, males and ever marijuana users had an increased probability of trying e-cigarettes by time 2. Furthermore, less perseverance (an index of impulsivity) and ever use of other tobacco products increased initial never users' chances of trying both cigarettes and e-cigarettes by time 2.
Conclusions: Given that never-smoking participants who had tried e-cigarettes were more likely to initiate cigarette use later, limiting young adults' access to these products may be beneficial. As the long-term health implications of e-cigarette use become clearer, predictors of e-cigarette use could help identify future populations likely to use and abuse these products.
 
Here is the full citation:  Spindle, et al.  Electronic cigarette use and uptake of cigarette smoking: A longitudinal examination of U.S. college students.  Addictive Behaviors 2017; 67:66-72.  http://dx.doi.org/10.1016/j.addbeh.2016.12.009