Risky business: a longitudinal study examining cigarette smoking initiation among susceptible and non-susceptible e-cigarette users in Canada
Bibliographic record
Abstract
OBJECTIVES: Given that many adolescent e-cigarette users are never-smokers, the possibility that e-cigarettes may act as a gateway to future cigarette smoking has been discussed in various studies. Longitudinal data are needed to explore the pathway between e-cigarette and cigarette use, particularly among different risk groups including susceptible and non-susceptible never-smokers. The objective of this study was to examine whether baseline use of e-cigarettes among a sample of never-smoking youth predicted cigarette smoking initiation over a 2-year period. DESIGN: Longitudinal cohort study. SETTING: 89 high schools across Ontario and Alberta, Canada. PARTICIPANTS: A sample of grade 9-11 never-smoking students at baseline (n=9501) who participated in the COMPASS study over 2 years. PRIMARY AND SECONDARY OUTCOME MEASURES: Participants completed in-class questionnaires that assessed smoking susceptibility and smoking initiation. RESULTS: Among the baseline sample of non-susceptible never-smokers, 45.2% of current e-cigarette users reported trying a cigarette after 2 years compared with 13.5% of non-current e-cigarette users. Among the baseline sample of susceptible never-smokers, 62.4% of current e-cigarette users reported trying a cigarette after 2 years compared with 36.1% of non-current e-cigarette users. Overall, current e-cigarette users were more likely to try a cigarette 2 years later. This association was stronger among the sample of non-susceptible never-smokers (AOR=5.28, 95% CI 2.81 to 9.94; p<0.0001) compared with susceptible never-smokers (AOR=2.78, 95% CI 1.84 to 4.20; p<0.0001). CONCLUSIONS: Findings from this large, longitudinal study support public health concerns that e-cigarette use may contribute to the development of a new population of cigarette smokers. They also support the notion that e-cigarettes are expanding the tobacco market by attracting low-risk youth who would otherwise be unlikely to initiate using cigarettes. Careful consideration will be needed in developing an appropriate regulatory framework that prevents e-cigarette use among youth.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.004 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".