Exploring the gateway hypothesis of e-cigarettes and tobacco: a prospective replication study among adolescents in the Netherlands and Flanders
BackgroundStudies demonstrated that adolescent e-cigarette use is associated with subsequent tobacco smoking, commonly referred to as the gateway effect. However, most studies only investigated gateways from e-cigarettes to tobacco smoking. This study replicates a cornerstone study revealing a posit...
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| Published in | Tobacco control Vol. 32; no. 2; pp. 170 - 178 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
BMJ Publishing Group Ltd
01.03.2023
BMJ Publishing Group LTD BMJ Publishing Group |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0964-4563 1468-3318 1468-3318 |
| DOI | 10.1136/tobaccocontrol-2021-056528 |
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| Abstract | BackgroundStudies demonstrated that adolescent e-cigarette use is associated with subsequent tobacco smoking, commonly referred to as the gateway effect. However, most studies only investigated gateways from e-cigarettes to tobacco smoking. This study replicates a cornerstone study revealing a positive association between both adolescent e-cigarette use and subsequent tobacco use; and tobacco and subsequent e-cigarette use in the Netherlands and Flanders.DesignThe longitudinal design included baseline (n=2839) and 6-month (n=1276) and 12-month (n=1025) follow-up surveys among a school-based cohort (mean age: 13.62). Ten high schools were recruited as a convenience sample. The analyses involved (1) associations of baseline e-cigarette use and subsequent tobacco smoking among never smokers; (2) associations of e-cigarette use frequency at baseline and tobacco smoking frequency at follow-up; and (3) the association of baseline tobacco smoking and subsequent e-cigarette use among non-users of e-cigarettes.FindingsConsistent with prior findings, baseline e-cigarette use was associated with higher odds of tobacco smoking at 6-month (OR=1.89; 95% CI 1.05 to 3.37) and 12-month (OR=5.63; 95% CI 3.04 to 10.42) follow-ups. More frequent use of e-cigarettes at baseline was associated with more frequent smoking at follow-ups. Baseline tobacco smoking was associated with subsequent e-cigarette use (OR=3.10; 95% CI 1.58 to 6.06 at both follow-ups).ConclusionOur study replicated the positive relation between e-cigarette use and tobacco smoking in both directions for adolescents. This may mean that the gateway works in two directions, that e-cigarette and tobacco use share common risk factors, or that both mechanisms apply. |
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| AbstractList | BackgroundStudies demonstrated that adolescent e-cigarette use is associated with subsequent tobacco smoking, commonly referred to as the gateway effect. However, most studies only investigated gateways from e-cigarettes to tobacco smoking. This study replicates a cornerstone study revealing a positive association between both adolescent e-cigarette use and subsequent tobacco use; and tobacco and subsequent e-cigarette use in the Netherlands and Flanders.DesignThe longitudinal design included baseline (n=2839) and 6-month (n=1276) and 12-month (n=1025) follow-up surveys among a school-based cohort (mean age: 13.62). Ten high schools were recruited as a convenience sample. The analyses involved (1) associations of baseline e-cigarette use and subsequent tobacco smoking among never smokers; (2) associations of e-cigarette use frequency at baseline and tobacco smoking frequency at follow-up; and (3) the association of baseline tobacco smoking and subsequent e-cigarette use among non-users of e-cigarettes.FindingsConsistent with prior findings, baseline e-cigarette use was associated with higher odds of tobacco smoking at 6-month (OR=1.89; 95% CI 1.05 to 3.37) and 12-month (OR=5.63; 95% CI 3.04 to 10.42) follow-ups. More frequent use of e-cigarettes at baseline was associated with more frequent smoking at follow-ups. Baseline tobacco smoking was associated with subsequent e-cigarette use (OR=3.10; 95% CI 1.58 to 6.06 at both follow-ups).ConclusionOur study replicated the positive relation between e-cigarette use and tobacco smoking in both directions for adolescents. This may mean that the gateway works in two directions, that e-cigarette and tobacco use share common risk factors, or that both mechanisms apply. Studies demonstrated that adolescent e-cigarette use is associated with subsequent tobacco smoking, commonly referred to as the . However, most studies only investigated gateways from e-cigarettes to tobacco smoking. This study replicates a cornerstone study revealing a positive association between both adolescent e-cigarette use and subsequent tobacco use; and tobacco and subsequent e-cigarette use in the Netherlands and Flanders. The longitudinal design included baseline (n=2839) and 6-month (n=1276) and 12-month (n=1025) follow-up surveys among a school-based cohort (mean age: 13.62). Ten high schools were recruited as a convenience sample. The analyses involved (1) associations of baseline e-cigarette use and subsequent tobacco smoking among never smokers; (2) associations of e-cigarette use frequency at baseline and tobacco smoking frequency at follow-up; and (3) the association of baseline tobacco smoking and subsequent e-cigarette use among non-users of e-cigarettes. Consistent with prior findings, baseline e-cigarette use was associated with higher odds of tobacco smoking at 6-month (OR=1.89; 95% CI 1.05 to 3.37) and 12-month (OR=5.63; 95% CI 3.04 to 10.42) follow-ups. More frequent use of e-cigarettes at baseline was associated with more frequent smoking at follow-ups. Baseline tobacco smoking was associated with subsequent e-cigarette use (OR=3.10; 95% CI 1.58 to 6.06 at both follow-ups). Our study replicated the positive relation between e-cigarette use and tobacco smoking in both directions for adolescents. This may mean that the gateway works in two directions, that e-cigarette and tobacco use share common risk factors, or that both mechanisms apply. Studies demonstrated that adolescent e-cigarette use is associated with subsequent tobacco smoking, commonly referred to as the gateway effect. However, most studies only investigated gateways from e-cigarettes to tobacco smoking. This study replicates a cornerstone study revealing a positive association between both adolescent e-cigarette use and subsequent tobacco use; and tobacco and subsequent e-cigarette use in the Netherlands and Flanders.BACKGROUNDStudies demonstrated that adolescent e-cigarette use is associated with subsequent tobacco smoking, commonly referred to as the gateway effect. However, most studies only investigated gateways from e-cigarettes to tobacco smoking. This study replicates a cornerstone study revealing a positive association between both adolescent e-cigarette use and subsequent tobacco use; and tobacco and subsequent e-cigarette use in the Netherlands and Flanders.The longitudinal design included baseline (n=2839) and 6-month (n=1276) and 12-month (n=1025) follow-up surveys among a school-based cohort (mean age: 13.62). Ten high schools were recruited as a convenience sample. The analyses involved (1) associations of baseline e-cigarette use and subsequent tobacco smoking among never smokers; (2) associations of e-cigarette use frequency at baseline and tobacco smoking frequency at follow-up; and (3) the association of baseline tobacco smoking and subsequent e-cigarette use among non-users of e-cigarettes.DESIGNThe longitudinal design included baseline (n=2839) and 6-month (n=1276) and 12-month (n=1025) follow-up surveys among a school-based cohort (mean age: 13.62). Ten high schools were recruited as a convenience sample. The analyses involved (1) associations of baseline e-cigarette use and subsequent tobacco smoking among never smokers; (2) associations of e-cigarette use frequency at baseline and tobacco smoking frequency at follow-up; and (3) the association of baseline tobacco smoking and subsequent e-cigarette use among non-users of e-cigarettes.Consistent with prior findings, baseline e-cigarette use was associated with higher odds of tobacco smoking at 6-month (OR=1.89; 95% CI 1.05 to 3.37) and 12-month (OR=5.63; 95% CI 3.04 to 10.42) follow-ups. More frequent use of e-cigarettes at baseline was associated with more frequent smoking at follow-ups. Baseline tobacco smoking was associated with subsequent e-cigarette use (OR=3.10; 95% CI 1.58 to 6.06 at both follow-ups).FINDINGSConsistent with prior findings, baseline e-cigarette use was associated with higher odds of tobacco smoking at 6-month (OR=1.89; 95% CI 1.05 to 3.37) and 12-month (OR=5.63; 95% CI 3.04 to 10.42) follow-ups. More frequent use of e-cigarettes at baseline was associated with more frequent smoking at follow-ups. Baseline tobacco smoking was associated with subsequent e-cigarette use (OR=3.10; 95% CI 1.58 to 6.06 at both follow-ups).Our study replicated the positive relation between e-cigarette use and tobacco smoking in both directions for adolescents. This may mean that the gateway works in two directions, that e-cigarette and tobacco use share common risk factors, or that both mechanisms apply.CONCLUSIONOur study replicated the positive relation between e-cigarette use and tobacco smoking in both directions for adolescents. This may mean that the gateway works in two directions, that e-cigarette and tobacco use share common risk factors, or that both mechanisms apply. |
| Author | de Vries, Hein Nagelhout, Gera E Knapen, Vera Martinelli, Thomas Talhout, Reinskje van Schayck, Constant P Candel, Math J J M |
| AuthorAffiliation | 5 Laboratory for Health Protection Research , National Institute for Public Health and the Environment (RIVM) , Bilthoven , The Netherlands 3 Department of Methodology and Statistics , Maastricht University , Maastricht , The Netherlands 4 Department of Health Promotion , Maastricht University , Maastricht , The Netherlands 6 Department of Family Medicine , Maastricht University , Maastricht , The Netherlands 1 IVO , The Hague , The Netherlands 2 Tranzo, Tilburg School of Social and Behavioral Sciences , Tilburg University , Tilburg , The Netherlands |
| AuthorAffiliation_xml | – name: 3 Department of Methodology and Statistics , Maastricht University , Maastricht , The Netherlands – name: 6 Department of Family Medicine , Maastricht University , Maastricht , The Netherlands – name: 4 Department of Health Promotion , Maastricht University , Maastricht , The Netherlands – name: 2 Tranzo, Tilburg School of Social and Behavioral Sciences , Tilburg University , Tilburg , The Netherlands – name: 5 Laboratory for Health Protection Research , National Institute for Public Health and the Environment (RIVM) , Bilthoven , The Netherlands – name: 1 IVO , The Hague , The Netherlands |
| Author_xml | – sequence: 1 givenname: Thomas orcidid: 0000-0003-0055-5631 surname: Martinelli fullname: Martinelli, Thomas email: martinelli@ivo.nl organization: Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands – sequence: 2 givenname: Math J J M surname: Candel fullname: Candel, Math J J M organization: Department of Methodology and Statistics, Maastricht University, Maastricht, The Netherlands – sequence: 3 givenname: Hein surname: de Vries fullname: de Vries, Hein organization: Department of Health Promotion, Maastricht University, Maastricht, The Netherlands – sequence: 4 givenname: Reinskje surname: Talhout fullname: Talhout, Reinskje organization: Laboratory for Health Protection Research, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands – sequence: 5 givenname: Vera surname: Knapen fullname: Knapen, Vera organization: Department of Health Promotion, Maastricht University, Maastricht, The Netherlands – sequence: 6 givenname: Constant P surname: van Schayck fullname: van Schayck, Constant P organization: Department of Family Medicine, Maastricht University, Maastricht, The Netherlands – sequence: 7 givenname: Gera E surname: Nagelhout fullname: Nagelhout, Gera E organization: Department of Health Promotion, Maastricht University, Maastricht, The Netherlands |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/34226262$$D View this record in MEDLINE/PubMed |
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| Keywords | electronic nicotine delivery devices harm reduction public policy |
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| PublicationDate | 2023-03-01 |
| PublicationDateYYYYMMDD | 2023-03-01 |
| PublicationDate_xml | – month: 03 year: 2023 text: 2023-03-01 day: 01 |
| PublicationDecade | 2020 |
| PublicationPlace | England |
| PublicationPlace_xml | – name: England – name: London – name: BMA House, Tavistock Square, London, WC1H 9JR |
| PublicationTitle | Tobacco control |
| PublicationTitleAbbrev | Tob Control |
| PublicationTitleAlternate | Tob Control |
| PublicationYear | 2023 |
| Publisher | BMJ Publishing Group Ltd BMJ Publishing Group LTD BMJ Publishing Group |
| Publisher_xml | – name: BMJ Publishing Group Ltd – name: BMJ Publishing Group LTD – name: BMJ Publishing Group |
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| Snippet | BackgroundStudies demonstrated that adolescent e-cigarette use is associated with subsequent tobacco smoking, commonly referred to as the gateway effect.... Studies demonstrated that adolescent e-cigarette use is associated with subsequent tobacco smoking, commonly referred to as the . However, most studies only... Studies demonstrated that adolescent e-cigarette use is associated with subsequent tobacco smoking, commonly referred to as the gateway effect. However, most... |
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| SubjectTerms | Addictions Adolescent Adolescent Behavior Adolescents Cigarettes Cigars Drug use Electronic cigarettes electronic nicotine delivery devices Electronic Nicotine Delivery Systems Ethnicity harm reduction Humans Longitudinal Studies Netherlands - epidemiology Nicotine Original Research Prospective Studies public policy Risk factors Schools Smoking Sociodemographics Students Teenagers Tobacco Tobacco Products Tobacco smoking Vaping - adverse effects Vaping - epidemiology Vocational education |
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