WEDNESDAY, March 18, 2020 (HealthDay News) — U.S. adolescents who first use electronic cigarettes (e-cigarettes) are less likely to be subsequent smokers, according to a study published online March 17 in Tobacco Control.

Lion Shahab, Ph.D., from University College London, and colleagues examined ever, past 30-day, and established cigarette smoking in adolescents who first used an e-cigarette (exposure group), a noncigarette combustible (CT) or other noncombustible tobacco (NT) product (behavioral controls), and propensity score-matched adolescents without initial cigarette use (synthetic controls). Data were obtained from the National Youth Tobacco Survey (2014 to 2017).

The researchers found that compared with behavioral controls, adolescents who tried e-cigarettes first were less likely to have ever smoked cigarettes (odds ratios, 0.48 and 0.32 versus CT and NT, respectively), to be past 30-day smokers (odds ratios, 0.48 and 0.26 versus CT and NT, respectively), or to be established cigarette smokers (odds ratios, 0.17 and 0.08 versus CT and NT, respectively). Compared with synthetic controls without initial e-cigarette use, e-cigarette initiators were also less likely to have ever smoked cigarettes, be past 30-day smokers, or be established cigarette smokers (odds ratios, 0.76, 0.71, and 0.26, respectively).

“Over the time period considered, e-cigarettes were unlikely to have acted as an important gateway towards cigarette smoking and may, in fact, have acted as a gateway away from smoking for vulnerable adolescents,” the authors write.

Two authors disclosed financial ties to manufacturers of smoking cessation medications.

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