Does E-Cigarette Use Lead to Combustible Tobacco Product Use in Adolescents?

An estimated 16% of U.S. tenth graders have tried e-cigarettes, of whom 43% have never smoked combustible cigarettes. To determine whether use of e-cigarettes during adolescence increases the likelihood of subsequently using combustible tobacco products (cigarette, cigar, or hookah), investigators analyzed data from a longitudinal study of high school students surveyed in the fall of ninth grade (baseline) and then 6 and 12 months later.

Of 2530 students who had never used combustible tobacco control products at baseline (mean age, 14 years; 53% female; 19% Asian, 44% Hispanic, 16% white), 222 (9%) had used e-cigarettes. At each follow-up period, e-cigarette users at baseline were more likely than nonusers to begin using any combustible toba…