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Systematic Review and Critical Analysis of Longitudinal Studies Assessing Effect of E-Cigarettes on Cigarette Initiation among Adolescent Never-Smokers

Author

Listed:
  • Bertrand Dautzenberg

    (Sorbonne Université & ex CHU Pitié-Salpêtrière (APHP), 14 Avenue Bosquet, 75007 Paris, France
    Institut Arthur Vernes, Tabacologie, 75006 Paris, France)

  • Stéphane Legleye

    (Ensai & Cesp, 35172 Bruz, France
    Université Paris-Saclay, Faculté de Médecine UVSQ, 91190 Gif-sur-Yvette, France)

  • Michel Underner

    (Centre Hospitalier Laborit, Unité de Recherche Clinique Pierre Deniker, Tabacologie, 86000 Poitiers, France)

  • Philippe Arvers

    (7ème Centre Médical des Armées, Quartier De Reyniès, D1075, Consultation Addictologie et Tabacologie, 38760 Varces-Allières-et-Risset, France)

  • Bhavish Pothegadoo

    (Hôpital Maison Lafitte, Unité de Cardiologie, 78600 Maison Lafitte, France)

  • Abdelhalim Bensaidi

    (Hôpital de Nanterre, Diabétologie, 92000 Nanterre, France)

Abstract

Prospective longitudinal studies mainly conclude on a causal role of e-cigarettes in the initiation of cigarettes in flagrant contradiction with conclusions drawn from epidemiology and other studies showing a sharp decline in cigarette use in parallel with the spread of e-cigarette use. This systematic review explores the reasons for this discrepancy. Methods. Among 84 publications on e-cigarette/cigarette association in adolescents identified in the Medline database from 2011 to 2022, 23 concern 22 never-smoker longitudinal sub-cohorts. Results. A link between e-cigarette experimentation at T1 and cigarette initiation at T2 is reported in sub-cohort analyses of never-smokers (AOR: 1.41 to 8.30). However, studies exclude 64.3% of T1 e-cigarette experimenters (because of dual-use) and 74.1% of T2 cigarette experimenters. With this study design, e-cigarettes contribute only to 5.3% of T2 cigarette experimentation, casting major doubt on the external validity of results and authors’ conclusions that e-cigarettes have a significant effect on the initiation of cigarettes ( Gateway effect ) at the population level. This sub-cohort design prohibits highlighting any Diversion effect , which is the most likely mechanism accounting for the competition between these two products. Conclusions. While nicotine abstinence remains the best medical option, over-regulation of e-cigarettes because of misinterpretation of longitudinal study results may be detrimental to public health and tobacco control.

Suggested Citation

  • 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.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:20:p:6936-:d:1262246
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    References listed on IDEAS

    as
    1. 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.
    2. Yu-Ning Chien & Wayne Gao & Mattia Sanna & Ping-Ling Chen & Yi-Hua Chen & Stanton Glantz & Hung-Yi Chiou, 2019. "Electronic Cigarette Use and Smoking Initiation in Taiwan: Evidence from the First Prospective Study in Asia," IJERPH, MDPI, vol. 16(7), pages 1-11, March.
    3. Rehab Auf & Mary Jo Trepka & Mazen Selim & Ziyad Ben Taleb & Mario De La Rosa & Elena Bastida & Miguel Ángel Cano, 2019. "E-cigarette use is associated with other tobacco use among US adolescents," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 64(1), pages 125-134, January.
    4. Victor M. Cardenas & Victoria L. Evans & Appathurai Balamurugan & Mohammed F. Faramawi & Robert R. Delongchamp & J. Gary Wheeler, 2016. "Use of electronic nicotine delivery systems and recent initiation of smoking among US youth," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 61(2), pages 237-241, March.
    5. Sutfin, E.L. & Reboussin, B.A. & Debinski, B. & Wagoner, K.G. & Spangler, J. & Wolfson, M., 2015. "The impact of trying electronic cigarettes on cigarette smoking by college students: A prospective analysis," American Journal of Public Health, American Public Health Association, vol. 105(8), pages 83-89.
    6. Jaana M. Kinnunen & Hanna Ollila & Jaana Minkkinen & Pirjo L. Lindfors & Arja H. Rimpelä, 2018. "A Longitudinal Study of Predictors for Adolescent Electronic Cigarette Experimentation and Comparison with Conventional Smoking," IJERPH, MDPI, vol. 15(2), pages 1-17, February.
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