Modeling the longitudinal transitions of electronic cigarettes and conventional cigarettes with time-dependent covariates among adolescents

The rapid increase in the popularity of electronic cigarettes (e-cigarettes) among youth over the past decade (Miech et al., 2019; Cullen et al., 2019; Gentzke et al., 2019) has raised concerns among the public health community about whether e-cigarettes may effectively help combustible cigarette smokers quit or reduce cigarette consumption, or whether e-cigarettes may increase the risk of subsequent initiation of combustible cigarettes among youth with no prior history of cigarette use – or both. Studies from the United States and elsewhere have reported on associations of e-cigarette use with subsequent cigarette initiation among youth (Soneji et al., 2017; Leventhal et al., 2015a; Primack et al., 2015; Barrington-Trimis et al., 2016; Spindle et al., 2017; Miech et al., 2017; Loukas et al., 2018; Morgenstern et al., 2018; Bold et al., 2018; Hammond et al., 2017; Aleyan et al., 2018; Conner et al., 2017; Treur et al., 2018; Lozano et al., 2017; Best et al., 2017; Wills et al., 2017; Unger et al., 2016); a meta-analysis of 7 studies reported that among adolescents, ever e-cigarette users had 3–4 times the odds of subsequent smoking initiation compared to never e-cigarette users (Soneji et al., 2018). On the other hand, studies have reported increased odds of smoking cessation associated with e-cigarette use in observational studies and clinical trials (Hajek et al., 2019; Eisenberg et al., 2020; Walker et al., 2020; Chan et al., 2021; Harlow et al., 2022; Berry et al., 2019; Brose et al., 2015; Biener and Hargraves, 2015; McDermott et al., 2021; Glasser et al., 2021; Zhuang et al., 2016), and in a recent meta-analysis that suggested that daily e-cigarette use was associated with higher odds of prolonged cigarette smoking abstinence over 2 years, which might help some smokers to stop smoking cigarettes (Kalkhoran et al., 2020).

Most of these studies have focused on uni-directional transitions from e-cigarette to cigarette use, or cigarette to e-cigarette use. Analyses to date have not yet simultaneously considered both initiation of and abstention from both products across an extended time period. In this study, we address this important gap by focusing on the two major products, e-cigarettes and combustible cigarettes, using binary indicators for use or non-use. The primary objective of this study was to develop a statistical modeling framework that allows for describing e-cigarette and cigarette use transition probabilities over time, accounting for time-dependent covariates.

留言 (0)

沒有登入
gif