The report, published Tuesday in JAMA Pediatrics, comes as e-cigarettes are becoming increasingly popular among adolescents.
In a survey of more than 10,000 youths ages 12 to 17, researchers found that any use of hookahs, non-cigarette combustible tobacco, smokeless tobacco or e-cigarettes was “independently associated” with a doubled likelihood of smoking cigarettes in the future. Using multiple products increased the chances.
“Approximately 90 percent of adult smokers first tried a cigarette by 18 years of age, and even infrequent smoking in adolescence is associated with established adult smoking,” the team writes. “Non-cigarette tobacco use is increasing and could stimulate subsequent conventional cigarette smoking in youths.”
The report might be the first to compare multiple non-cigarette tobacco products simultaneously with subsequent cigarette smoking.
Using data from the National Institutes of Health and the U.S. Food and Drug Administration’s Population Assessment of Tobacco and Health, the team was able to capture both baseline tobacco use and changes a year later.
None of the participants had ever smoked traditional cigarettes prior to the start of the study.
“After adjusting for sociodemographic, environmental, and behavioral smoking risk factors and for baseline ever use of other tobacco products, the odds of past 30-day cigarette use at follow-up were approximately twice as high among baseline ever-users of e-cigarettes, non-cigarette combustible tobacco, and smokeless tobacco,” the study reads.
“Youths who had tried more than one type of tobacco product at baseline had 3.81 greater adjusted odds of past 30-day cigarette smoking at follow-up than did baseline never-tobacco users.”