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Exploring the Bi-Directional Association between Tobacco and E-Cigarette Use among Youth in Canada

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  • Sarah Aleyan

    (School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada
    Department of Addictions, King’s College London, London SE5 8BB, UK)

  • Mahmood R. Gohari

    (School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada)

  • Adam G. Cole

    (School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada
    Faculty of Health Sciences, Ontario Tech University, Oshawa, ON L1G 0C5, Canada)

  • Scott T. Leatherdale

    (School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada)

Abstract

Research has demonstrated associations between e-cigarette use and tobacco use among youth. However, few studies have examined whether reciprocal relationships exist between e-cigarette and tobacco use. The objective of this study was to examine whether bi-directional associations exist between e-cigarette and tobacco use in a large longitudinal sample of Canadian youth. A longitudinal sample of secondary students (n = 6729) attending 87 schools in Ontario and Alberta, Canada, who completed the COMPASS student questionnaire across three waves (from 2014–2015 to 2016–2017) was identified. Using cross-lagged models, we explored bi-directional associations between current tobacco and e-cigarette use, adjusting for relevant covariates. Our findings showed that current e-cigarette use predicted subsequent tobacco use between Wave 1 (W 1 ) and Wave 2 (W 2 ) of the study (W 1–2 : OR = 1.54, 95% CI = 1.37–1.74). Similarly, current tobacco use predicted e-cigarette use during earlier waves of the study (W 1–2 : OR = 1.43, 95% CI = 1.30–1.58). However, these relationships dissipated in later waves, when tobacco use no longer predicted e-cigarette use (W 2–3 : OR = 1.07, 95% CI = 0.99–1.16). This study extends prior work that focused mainly on the association between e-cigarette and subsequent tobacco use. Specifically, our findings portray a more complex relationship, where e-cigarette use may influence and be influenced by tobacco use.

Suggested Citation

  • Sarah Aleyan & Mahmood R. Gohari & Adam G. Cole & Scott T. Leatherdale, 2019. "Exploring the Bi-Directional Association between Tobacco and E-Cigarette Use among Youth in Canada," IJERPH, MDPI, vol. 16(21), pages 1-9, November.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:21:p:4256-:d:282808
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    References listed on IDEAS

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    1. Shannon Gravely & Geoffrey T. Fong & K. Michael Cummings & Mi Yan & Anne C. K. Quah & Ron Borland & Hua-Hie Yong & Sara C. Hitchman & Ann McNeill & David Hammond & James F. Thrasher & Marc C. Willemse, 2014. "Awareness, Trial, and Current Use of Electronic Cigarettes in 10 Countries: Findings from the ITC Project," IJERPH, MDPI, vol. 11(11), pages 1-14, November.
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    Cited by:

    1. Bertrand Dautzenberg & Stéphane Legleye & Michel Underner & Philippe Arvers & Bhavish Pothegadoo & Abdelhalim Bensaidi, 2023. "Systematic Review and Critical Analysis of Longitudinal Studies Assessing Effect of E-Cigarettes on Cigarette Initiation among Adolescent Never-Smokers," IJERPH, MDPI, vol. 20(20), pages 1-20, October.

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