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The use of electronic nicotine delivery systems by young smokers has nothing to do with the increase or decrease in smoking.

The widespread use of electronic nicotine delivery systems (ENDS, including e-cigarettes) among young people (YAs) aged 18 to 24 in the United States raises questions about how these products will affect future tobacco and nicotine users.

The National Academy of Sciences, Engineering, and Medicine (NASEM) recently published a literature review on the impact of ENDS on public health. The conclusion is that end-use harm to adult smokers may be reduced, but if more non-smokers, Especially young people are induced to start smoking, so this method may actually cause harm. The authors of the NASEM report found that there is “moderate evidence” to support the thesis that “the use of electronic cigarettes increases the frequency and intensity of future smoking”. Recently, a new study published by JAMA Network Open explores this question: among young people who have been smoking, is there a link between (cessation) use and changes in smoking frequency or intensity?

The cohort study used three waves of data (2013-2014, 2014-2015 and 2015-2016) from the Tobacco and Healthy Population Assessment (PATH) study, which is an ongoing longitudinal cohort study of adults and youth. Between August 2018 and October 2019, a total of 1,096 YAs (18-24 years old) were included in the analysis.

In a sample of 1096 YAs, 609 (55.6%) were young women, 698 (63.7%) were white, and 276 (25.2%) were Hispanic. The average (SD) age is 21.4 (1.9) years, and 584 (53.3%) have completed at least university studies. Among them, 214 (19.5%) were marijuana users in the first 30 days, and 161 (14.75%) smoked daily in the first 30 days. In the first wave, the average smoking frequency and intensity increased with the increase in smoking frequency in the first 30 days until the end of the second wave. In wave 3, the average change in smoking frequency was close to zero in all groups (0.4-0.7 days). From wave 2 to wave 3, the average change in smoking intensity changed more, from 5.0 cigarettes (at the end of the initial period) to 22.6 cigarettes or more (at the end of the first 30 days of use for 6 days).

Describe the sample size and exposure status of the samples analyzed in the first to third waves of the tobacco health population assessment study

The connection between the end of the second wave of use and the third wave of smoking changes:

In the PSM data set, the number of smoking days in the first 30 days increased by 0.33 days to 1.64 days, depending on the end-use definition of wave 2; these changes are not related to the end-use of wave 2. Between wave 2 and wave 3, smoking intensity also increased in the first 30 days, especially in YAs that used cigarette butts for 6 days or more in the first 30 days; however, these estimates are similar to those of wave 2. The person is not associated. Compared with people who have never used cigarette butts for 6 days or more in the past 30 days, the number of people who smoked in the past 30 days increased by 44.4, but this increase was not statistically significant.

The non-weighted correlation between the different levels of terminal exposure in wave 2 and the changes in frequency and intensity of smoking in wave 3

In this study, the use of electronic nicotine delivery systems in YA smokers was not associated with an increase or decrease in smoking during the 1 year period from 2014 to 2015. However, with the rapid development of the e-cigarette market, the use of e-cigarettes may move in different directions in the future.


Pearson JL, Sharma E, Rui N, et al. Association of Electronic Nicotine Delivery System Use With Cigarette Smoking Progression or Reduction Among Young Adults. JAMA Netw Open. 2020;3(11): e2015893. doi:10.1001/jamanetworkopen.2020.15893