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“Adolescents who use e-cigarettes with higher levels of nicotine may be at greater risk for developing a tolerance to and dependence on nicotine that could contribute to the persistence and progression of vaping as well as use of combustible tobacco products,” wrote corresponding author Adam M. Leventhal, Ph.D., of the University of Southern California Keck School of Medicine and colleagues.
In this cohort of 181 adolescent e-cigarette users (96 boys and 85 girls), the use of electronic cigarettes with higher nicotine concentrations at baseline was associated with greater levels of combustible cigarette and electronic cigarette use at the six-month follow-up.
Tenth graders from the Los Angeles metro area were asked about the number of days they smoked cigarettes and used e-cigarettes within the past 30 days, the frequency of smoking/vaping on these days, and the level of nicotine used in e-cigarettes (none [0 mg/mL], low [1-5 mg/mL], medium [6-17 mg/mL], high [≥18 mg/mL]). At a six-month follow-up, the students were again asked about the number of days that they had smoked cigarettes and used e-cigarettes within the past 30 days, and the frequency of smoking/vaping on these days.
Each successive increase in nicotine concentration (none to low, low to medium, and medium to high) vaped was associated with a 2.26 increase in the odds of frequent (versus no) smoking and a 1.65 increase in the odds of frequent (versus no) vaping at follow-up after adjustment for baseline frequency of smoking and vaping and other relevant covariates.
“To our knowledge this is the first prospective study to evaluate the association of varying e-cigarette nicotine concentrations with future smoking and vaping behavior,” the researchers noted.
For related information, see the Psychiatric News article “Could FDA’s Proposed Plan Help Smokers With Mental Disorders Quit For Good?”
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