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Article

Sex Difference in the Association between Electronic Cigarette Use and Subsequent Cigarette Smoking among U.S. Adolescents: Findings from the PATH Study Waves 1–4

School of Public Health, Georgia State University, Atlanta, GA 30303, USA
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Author to whom correspondence should be addressed.
Academic Editors: Mary Hrywna, Ollie Ganz and Adam Cole
Int. J. Environ. Res. Public Health 2021, 18(4), 1695; https://doi.org/10.3390/ijerph18041695
Received: 22 December 2020 / Revised: 28 January 2021 / Accepted: 8 February 2021 / Published: 10 February 2021
E-cigarettes are the most-used tobacco products among U.S. adolescents. Emerging evidence suggests that adolescents using e-cigarettes are at elevated risk for initiating cigarette smoking. However, whether this risk may differ by sex remains unknown. This study analyzed data from Wave 1 to 4 of the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative longitudinal survey. Generalized estimation equations (GEE) were performed to estimate the associations between baseline e-cigarette use and subsequent cigarette smoking, controlling for sociodemographic characteristics, mental health conditions, and other tobacco use. Effect modifications by sex were examined. Multivariate analyses showed that, among baseline never cigarette smokers, past-30-day e-cigarette use at baseline waves was significantly associated with past-30-day cigarette smoking at follow-up waves (aOR = 3.90, 95% CI: 2.51–6.08). This association was significantly stronger for boys (aOR = 6.17, 95% CI: 2.43–15.68) than for girls (aOR = 1.10, 95% CI: 0.14–8.33). Additionally, using other tobacco products, older age, and having severe externalizing mental health problems at baseline were significantly associated with an increased likelihood of cigarette smoking at follow-up. The prospective association between e-cigarette use and cigarette smoking differs by sex among U.S. adolescents. Sex-specific tobacco control interventions may be warranted to curb the youth tobacco use epidemic. View Full-Text
Keywords: adolescents; electronic cigarettes; cigarettes; sex difference; youth tobacco prevention adolescents; electronic cigarettes; cigarettes; sex difference; youth tobacco prevention
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MDPI and ACS Style

Duan, Z.; Wang, Y.; Huang, J. Sex Difference in the Association between Electronic Cigarette Use and Subsequent Cigarette Smoking among U.S. Adolescents: Findings from the PATH Study Waves 1–4. Int. J. Environ. Res. Public Health 2021, 18, 1695. https://doi.org/10.3390/ijerph18041695

AMA Style

Duan Z, Wang Y, Huang J. Sex Difference in the Association between Electronic Cigarette Use and Subsequent Cigarette Smoking among U.S. Adolescents: Findings from the PATH Study Waves 1–4. International Journal of Environmental Research and Public Health. 2021; 18(4):1695. https://doi.org/10.3390/ijerph18041695

Chicago/Turabian Style

Duan, Zongshuan, Yu Wang, and Jidong Huang. 2021. "Sex Difference in the Association between Electronic Cigarette Use and Subsequent Cigarette Smoking among U.S. Adolescents: Findings from the PATH Study Waves 1–4" International Journal of Environmental Research and Public Health 18, no. 4: 1695. https://doi.org/10.3390/ijerph18041695

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