International Journal of Public Health

, Volume 64, Issue 1, pp 125–134 | Cite as

E-cigarette use is associated with other tobacco use among US adolescents

  • Rehab AufEmail author
  • Mary Jo Trepka
  • Mazen Selim
  • Ziyad Ben Taleb
  • Mario De La Rosa
  • Elena Bastida
  • Miguel Ángel Cano
Original Article



To examine whether tobacco initiation via e-cigarettes increases the likelihood of subsequent tobacco use among a large representative sample of US adolescents.


This study is a retrospective longitudinal analysis from a representative sample of US middle and high school students (n = 39,718) who completed the 2014 and 2015 National Youth Tobacco Survey. The adjusted odds ratios of lifetime and current use of tobacco use were estimated by logistic regression analysis while controlling for important socio-ecological factors associated with tobacco use.


E-cigarette initiators were more likely to report current use of cigarettes (AOR 2.7; 1.9–4.0, p < 0.001), cigars (AOR 1.7; 1.2–2.4, p < 0.01), or smokeless tobacco (AOR 3.1; 2.2–5.4, p < 0.001), and lifetime use of the same products as well. Also, lifetime and current use of e-cigarettes significantly increased the likelihood of cigarettes, cigars, and smokeless tobacco use.


Initiation of tobacco via e-cigarette, lifetime, and current use of e-cigarettes are associated with higher odds of lifetime and current use of cigarettes, cigars, and smokeless tobacco. Collectively this suggests e-cigarettes may lead to an increased use of tobacco among adolescents.


E-cigarette Tobacco initiation Cigarette Cigar Smokeless tobacco Adolescents 



MAC was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism. Grant number K01 AA025992.

Compliance with ethical standards

The study was approved by Florida International University Institutional Review Board (see methods sections for details).

Conflict of interest

The authors report no conflict of interest.


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Copyright information

© Swiss School of Public Health (SSPH+) 2018

Authors and Affiliations

  • Rehab Auf
    • 1
    • 2
    Email author
  • Mary Jo Trepka
    • 2
    • 3
  • Mazen Selim
    • 4
  • Ziyad Ben Taleb
    • 2
  • Mario De La Rosa
    • 3
    • 5
  • Elena Bastida
    • 6
  • Miguel Ángel Cano
    • 2
    • 3
  1. 1.Department of Health, Human Performance, and Leisure (HHPL), College of Arts and Science (COAS)Howard UniversityWashingtonUSA
  2. 2.Department of Epidemiology, Robert Stempel College of Public Health and Social WorkFlorida International UniversityMiamiUSA
  3. 3.Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA)Florida International UniversityMiamiUSA
  4. 4.Jackson South Community HospitalMiamiUSA
  5. 5.School of Social Work, Robert Stempel College of Public Health and Social WorkFlorida International UniversityMiamiUSA
  6. 6.Department of Health Promotion, Robert Stempel College of Public Health and Social WorkFlorida International UniversityMiamiUSA

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