(Press-News.org) PITTSBURGH, Sept. 8, 2015 - Young people across the United States who smoke electronic cigarettes are considerably more likely to start smoking traditional cigarettes within a year than their peers who do not smoke e-cigarettes, according to an analysis led by the University of Pittsburgh Center for Research on Media, Technology, and Health (CRMTH) and the Dartmouth-Hitchcock Norris Cotton Cancer Center. The study, funded by the National Cancer Institute (NCI), was the first to assess this relation in a national U.S. sample of youth, and to include people older than 18 among its participants.
The results, published online today and scheduled for the November print issue of JAMA Pediatrics, are particularly timely as the U.S. Food and Drug Administration considers how to regulate e-cigarettes, which are easier for adolescents to purchase and, in many respects, more attractive to young people than traditional cigarettes.
"E-cigarettes are not subject to many laws that regulate traditional cigarettes, such as age limits on sales, taxation and labeling requirements. They also come in youth-oriented flavorings that laws have limited in traditional cigarettes, such as apple bubble gum and chocolate candy cane," said lead author Brian A. Primack, M.D., Ph.D., director of CRMTH and assistant vice chancellor for health and society in Pitt's Schools of the Health Sciences.
James D. Sargent, M.D., professor of pediatrics at Dartmouth's Geisel School of Medicine and senior author on the study, adds that "It also is notable that electronic cigarettes are marketed on television. This represents the first time in more than 40 years that a smoking-related device has been advertised on this medium, which has tremendous reach and could drive appeal of these products among youth."
For the current publication, the research team analyzed data on a national sample of nearly 700 16- to 26-year-old nonsmokers surveyed in 2012 and again in 2013 through the Dartmouth Media, Advertising, and Health Study. All participants were considered "non-susceptible" to initiating traditional cigarette smoking at the beginning of the study, because they had responded "definitely no" when asked if they would try a cigarette offered by a friend or believed they would smoke a cigarette within the next year.
By the next year, 38 percent of the baseline e-cigarette users had initiated traditional cigarette smoking. In comparison, only 10 percent of the youths who were not baseline e-cigarette users started smoking traditional cigarettes.
"These differences remained statistically significant and robust even when we controlled for multiple known risk factors for initiating cigarette smoking, such as age, sex, race, ethnicity, socioeconomic status, sensation seeking, parental smoking and friend smoking," Dr. Primack said.
In the manuscript, Drs. Primack and Sargent, and their team, theorize why e-cigarette smoking may serve as a gateway to traditional cigarette smoking, including:
E-cigarettes deliver nicotine more slowly than traditional cigarettes, allowing a new user to advance to cigarette smoking as he or she becomes tolerant of nicotine side effects.
Unlike other forms of nicotine, such as smokeless tobacco, e-cigarettes are designed to mimic the behavioral and sensory act of cigarette smoking, allowing the user to become accustomed to the act of smoking.
E-cigarettes are not subject to the same regulations as traditional cigarettes, potentially renormalizing the act of smoking after decades of public health efforts to shift public norms around smoking.
Regulating e-cigarettes is particularly controversial because they are sometimes used as harm reduction tools by established smokers.
"However, recent data suggest that more youth than ever are using e-cigarettes and that as many half of these adolescents are not smoking traditional cigarettes," Dr. Sargent said. "Therefore, it is important to continue surveillance of both e-cigarettes and tobacco products among young people so policymakers can establish research-informed regulations to help prevent e-cigarettes from becoming gateway products on the road to youth smoking."
INFORMATION:
Additional authors on this research are Samir Soneji, Ph.D., of The Dartmouth Institute for Health Policy and Clinical Practice; Michael Stoolmiller, Ph.D., of the University of Oregon; and Michael J. Fine, M.D., M.Sc., of Pitt and the VA Pittsburgh Healthcare System.
This research was supported by NCI grants R01-CA077026, R01-CA140150 and R21-CA185767, and National Center for Advancing Translational Sciences grant KL2-TR001088.
About the University of Pittsburgh Schools of the Health Sciences
The University of Pittsburgh Schools of the Health Sciences include the schools of Medicine, Nursing, Dental Medicine, Pharmacy, Health and Rehabilitation Sciences and the Graduate School of Public Health. The schools serve as the academic partner to the UPMC (University of Pittsburgh Medical Center). Together, their combined mission is to train tomorrow's health care specialists and biomedical scientists, engage in groundbreaking research that will advance understanding of the causes and treatments of disease and participate in the delivery of outstanding patient care. Since 1998, Pitt and its affiliated university faculty have ranked among the top 10 educational institutions in grant support from the National Institutes of Health. For additional information about the Schools of the Health Sciences, please visit http://www.health.pitt.edu.
About the Geisel School of Medicine at Dartmouth
Founded in 1797, the Geisel School of Medicine at Dartmouth strives to improve the lives of the communities it serves through excellence in learning, discovery, and healing. The Geisel School of Medicine is renowned for its leadership in medical education, health care policy and delivery science, biomedical research, global health, and in creating innovations that improve lives worldwide. As one of America's leading medical schools, Dartmouth's Geisel School of Medicine is committed to training new generations of diverse leaders who will help solve our most vexing challenges in health care.
http://www.upmc.com/media
Contact: Allison Hydzik
Phone: 412-647-9975
E-mail: HydzikAM@upmc.edu
Contact: John Cramer, Dartmouth
Phone: 603-646-9130
Email: John.D.Cramer@dartmouth.edu
Continued smoking after a diagnosis of multiple sclerosis (MS) appears to be associated with accelerated disease progression compared with those patients who quit smoking, according to an article published online by JAMA Neurology.
MS is a neurogenerative disease and smoking is one of its known risk factors. While MS begins with an initial course of irregular and worsening relapses, it usually changes after about 20 years into secondary progressive (SP) disease. The time from onset to conversion to SPMS is a frequently used measure of disease progression.
Jan Hillert, ...
About one-third of girls and boys who survived child trafficking experienced physical and/or sexual violence during their ordeal in a study of children receiving posttrafficking services in Cambodia, Thailand and Vietnam, according to an article published online by JAMA Pediatrics.
Many of these survivors of child trafficking in the Greater Mekong Subregion of Southeast Asia screened positive for depression, anxiety and posttraumatic stress disorder (PTSD), and mental health symptoms were associated with self-harm and suicide ideation, according to the article.
Millions ...
A new study of U.S. adolescents and young people suggests that using electronic cigarettes was associated with progression to traditional cigarette smoking, according to an article published online by JAMA Pediatrics.
Some studies suggest e-cigarettes may help smokers reduce the use of traditional tobacco products. Still, there is concern that e-cigarette marketing could position the product to recruit nonsmokers and the use of e-cigarettes has increased among both adolescents and young adults.
Brian A. Primack, M.D., Ph.D., of the University of Pittsburgh School of ...
The California Public Employees' Retirement System (CalPERS) saved $7 million on spending for colonoscopy two years after it implemented a reference payment initiative that offered full insurance coverage at low-priced facilities but required substantial cost sharing if patients picked a high-priced alternative, according to an article published online by JAMA Internal Medicine.
Some employers are experimenting with payment methods that seek to counter high health care prices while upholding consumer access to valuable services. Employers, insurers and consumers face ...
In 2011-2012, the estimated prevalence of diabetes among U.S. adults was 12 percent to 14 percent and the prevalence of prediabetes was 37 percent to 38 percent, indicating that about half of the U.S. adult population has either diabetes or prediabetes, according to a study in the September 8 issue of JAMA. Though data from recent years suggests that the increasing prevalence of diabetes may be leveling off.
Diabetes is a major cause of illness and death in the United States, costing an estimated $245 billion in 2012 due to increased use of health resources and lost productivity. ...
Over the last 20 years, complications have decreased and survival has improved for extremely preterm infants, according to a study in the September 8 issue of JAMA.
Advances in medicine over the past 2 decades have changed care for mothers in preterm labor and for extremely preterm infants. Evaluation of current in-hospital complications and mortality data among extremely preterm infants is important in counseling families and considering new interventions to improve outcomes. Barbara J. Stoll, M.D., of the Emory University School of Medicine, Atlanta, and colleagues ...
Among women in a malaria-endemic region in Kenya, daily iron supplementation during pregnancy did not result in an increased risk of malaria, according to a study in the September 8 issue of JAMA. Iron supplementation did result in increased birth weight, gestational duration, neonatal length, and a decreased risk of low birth weight and prematurity.
Anemia in pregnancy is a moderate or severe health problem in more than 80 percent of countries worldwide, but particularly in Africa, where it affects 57 percent of pregnant women. Iron deficiency is the most common cause, ...
The lack of adherence to usability testing standards among several widely used electronic health record (EHR) products that were certified as having met these requirements may be a major factor contributing to the poor usability of EHRs, according to a study in the September 8 issue of JAMA.
Many EHRs have poor usability, leading to user frustration and safety risks. The U.S. Department of Health and Human Services' Office of the National Coordinator for Health Information Technology (ONC) has established certification requirements to promote usability practices by EHR ...
Banning smoking in the workplace and increasing taxes on cigarettes have discouraged teens and young adults from taking up smoking, according to a study by researchers at UC San Francisco and UC Merced.
The study, published today (Sept. 8, 2015) in JAMA Pediatrics, used data on the smoking habits of a group of 12- to 18-year-olds living throughout the country in 1997. They were tracked for 11 years as they transitioned to young adults.
The researchers found that a 100 percent smoke-free environment reduced the odds of taking up smoking by one third and that the number ...
Poor mental health, self-harm and suicide attempts are common among children and adolescents who have been trafficked for forced labour or sexual exploitation, according to a new study published in JAMA Pediatrics.
The research was led by the London School of Hygiene & Tropical Medicine, in collaboration with the International Organization for Migration, and included interviews with 387 children and adolescents aged 10 to 17 years in post-trafficking services in Cambodia, Thailand and Vietnam.
Researchers found that one third of boys and girls surveyed had experienced ...
