International Journal of Public Health

, Volume 61, Issue 2, pp 189–197 | Cite as

Dual use of electronic and tobacco cigarettes among adolescents: a cross-sectional study in Poland

  • Maciej L. GoniewiczEmail author
  • Noel J. Leigh
  • Michal Gawron
  • Justyna Nadolska
  • Lukasz Balwicki
  • Connor McGuire
  • Andrzej Sobczak
Original Article



Electronic cigarettes (e-cigarettes) are gaining in popularity among youth. While these products may be beneficial in adult smokers, the effect on young users of electronic and tobacco cigarettes (dual users) is unknown. The objective of this study was to assess the frequency of dual use among adolescents and to compare tobacco cigarette consumption among dual and exclusive tobacco cigarette users.


A cross-sectional survey of a sample of 2213 Polish students aged 16–18 conducted between December 2013 and February 2014.


Overall, 21.8 % of students were dual users. Dual users were more likely to smoke tobacco cigarettes on a daily basis [adjusted odds ratio, AOR 3.54 (95 % CI 2.34–5.36) and less likely to smoke fewer cigarettes per day (AOR 0.27 (95 % CI 0.12–0.57)] than exclusive tobacco cigarette users.


The frequency of dual use was higher than exclusive use of a single product among Polish adolescents. Young dual users do not smoke a lower number of tobacco cigarettes per day than exclusive tobacco cigarette users.


Electronic cigarette Tobacco cigarette Dual use Adolescent 



Mr. McGuire was supported with a scholarship funded by the Roswell Park Alliance Foundation. We thank Danielle Smith and Craig Steger for editorial help.

Compliance with ethical standards

Conflict of interest

Dr. Goniewicz reports grants from Pfizer Inc., a manufacturer of smoking cessation drugs, outside the submitted work; Dr. Balwicki reports grants from Tobacco-Free Kids, outside the submitted work; Dr. Sobczak reports personal fees from the eSmoking Institute, Poznan, Poland and non-financial support from Chic Group LTD, a manufacturer of electronic cigarettes in Poland, outside the submitted work. The other authors have nothing to disclose.


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Copyright information

© Swiss School of Public Health (SSPH+) 2015

Authors and Affiliations

  • Maciej L. Goniewicz
    • 1
    Email author
  • Noel J. Leigh
    • 1
  • Michal Gawron
    • 2
  • Justyna Nadolska
    • 3
  • Lukasz Balwicki
    • 3
  • Connor McGuire
    • 1
  • Andrzej Sobczak
    • 2
    • 4
  1. 1.Department of Health BehaviorRoswell Park Cancer InstituteBuffaloUSA
  2. 2.Division of Laboratory Medicine in Sosnowiec, Department of General and Inorganic Chemistry, School of PharmacyMedical University of SilesiaKatowicePoland
  3. 3.Department of Public Health and Social MedicineMedical University of GdanskGdanskPoland
  4. 4.Department of Chemical HazardsInstitute of Occupational and Environmental HealthSosnowiecPoland

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