Study Finds Adolescents Using Alternative Tobacco Products Are More Likely to Smoke 1 Year Later

Key Points

  • Any form of tobacco, including e-cigarettes, was associated with future smoking, the authors reported, especially when adolescents used more than one product.
  • In 2016, nearly 4 million middle and high school students used at least 1 tobacco product, and 1.8 million of the students reported using 2 or more products, studies have shown.

Nonsmoking adolescents who use e-cigarettes, smokeless tobacco, or tobacco water pipes are more likely to start smoking conventional cigarettes within a year, according to new research by the University of California, San Francisco (UCSF). Findings were published by Watkins et al in JAMA Pediatrics.

Approximately 90% of adult smokers smoked their first cigarette by the time they were 18. Earlier studies have shown that smoking a single cigarette per month during adolescence is tied to daily smoking during adulthood.

The new UCSF study was based on some 10,384 respondents in the Population Assessment of Tobacco and Health (PATH) study, who said they’d never tried a cigarette. The PATH Study is a collaboration between the U.S. Food and Drug Administration and the National Institutes of Health. Never-smoking youth were first interviewed from September 2013 to December 2014.

Study Findings

The study analyzed data from a nationally representative sample of more than 10,000 adolescents, aged 12 to 17. It is the largest study to date to estimate the impact between alternative tobacco use and the subsequent start of conventional cigarette smoking in youth.

Any form of tobacco, including e-cigarettes, was associated with future smoking, the authors reported, especially when adolescents used more than one product. As a result, novel tobacco products have the potential to undermine public health gains in combating smoking, the researchers said.

“We found that teens who experimented with tobacco in any form were at greater risk of future smoking,” said senior author Benjamin W. Chaffee, DDS, PhD, Assistant Professor at the UCSF School of Dentistry. “In the last few years, research has focused on the potential of e-cigarettes to engage never-smoking adolescents in tobacco use. Our findings confirm that the use of the full range of tobacco products—including e-cigarettes, cigars, tobacco water pipes, and smokeless tobacco—is associated with greater odds of future cigarette smoking.”

In recent years, noncigarette tobacco products have become increasingly popular, especially e-cigarettes, the most common form of tobacco used by youth. In 2016, nearly 4 million middle and high school students used at least 1 tobacco product, and 1.8 million of the students reported using 2 or more products, studies have shown.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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