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News Release

July 17, 2017

Teens and Young Adults Have Greater Risk of Smoking Tobacco Cigarettes if They Use E-cigarettes

HONOLULU – A comprehensive review of nine e-cigarette studies conducted across the United States indicated that teenagers and young adults who used e-cigarettes, but had never smoked tobacco cigarettes before, were more likely to smoke the "real" thing a year later.

  • Teens were more than three times more likely
  • Young adults were more than four times more likely

The review confirmed findings on e-cigarette use from Hawai'i
A 2015 UH Cancer Center study with Hawai'i high school students found that teens who used e-cigarettes, but had never smoked tobacco cigarettes, were more likely to start smoking tobacco cigarettes one year later.

The current report, published in JAMA Pediatrics, included research conducted by the director of the UH Cancer Center's Cancer Prevention in the Pacific Program, Thomas Wills, PhD, and six other collaborators; it showed that this same finding has now been confirmed in studies of adolescents and young adults in California, Pennsylvania, and Virginia, as well as in representative national samples of respondents all over the U.S. The report was the first ever to systematically review data from multiple observational studies, in order to obtain generalizable estimates of risk for cigarette smoking associated with e-cigarette use across a wide range of populations.

"There had been debate about whether research conducted with Hawai'i youth would be found in other places," said Dr. Wills. "There is now no doubt that Hawai'i teens are being affected by e-cigarettes just like young people elsewhere."

Rates of e-cigarette use are relatively high in Hawai'i
The most recent survey of Hawai'i youth, conducted in 2016 by the Hawai'i Department of Health, showed that 49 percent of high school students had used e-cigarettes and half of those students were regular users.

E-cigarette use related to asthma among Hawai'i teens
Dr. Wills noted, "Data from this survey not only shows that e-cigarette use is related to smoking, but also suggests that e-cigarette use is related to asthma above and beyond the effect of cigarette smoking (which also was related to asthma). So there may be health effects of e-cigarette use that have not been previously recognized. It is important for public health to do everything possible to discourage smoking because of its many adverse health effects."

JAMA Pediatrics:
DOI: 10.1001/jamapediatrics.2017.1488
The publication research was supported by the National Institutes of Health.

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