Longitudinal transitions of cigarettes and electronic nicotine delivery systems among adolescents: Construction of a retrospective cohort using recall data from a cross-sectional sample

Tobacco Induced Diseases
Heewon Kang, Sung-Il Cho

Abstract

A major concern regarding non-cigarette tobacco or nicotine products (NCTNPs) is whether they facilitate or mitigate overall tobacco or nicotine use. We examined longitudinal transitions of cigarettes and electronic nicotine delivery systems (ENDS) by constructing a retrospective cohort based on the recall data of a cross-sectional sample. Using the Korea Youth Risk Behavior Survey, we constructed crosssectional data of 59576 adolescents into retrospective cohort data. Participants were categorized into 4 mutually exclusive tobacco or nicotine use states. We used a multistate Markov model to identify transitions between the states to calculate transition intensity ratios (TIRs), and examined the current use of tobacco or nicotine products to assess both gateway effects to cigarettes, and whether ENDS use helps adolescents quit cigarette smoking. Compared with never use, use of ENDS was associated with an increased risk of initiation of cigarette use (TIR=6.8; 95% CI: 4.5-10.2). The risk of transitioning from cigarette ever use to ENDS, compared with never use to ENDS, was even more pronounced (TIR=44.1; 95% CI: 34.1-56.9). The prevalence of current cigarette smoking was higher among those who started ENDS then cigarettes, compa...Continue Reading

References

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Jun 6, 2019·Tobacco Control·Heewon Kang, Sung-Il Cho
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