Multistate transition modelling of e-cigarette use and cigarette smoking among youth in the UK
Author(s)
Type
Journal Article
Abstract
Introduction E-cigarette use remains a controversial topic, with questions over how people transition between e-cigarette use and cigarette smoking. This paper examined transitions into and out of nicotine product use in a representative sample of UK youth.
Methods We used Markov multistate transition probability models on data from 10 229 participants (10–25 years old) in the UK Household Longitudinal Study (2015–2021). We used four product use states (‘never’, ‘non-current use’, ‘e-cigarette only’ and ‘smoking and dual use’) and estimated likelihood of transitions according to sociodemographic characteristics.
Results Among participants who had never used nicotine products, most were still non-users a year later (92.9% probability; 95% CI 92.6%, 93.2%); a small proportion transitioned to using e-cigarettes only (4.0%; 95% CI 3.7%, 4.2%) and cigarettes (2.2%; 95% CI 2.0%, 2.4%). Those aged 14–17 years were the most likely to start using a nicotine product. E-cigarette use was less persistent overtime than cigarette smoking, with a 59.1% probability (95% CI 56.9%, 61.0%) of e-cigarette users still using after 1 year compared with 73.8% (95% CI 72.1%, 75.4%) for cigarette smoking. However, there was a 14% probability (95% CI 12.8%, 16.2%) that e-cigarette users went onto smoke cigarettes after 1 year, rising to 25% (95% CI 23%, 27%) after 3 years.
Conclusion This study found that although overall nicotine product use was relatively rare, participants were more likely to experiment with e-cigarette use than cigarette smoking. This was mostly not persistent over time; however, approximately one in seven transitioned to cigarette smoking. Regulators should aim to deter all nicotine product use among children.
Methods We used Markov multistate transition probability models on data from 10 229 participants (10–25 years old) in the UK Household Longitudinal Study (2015–2021). We used four product use states (‘never’, ‘non-current use’, ‘e-cigarette only’ and ‘smoking and dual use’) and estimated likelihood of transitions according to sociodemographic characteristics.
Results Among participants who had never used nicotine products, most were still non-users a year later (92.9% probability; 95% CI 92.6%, 93.2%); a small proportion transitioned to using e-cigarettes only (4.0%; 95% CI 3.7%, 4.2%) and cigarettes (2.2%; 95% CI 2.0%, 2.4%). Those aged 14–17 years were the most likely to start using a nicotine product. E-cigarette use was less persistent overtime than cigarette smoking, with a 59.1% probability (95% CI 56.9%, 61.0%) of e-cigarette users still using after 1 year compared with 73.8% (95% CI 72.1%, 75.4%) for cigarette smoking. However, there was a 14% probability (95% CI 12.8%, 16.2%) that e-cigarette users went onto smoke cigarettes after 1 year, rising to 25% (95% CI 23%, 27%) after 3 years.
Conclusion This study found that although overall nicotine product use was relatively rare, participants were more likely to experiment with e-cigarette use than cigarette smoking. This was mostly not persistent over time; however, approximately one in seven transitioned to cigarette smoking. Regulators should aim to deter all nicotine product use among children.
Date Issued
2024-06-20
Date Acceptance
2023-02-26
Citation
Tobacco Control, 2024, 33 (4), pp.489-496
ISSN
0964-4563
Publisher
BMJ Publishing Group
Start Page
489
End Page
496
Journal / Book Title
Tobacco Control
Volume
33
Issue
4
Copyright Statement
© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made.
License URL
Identifier
https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000951198300001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=a2bf6146997ec60c407a63945d4e92bb
Subjects
Co-substance use
Electronic nicotine delivery devices
Life Sciences & Biomedicine
Pediatrics
Priority
Science & Technology
special populations
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2023-03-10