期刊
TOBACCO CONTROL
卷 30, 期 1, 页码 8-15出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/tobaccocontrol-2019-055433
关键词
electronic nicotine delivery devices; addiction; co-substance use
资金
- British Heart Foundation
- Cancer Research UK
- Economic and Social Research Council
- Medical Research Council
- National Institute for Health Research, under UK Clinical Research Collaboration
- Medical Research Centre Integrative Epidemiology Unit at the University of Bristol [MC_UU_0011/7]
- NIHR Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust
- University of Bristol
- MRC [MC_UU_00011/7] Funding Source: UKRI
The study found that young non-smokers who use e-cigarettes are more likely to start smoking later on, with strong evidence supporting the association. However, the evidence is limited by reliance on self-report measures and lack of consideration for nicotine content, requiring further research to explore this relationship.
Objective The aim of this review was to investigate whether e-cigarette use compared with non-use in young non-smokers is associated with subsequent cigarette smoking. Data sources PubMed, Embase, Web of Science, Wiley Cochrane Library databases, and the 2018 Society for Research on Nicotine and Tobacco and Society for Behavioural Medicine conference abstracts. Study selection All studies of young people (up to age 30 years) with a measure of e-cigarette use prior to smoking and an outcome measure of smoking where an OR could be calculated were included (excluding reviews and animal studies). Data extraction Independent extraction was completed by multiple authors using a preprepared extraction form. Data synthesis Of 9199 results, 17 studies were included in the meta-analysis. There was strong evidence for an association between e-cigarette use among non-smokers and later smoking (OR: 4.59, 95% CI: 3.60 to 5.85) when the results were meta-analysed in a random-effects model. However, there was high heterogeneity (I-2=88%). Conclusions Although the association between e-cigarette use among non-smokers and subsequent smoking appears strong, the available evidence is limited by the reliance on self-report measures of smoking history without biochemical verification. None of the studies included negative controls which would provide stronger evidence for whether the association may be causal. Much of the evidence also failed to consider the nicotine content of e-liquids used by non-smokers meaning it is difficult to make conclusions about whether nicotine is the mechanism driving this association.
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