Researchers at the University of California, San Francisco, examined the records of 13,651 adolescents enrolled in the Population Assessment of Tobacco and Health, a nationwide study begun in 2013 by the National Institutes of Health and the Food and Drug Administration.
However, this study was the first to directly compare these products, as well as compare use of a single product to polyuse of noncigarette products. Health experts in Britain view e-cigarettes as a crucial tool in the fight against tobacco, and past year Public Health England even endorsed the devices. They studied ever, former, and past 30-day use of noncigarette tobacco products in 4 categories: e-cigarettes, hookah, noncigarette combustible tobacco (bidis, cigarillos, filtered cigars, kreteks, pipes, and traditional cigars), and smokeless tobacco at baseline.
Among youth in the study who had tried more than one product at the start, 74 percent has used e-cigarettes and 65 percent had used a hookah.
According to the Centers for Disease Control and Prevention, about 90 percent of adult smokers tried their first cigarette before the age of 18.
Study Conclusions: Strategies aimed at preventing young people from starting to smoke conventional cigarettes should be extended to other tobacco products.
"Any use of all forms of non-cigarette tobacco was independently associated with greater risk of future cigarette smoking", the JAMA study authors concluded. The results showed that teens who used e-cigarettes, hookahs, or non-cigarette tobacco were twice as likely to have smoked cigarettes within the past 30 days at the one-year follow up.
"We have a public rhetoric around e-cigarettes that's really strong, but we should be thinking about other products", said Shannon Lea Watkins, one of the study's authors and a postdoctoral scholar at the UCSF's Center for Tobacco Control Research and Education.
The success rate for people who used e-cigarettes was 40 percent lower than the rate for people who did not use the products, the study found. That's important because cigarette smoking rates have gone down in teens, which could be seen as a win by health advocates.
"I think the FDA needs to be very careful about how they move forward with the message that these products might be useful for cessation", said McIntosh, who was not involved in the current study.
Initially, about 78 percent of the respondents had never used tobacco products, 77 percent said they accessed the Internet at least once per day, and 63 percent used a social network at least once per day. In all, approximately 12,000 adolescents provided information about their use of tobacco products.
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