E-cigarette use among young adolescents linked to subsequent cannabis use


E-cigarette use in early adolescence is associated with a higher likelihood of later initiation and frequent cannabis use, independent of smoking, according to a new study. The results were published in the journal Drug and alcohol addiction .

The adoption of e-cigarette has increased significantly among young people and adults in recent times and e-cigarettes have replaced the use of tobacco cigarettes among many young people. However, concerns remain about later tobacco use, as well as transitioning to other drugs, including cannabis.

Study details

Researchers at Pennsylvania State University in the US analyzed prospective data from 10,251 adolescents from the UK’s Millennium Cohort Study, who had been followed since childhood and had not used cannabis at the age of 14. Multivariate logistic regressions were used to predict cannabis use at age 17.

By age 14, about 13% of teens had ever used e-cigarettes and 12% had ever smoked tobacco cigarettes. By age 17, the proportion of e-cigarette and tobacco cigarette users had increased to 51% and 44%, respectively. At age 17, 29% said they had used cannabis and 8% said they had used it frequently (more than 10 times in the previous year).

E-cigarette use at age 14 was associated with a 2.75-fold increased odds (95% CI 1.82 to 4.15) of later cannabis use at age 17 years, regardless of smoking and childhood confounders. Similarly, e-cigarette use at age 14 was associated with a 2.46-fold (95% CI 1.48 to 4.08) greater likelihood of frequent cannabis use (over 10 times in the past year) at the age of 17.

Simultaneous use of e-cigarettes and tobacco cigarettes at age 14 was associated with a 75% chance of starting cannabis use and a 25% chance of frequent use at age 14. 17 years. In contrast, the odds of cannabis initiation and frequent use were much lower. (23% and 6%, respectively) in adolescents who had not used either product before age 14.

Additionally, the study found no evidence of a “reverse gateway” between early cannabis use and later use of e-cigarettes or tobacco cigarettes.

‘Stricter policies’ needed

“Prevention and intervention efforts targeting adolescent e-cigarette use can not only prevent tobacco use, but also prevent later cannabis and other drug use,” the authors said.

They call for stricter policies to limit e-cigarette use among teens, such as restrictions on advertising, minimum purchase age and taxation.

The authors declare no conflict of interest.

Staff J, Vuolo M, Kelly BC, Maggs JL, Silva CP. E-cigarette use in adolescence is associated with later cannabis use. Alcohol addiction. January 10, 2022 [Epub ahead of print];232:109302. doi: 10.1016/j.drugalcdep.2022.109302. PMID: 35038607


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