International Journal of Public Health

, Volume 61, Issue 2, pp 237–241 | Cite as

Use of electronic nicotine delivery systems and recent initiation of smoking among US youth

  • Victor M. CardenasEmail author
  • Victoria L. Evans
  • Appathurai Balamurugan
  • Mohammed F. Faramawi
  • Robert R. Delongchamp
  • J. Gary Wheeler
Original Article



We assessed whether the prevalence of recent (within a year) initiation of cigarette smoking was associated with reports of ever using electronic delivery systems (ENDS) in the National Youth Tobacco Survey (NYTS) and whether the association varied by age.


Weighted cross-sectional analysis of use of ENDS, cigarette smoking, age at interview and age at initiation of smoking collected systematically through the 2011–2013 NYTS cycles.


In multivariate analyses those who ever used ENDS were twice as likely as nonusers of ENDS to have tried cigarette smoking in the last year (multivariate PR: 2.3; 95 % CI 1.9, 2.7). This average hid significant variations by age: a 4.1-fold increase (95 %; 2.6, 6.4) among those 11–13 years of age, compared to a smaller increase among those 16–18 years: 1.4-fold (95 % CI 1.1, 1.8).


Use of ENDS by adolescents was associated with initiation of cigarette smoking in the last year. This association was stronger in younger adolescents.


Electronic cigarettes Cross-sectional studies United States Adolescent Nicotine Dependence Age Epidemiology 


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Copyright information

© Swiss School of Public Health (SSPH+) 2016

Authors and Affiliations

  1. 1.Fay W. Boozman College of Public HealthLittle RockUSA

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