Use of non-cigarette tobacco products tied to teen smoking

Alicia Farmer
January 12, 2018

Consequently, the gains made in public health as cigarette smoking has declined in recent years may be at risk if the use of novel tobacco products continues to rise, according to the authors of the study, published Tuesday in the journal JAMA Pediatrics.

Teens may think they're playing it safe by using e-cigarettes, hookahs and smokeless tobacco, but they're twice as likely to have smoked cigarettes a year later if they use alternative tobacco products, a new report says.

"Although e-cigarettes are the most common form of non-cigarette tobacco used by youths (exceeding cigarette use), any use of all forms of non-cigarette tobacco was independently associated with greater risk of future cigarette smoking; risk was greatest with use of multiple products, a use pattern that is increasing among youths", the researchers wrote.

Among the small proportion of teens who had tried e-cigarettes at the start of the study, however, 19 percent had become smokers a year later, as had about 18 percent of hookah users.

Meanwhile, teen smoking rates have declined amid national anti-smoking efforts: About 5.4 percent of teenagers reported smoking cigarettes in 2017, compared to 5.9 percent in 2016, according to the University of Michigan's annual "Monitoring the Future" survey on teens' use of substances. A 50-percent reduction in cigarettes per day can help some people get started towards the ultimate goal of being smoke-free.

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The researchers studied cigarette-smoking initiation among more than 10,000 participants in the PATH study.

Schoolchildren in England are now more likely to have tried e-cigarettes than traditional cigarettes, with more than one in three 15-year-olds having used the devices, despite the fact it has been illegal to sell them to under-18s since October 2015. For example, smokeless tobacco use is higher among rural white adolescents, while cigarillo use is seen more often among lower-income African-American teens, she said.

"The elevated risk of cigarette use uptake in young populations who use e-cigarettes is strong and consistent, and this risk is amplified by the presence or amount of nicotine in e-cigarettes", Leventhal, who wasn't involved in the study, said by email. Similar results were obtained for past 30-day cigarette use, and for both former and past 30-day use of each noncigarette tobacco product.

A new law to control smoking and the sale of tobacco has entered into force in Macao since Monday, the special administrative region's Health Service Bureau said. Researchers analyzed data from almost 12,000 teens. It is also prohibited to sell tobacco products in casinos.

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