Electronic Cigarette Use and Smoking Initiation in Taiwan: Evidence from the First Prospective Study in Asia

Yu-Ning Chien, Wayne Gao, Mattia Sanna, Ping-Ling Chen, Yi-Hua Chen, Stanton Glantz and Hung-Yi Chiou
Additional contact information
Yu-Ning Chien: Chung-Hua Institution for Economic Research, Taipei 106, Taiwan
Wayne Gao: Master’s Program in Global Health and Development, Taipei Medical University, Taipei 110, Taiwan
Mattia Sanna: Master’s Program in Global Health and Development, Taipei Medical University, Taipei 110, Taiwan
Ping-Ling Chen: Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei 110, Taiwan
Yi-Hua Chen: College of Public Health, Taipei Medical University, Taipei 110, Taiwan
Stanton Glantz: Department of Medicine, Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA 94117, USA
Hung-Yi Chiou: College of Public Health, Taipei Medical University, Taipei 110, Taiwan

IJERPH, 2019, vol. 16, issue 7, 1-11

Abstract: A growing literature indicates that electronic cigarette use increases the risk of subsequent initiation of conventional smoking among cigarette-naïve adolescents in several Western countries. This research assesses the same relationship in an Asian country, Taiwan. The Taiwan Adolescent to Adult Longitudinal Study is a school-based survey that was carried out in two waves in 2014 (baseline) and in 2016 (follow-up). It employs probability sampling to create nationally representative samples of students in junior high school (mean age 13, 7th grade at baseline) and in senior high school (mean age 16, 10th grade at baseline). Data from this survey were analyzed via logistic regression to estimate the association between ever use of e-cigarettes at baseline and smoking initiation at follow-up, accounting for susceptibility to smoking, socio-demographic profile, depression status, and peer support. Among the 12,954 cigarette-naïve students surveyed, those with e-cigarette experience at baseline exhibited higher odds of smoking initiation at follow-up (Odds Ratio = 2.14, 95% CI (1.66, 2.75), p < 0.001). For the first time, we confirmed, through a longitudinal survey, a prospective association between ever use of e-cigarettes and smoking initiation in an Asian adolescent population. The restrictive policy on e-cigarettes currently in force in Taiwan is justified to prevent both e-cigarette and cigarette use among adolescents.

Keywords: e-cigarette; smoking initiation; prospective study; Asian youth; Taiwan (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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