Teens Who Use E-Cigarettes Are Over 5 Times More Likely to Turn to Traditional Cigarettes

Adolescents who use electronic cigarettes are significantly more likely than nonusers to turn to traditional cigarettes when they reach the legal age to buy tobacco, a small Pediatrics study suggests.

Roughly 150 California teens who, in the 11th or 12th grade, reported using e-cigarettes but never smoking traditional cigarettes were matched with 150 students who never used either. Participants answered follow-up questions about cigarette smoking after they turned 18.

Some 40% of teens who reported e-cigarette use on the initial questionnaire reported smoking traditional cigarettes at follow-up, versus just 11% of e-cigarette never-users. After multivariable adjustment, e-cigarette users were over 5 times as likely to initiate traditional smoking as e-cigarette never-users. The association was even higher among teens considered not susceptible to smoking — that is, those who initially said they had no intention of smoking cigarettes (odds ratio, 9.7).