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Sex Difference in the Association between Electronic Cigarette Use and Subsequent Cigarette Smoking among U.S. Adolescents: Findings from the PATH Study Waves 1–4

Author

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  • Zongshuan Duan

    (School of Public Health, Georgia State University, Atlanta, GA 30303, USA)

  • Yu Wang

    (School of Public Health, Georgia State University, Atlanta, GA 30303, USA)

  • Jidong Huang

    (School of Public Health, Georgia State University, Atlanta, GA 30303, USA)

Abstract

E-cigarettes are the most-used tobacco products among U.S. adolescents. Emerging evidence suggests that adolescents using e-cigarettes are at elevated risk for initiating cigarette smoking. However, whether this risk may differ by sex remains unknown. This study analyzed data from Wave 1 to 4 of the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative longitudinal survey. Generalized estimation equations (GEE) were performed to estimate the associations between baseline e-cigarette use and subsequent cigarette smoking, controlling for sociodemographic characteristics, mental health conditions, and other tobacco use. Effect modifications by sex were examined. Multivariate analyses showed that, among baseline never cigarette smokers, past-30-day e-cigarette use at baseline waves was significantly associated with past-30-day cigarette smoking at follow-up waves (aOR = 3.90, 95% CI: 2.51–6.08). This association was significantly stronger for boys (aOR = 6.17, 95% CI: 2.43–15.68) than for girls (aOR = 1.10, 95% CI: 0.14–8.33). Additionally, using other tobacco products, older age, and having severe externalizing mental health problems at baseline were significantly associated with an increased likelihood of cigarette smoking at follow-up. The prospective association between e-cigarette use and cigarette smoking differs by sex among U.S. adolescents. Sex-specific tobacco control interventions may be warranted to curb the youth tobacco use epidemic.

Suggested Citation

  • Zongshuan Duan & Yu Wang & Jidong Huang, 2021. "Sex Difference in the Association between Electronic Cigarette Use and Subsequent Cigarette Smoking among U.S. Adolescents: Findings from the PATH Study Waves 1–4," IJERPH, MDPI, vol. 18(4), pages 1-12, February.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:4:p:1695-:d:497016
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    References listed on IDEAS

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    1. Waldron, Ingrid, 1991. "Patterns and causes of gender differences in smoking," Social Science & Medicine, Elsevier, vol. 32(9), pages 989-1005, January.
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    1. Yu Wang & Zongshuan Duan & Scott R. Weaver & Lucy Popova & Claire A. Spears & David L. Ashley & Terry F. Pechacek & Michael P. Eriksen & Jidong Huang, 2022. "Consumption of JUUL vs. Other E-Cigarette Brands among U.S. E-Cigarette Users: Evidence from Wave 5 of the PATH Study," IJERPH, MDPI, vol. 19(17), pages 1-12, August.

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