Research has demonstrated an association between e-cigarette use (vaping) and initiation of combustible cigarette (tobacco) use among youth. This study used data from a US national sample (N=3426, age 15–27) to examine the magnitude of this association among youth with e-cigarette use from 2017 to 2019, when “pod mod” devices—which deliver high nicotine concentrations—had the largest share of the market.

• Compared with youth who had never had e-cigarette use, those who initiated it in 2018 were 7 times more likely to initiate combustible cigarette use in 2019 (adjusted odds ratio [aOR], 7.29), and 8 times more likely to have current combustible cigarette use (aOR, 8.26).
• Other predictors of combustible cigarette use included male gender, household tobacco use, and sensation seeking.

Comments: E-cigarette use during adolescence greatly increases the risk of later combustible cigarette use. The popularity of vaping is a concern because the vast majority of adults with combustible cigarette use initiated it in their teen years. While e-cigarettes were introduced to the marketplace as a solution to the public health problem of smoking, the popularity of “pod mod” devices among adolescents may result in these devices introducing a greater number people to smoking than the number of those they help to quit.

Sharon Levy, MD

Reference: Hair EC, Barton AA, Perks SN, et al. Association between e-cigarette use and future combustible cigarette use: evidence from a prospective cohort of youth and young adults, 2017–2019. Add Behav. 2021;112:106593.