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Many teens try e-cigarettes but few become regular users

Frequent use is highest amongst existing smokers

Jo Carlowe

Thursday, 16 April 2015

E-cigarettes are popular with teens, including those who have never smoked, but few who try them become regular users, according to new research.

The study*, published in the online journal BMJ Open, was based on the results of two nationally representative surveys of primary and secondary schoolchildren (CHETS Wales 2 and the Welsh Health Behaviour in School aged Children) from more than 150 schools in Wales carried out in 2013 and 2014.

In all, 1,601 children aged 10-11 and 9,055 11-16 year olds were quizzed about their use of e-cigarettes.

Use of e-cigarettes at least once was more common than having smoked a conventional cigarette among all age groups, except the oldest (15-16 year olds).

Some 5.8% of 10-11 year olds had tried e-cigarettes—far more than had tried tobacco (1.6%)—while a sizeable proportion (12.3%) of 11-16 year olds said they had used e-cigarettes, irrespective of gender, ethnic background, or family affluence.

This contrasts with regular smoking, where all these factors come into play, suggesting that e-cigarettes may have wider appeal among all sectors of the teen population, say the researchers.

Similarly, the proportion of teens who had used e-cigarettes, but who had never smoked, rose from 5.3% among 10-11 year olds, to 8% among 15-16 year olds.

But only 1.5% (125) of those aged 11-16 said they used e-cigarettes regularly—defined as at least once a month. This included 0.3% of those who claimed they had never smoked conventional cigarettes.

These figures suggest that “e-cigarettes are unlikely to make a major direct contribution to adolescent nicotine addiction at present,” write the researchers, who point out that the World Health Organisation has recognised that there is little evidence on whether e-cigarettes may or may not act as a gateway to conventional smoking.

The odds of regular e-cigarette use were 100 times higher among current weekly smokers than among non-smokers, and 50 times higher among those who had smoked cannabis.

The strong link between current smoking and e-cigarette use suggests that teens are not using these products to help them quit smoking, say the researchers.

They admit that a lack of consensus about what constitutes ‘use’ of an e-cigarette presents something of a challenge for research in this area, and say longer-term studies, to include the generation of young people who have grown up with e-cigarettes, are needed before firmer conclusions can be drawn.

* Graham Moore, et al. Electronic-cigarette use among young people in Wales: evidence from two cross-sectional surveys. BMJ Open 2015;5:e007072 doi:10.1136/bmjopen-2014-007072

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