{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T13:10:13Z","timestamp":1789477813510,"version":"build-2803163510"},"reference-count":37,"publisher":"BMJ","issue":"4","funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01DA054234"],"award-info":[{"award-number":["R01DA054234"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Tob Control"],"accepted":{"date-parts":[[2023,2,26]]},"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n<jats:title>Objective<\/jats:title>\n<jats:p>Using longitudinal data from two large-scale cohorts in the UK and USA, we examine whether e-cigarette use steers adolescent early smokers away from tobacco cigarettes (disruption hypothesis) or deepens early patterns of tobacco smoking (entrenchment hypothesis) in comparison with early smokers who do not use e-cigarettes.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Youth who smoked tobacco cigarettes by early adolescence (before age 15) were selected from the ongoing UK Millennium Cohort Study (n=1090) and the US Population Assessment of Tobacco and Health (n=803) study. In regression models, the focal predictor was lifetime use of an e-cigarette by early adolescence and the primary outcome was current tobacco use by late adolescence (before age 18). Logistic and multinomial models controlled for early adolescent risk factors and sociodemographic background, and were weighted for attrition and adjusted for complex survey designs.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>\nAmong youth who were early cigarette smokers, 57% of UK and 58% of US youth also used e-cigarettes. The odds of later adolescent smoking among early smoking youth were significantly higher among e-cigarette users relative to those who had not used e-cigarettes (adjusted OR (AOR\n<jats:sub>UK<\/jats:sub>\n)=1.45; AOR\n<jats:sub>USA<\/jats:sub>\n=2.19). In both samples, multinomial models indicated that early smoking youth who used e-cigarettes were more likely to be frequent smokers relative to not smoking (AOR\n<jats:sub>UK<\/jats:sub>\n=2.01; AOR\n<jats:sub>USA<\/jats:sub>\n=5.11) and infrequent smoking (AOR\n<jats:sub>UK<\/jats:sub>\n=1.67; AOR\n<jats:sub>USA<\/jats:sub>\n=2.11).\n<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Despite national differences in e-cigarette regulation and marketing, there is evidence e-cigarette use among early adolescent smokers in the UK and USA leads to higher odds of any smoking and more frequent tobacco cigarette use later in adolescence.<\/jats:p>\n<\/jats:sec>","DOI":"10.1136\/tc-2022-057717","type":"journal-article","created":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T00:00:29Z","timestamp":1681862429000},"page":"497-502","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["E-cigarette use among early adolescent tobacco cigarette smokers: testing the disruption and entrenchment hypotheses in two longitudinal cohorts"],"prefix":"10.1136","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2039-1347","authenticated-orcid":false,"given":"Brian C","family":"Kelly","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2916-0046","authenticated-orcid":false,"given":"Mike","family":"Vuolo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1601-6990","authenticated-orcid":false,"given":"Jennifer","family":"Maggs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0939-2250","authenticated-orcid":false,"given":"Jeremy","family":"Staff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,4,18]]},"reference":[{"key":"2024072401151147000_33.4.497.1","unstructured":"U.S. Department of Health and . Preventing tobacco use among youth and young adults: A report of the Surgeon General. Atlanta, GA: U.S Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2012."},{"key":"2024072401151147000_33.4.497.2","doi-asserted-by":"crossref","unstructured":"Johnston LD , Miech RA , O\u2019Malley PM , et al . Monitoring the Future national survey results on drug use, 1975-2021: overview, key findings on adolescent drug use. Ann Arbor, MI: Institute for Social Research, The University of Michigan, 2022.","DOI":"10.3998\/2027.42\/162579"},{"key":"2024072401151147000_33.4.497.3","unstructured":"Kraus L , Nociar A . ESPAD report 2015: results from the european school survey project on alcohol and other drugs. European Monitoring Centre for Drugs and Drug Addiction. Lisbon, Portugal: EMCDDA\/ESPAD, 2016."},{"key":"2024072401151147000_33.4.497.4","unstructured":"National Health Statistics Digital . Smoking, drinking and drug use among young people in England \u2013 2018. 2019. Available: https:\/\/digital.nhs.uk\/data-andinformation\/publications\/statistical\/smoking-drinking-and-drug-use-among-young-people-in-england [Accessed 18 May 2022]."},{"key":"2024072401151147000_33.4.497.5","unstructured":"U.S. Department of Health and Human Services . E-cigarette use among youth and young adults. A report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2016."},{"key":"2024072401151147000_33.4.497.6","unstructured":"National Academies of Sciences, Engineering, and Medicine . Public health consequences of e-cigarettes. Washington, DC: The National Academies Press, 2018."},{"key":"2024072401151147000_33.4.497.7","unstructured":"U.S. Department of Health and Human Services . The health consequences of smoking \u2013 50 years of progress: a report of the Surgeon General. 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