Youth who have used e-cigarettes are more likely to try conventional cigarettes

A recent study by a Georgia State University scientist and her colleagues with the Centers for Disease Control and Prevention has found that youth who have never even touched a regular tobacco cigarette -- but have ever used e-cigarettes -- are more likely to report that they may try conventional cigarettes.

Shanta Dube, associate professor of epidemiology and biostatistics at Georgia State's School of Public Health, is a lead author of the recently released study, "Intentions to smoke cigarettes among never-smoking U.S. middle and high school electronic cigarette users, National Youth Tobacco Survey, 2011-2013," published in the journal Nicotine and Tobacco Research. The DOI for the study is 10.1093/ntr/ntu166.

The data comes from the 2011, 2012 and 2013 National Youth Tobacco surveys of middle and high school students. Among non-smoking youth who had ever used e-cigarettes, 43.9 percent said they intended to smoke conventional cigarettes within the next year, compared with 21.5 percent of those who had never used e-cigarettes.

"Preventing youth from initiating tobacco use and becoming nicotine dependence requires taking an upstream approach - that's why understanding the factors that influence intention to use cigarettes among youth who have never smoked cigarettes is critical in preventing the onset of tobacco use," Dube said.

In addition, exposure to pro-tobacco advertising was associated with the intention to smoke among U.S. middle and high school students who reported never smoking.

"We have to continue to focus on the fact that youth are still developing and therefore they are a vulnerable population; they are prone to experimenting and engaging in risk taking behaviors," Dube said. "Currently e-cigarettes are unregulated and they are sold in flavors such as Skittles, cotton candy, and the like, which can attract youth.

"Most importantly we know that e-cigarettes and conventional tobacco cigarettes are used exactly the same way, making it difficult for children and youth to tell them apart," she continued. "Youth exposure to e-cigarette use and pro-tobacco messaging creates an environment that can potentially undermine a half-century long effort to change social norms, thereby making youth susceptible to use cigarettes."

Dube's career includes 14 years at the CDC, where in 2007 she joined the CDC Office on Smoking and Health, and was responsible for implementing two large national tobacco control surveillance systems. In 2013, she was the lead author for a CDC report documenting the high rates of smoking among adults with mental illness. She was also involved in early cycles of data collection and assessing use of e-cigarettes.