Gateway or common liability? A systematic review and meta‐analysis of studies of adolescent e‐cigarette use and future smoking initiation

Background and Aims Studies have consistently found a longitudinal association between e‐cigarette use (vaping) and cigarette smoking. Many have interpreted such association as causal. This systematic review and meta‐analysis evaluated the plausibility of a causal interpretation by (1) estimating th...

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Veröffentlicht in:Addiction (Abingdon, England) England), 2021-04, Vol.116 (4), p.743-756
Hauptverfasser: Chan, Gary C. K., Stjepanović, Daniel, Lim, Carmen, Sun, Tianze, Shanmuga Anandan, Aathavan, Connor, Jason P., Gartner, Coral, Hall, Wayne D., Leung, Janni
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container_end_page 756
container_issue 4
container_start_page 743
container_title Addiction (Abingdon, England)
container_volume 116
creator Chan, Gary C. K.
Stjepanović, Daniel
Lim, Carmen
Sun, Tianze
Shanmuga Anandan, Aathavan
Connor, Jason P.
Gartner, Coral
Hall, Wayne D.
Leung, Janni
description Background and Aims Studies have consistently found a longitudinal association between e‐cigarette use (vaping) and cigarette smoking. Many have interpreted such association as causal. This systematic review and meta‐analysis evaluated the plausibility of a causal interpretation by (1) estimating the effect of adolescent vaping on smoking initiation, adjusted for study quality characteristics, (2) evaluating the sufficiency of adjustment for confounding based on the social development model (SDM) and the social ecological model (SEM) and E‐value analyses and (3) investigating sample attrition and publication bias. Methods Systematic review and meta‐analysis of longitudinal studies that examined the association between e‐cigarette use at baseline and smoking at follow‐up. Participants were non‐smokers aged
doi_str_mv 10.1111/add.15246
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A systematic review and meta‐analysis of studies of adolescent e‐cigarette use and future smoking initiation</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Chan, Gary C. K. ; Stjepanović, Daniel ; Lim, Carmen ; Sun, Tianze ; Shanmuga Anandan, Aathavan ; Connor, Jason P. ; Gartner, Coral ; Hall, Wayne D. ; Leung, Janni</creator><creatorcontrib>Chan, Gary C. K. ; Stjepanović, Daniel ; Lim, Carmen ; Sun, Tianze ; Shanmuga Anandan, Aathavan ; Connor, Jason P. ; Gartner, Coral ; Hall, Wayne D. ; Leung, Janni</creatorcontrib><description>Background and Aims Studies have consistently found a longitudinal association between e‐cigarette use (vaping) and cigarette smoking. Many have interpreted such association as causal. This systematic review and meta‐analysis evaluated the plausibility of a causal interpretation by (1) estimating the effect of adolescent vaping on smoking initiation, adjusted for study quality characteristics, (2) evaluating the sufficiency of adjustment for confounding based on the social development model (SDM) and the social ecological model (SEM) and E‐value analyses and (3) investigating sample attrition and publication bias. Methods Systematic review and meta‐analysis of longitudinal studies that examined the association between e‐cigarette use at baseline and smoking at follow‐up. Participants were non‐smokers aged &lt; 18 at baseline. Results Meta‐analysis of 11 studies showed a significant longitudinal association between vaping and smoking [adjusted odds ratio (aOR) = 2.93, 95% confidence interval (CI) = 2.22, 3.87]. Studies with sample sizes &lt; 1000 had a significantly higher odds ratio (OR = 6.68, 95% CI = 3.63, 12.31) than studies with sample sizes &gt; 1000 (OR = 2.49, 95% CI = 1.97, 3.15). Overall, the attrition rate was very high (median = 30%). All but one study reported results from complete sample analysis, despite those dropping out having higher risk profiles. Only two studies comprehensively adjusted for confounding. The median E‐value was 2.90, indicating that the estimates were not robust against unmeasured confounding. Conclusions There is a longitudinal association between adolescent vaping and smoking initiation; however, the evidence is limited by publication bias, high sample attrition and inadequate adjustment for potential confounders.</description><identifier>ISSN: 0965-2140</identifier><identifier>EISSN: 1360-0443</identifier><identifier>DOI: 10.1111/add.15246</identifier><identifier>PMID: 32888234</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adjustment ; Adolescent ; Adolescents ; Analysis ; Attrition ; Bias ; cigarette ; Cigarette smoking ; Cigarettes ; Dropping out ; Ecological models ; Ecological studies ; Electronic cigarettes ; e‐cigarette ; Meta-analysis ; Reviews ; Smoking ; Social development ; Systematic review ; Teenagers ; tobacco ; Vaping</subject><ispartof>Addiction (Abingdon, England), 2021-04, Vol.116 (4), p.743-756</ispartof><rights>2020 Society for the Study of Addiction</rights><rights>2020 Society for the Study of Addiction.</rights><rights>2021 Society for the Study of Addiction</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3536-850a537793eec60c415eabc6fe726f6dd9398e04229a17a2533bf1f3749a6c8d3</citedby><cites>FETCH-LOGICAL-c3536-850a537793eec60c415eabc6fe726f6dd9398e04229a17a2533bf1f3749a6c8d3</cites><orcidid>0000-0002-6651-8035 ; 0000-0001-5816-2959 ; 0000-0003-1595-6307 ; 0000-0002-7020-1196 ; 0000-0002-3939-9499 ; 0000-0002-7569-1948 ; 0000-0003-1984-0096</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fadd.15246$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fadd.15246$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32888234$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chan, Gary C. K.</creatorcontrib><creatorcontrib>Stjepanović, Daniel</creatorcontrib><creatorcontrib>Lim, Carmen</creatorcontrib><creatorcontrib>Sun, Tianze</creatorcontrib><creatorcontrib>Shanmuga Anandan, Aathavan</creatorcontrib><creatorcontrib>Connor, Jason P.</creatorcontrib><creatorcontrib>Gartner, Coral</creatorcontrib><creatorcontrib>Hall, Wayne D.</creatorcontrib><creatorcontrib>Leung, Janni</creatorcontrib><title>Gateway or common liability? A systematic review and meta‐analysis of studies of adolescent e‐cigarette use and future smoking initiation</title><title>Addiction (Abingdon, England)</title><addtitle>Addiction</addtitle><description>Background and Aims Studies have consistently found a longitudinal association between e‐cigarette use (vaping) and cigarette smoking. Many have interpreted such association as causal. This systematic review and meta‐analysis evaluated the plausibility of a causal interpretation by (1) estimating the effect of adolescent vaping on smoking initiation, adjusted for study quality characteristics, (2) evaluating the sufficiency of adjustment for confounding based on the social development model (SDM) and the social ecological model (SEM) and E‐value analyses and (3) investigating sample attrition and publication bias. Methods Systematic review and meta‐analysis of longitudinal studies that examined the association between e‐cigarette use at baseline and smoking at follow‐up. Participants were non‐smokers aged &lt; 18 at baseline. Results Meta‐analysis of 11 studies showed a significant longitudinal association between vaping and smoking [adjusted odds ratio (aOR) = 2.93, 95% confidence interval (CI) = 2.22, 3.87]. Studies with sample sizes &lt; 1000 had a significantly higher odds ratio (OR = 6.68, 95% CI = 3.63, 12.31) than studies with sample sizes &gt; 1000 (OR = 2.49, 95% CI = 1.97, 3.15). Overall, the attrition rate was very high (median = 30%). All but one study reported results from complete sample analysis, despite those dropping out having higher risk profiles. Only two studies comprehensively adjusted for confounding. The median E‐value was 2.90, indicating that the estimates were not robust against unmeasured confounding. Conclusions There is a longitudinal association between adolescent vaping and smoking initiation; however, the evidence is limited by publication bias, high sample attrition and inadequate adjustment for potential confounders.</description><subject>Adjustment</subject><subject>Adolescent</subject><subject>Adolescents</subject><subject>Analysis</subject><subject>Attrition</subject><subject>Bias</subject><subject>cigarette</subject><subject>Cigarette smoking</subject><subject>Cigarettes</subject><subject>Dropping out</subject><subject>Ecological models</subject><subject>Ecological studies</subject><subject>Electronic cigarettes</subject><subject>e‐cigarette</subject><subject>Meta-analysis</subject><subject>Reviews</subject><subject>Smoking</subject><subject>Social development</subject><subject>Systematic review</subject><subject>Teenagers</subject><subject>tobacco</subject><subject>Vaping</subject><issn>0965-2140</issn><issn>1360-0443</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp10c1u1DAUBWALUdFpYcELIEts6CKt_5Os0KgtpVIlNrCO7tg3lUsSF9vpKDteoBLPyJNgZgoLJLyxF5-Pr3UIec3ZKS_rDJw75Voo84ysuDSsYkrJ52TFWqMrwRU7JEcp3THG6qZVL8ihFE3TCKlW5PEKMm5hoSFSG8YxTHTwsPGDz8t7uqZpSRlHyN7SiA8etxQmR0fM8PP7D5hgWJJPNPQ05dl53B3BhQGTxSlTLMr6W4iYM9I54e56P-c5Ik1j-OqnW-onn315IkwvyUEPQ8JXT_sx-fLh8vP5x-rm09X1-fqmslJLUzWagZZ13UpEa5hVXCNsrOmxFqY3zrWybZApIVrgNQgt5abnvaxVC8Y2Th6Td_vc-xi-zZhyN_oy8DDAhGFOnVCKKaNYKwt9-w-9C3MsHy9Ks1bIkq6LOtkrG0NKEfvuPvoR4tJx1v3uqCsddbuOin3zlDhvRnR_5Z9SCjjbg60fcPl_Ure-uNhH_gI-zJ47</recordid><startdate>202104</startdate><enddate>202104</enddate><creator>Chan, Gary C. K.</creator><creator>Stjepanović, Daniel</creator><creator>Lim, Carmen</creator><creator>Sun, Tianze</creator><creator>Shanmuga Anandan, Aathavan</creator><creator>Connor, Jason P.</creator><creator>Gartner, Coral</creator><creator>Hall, Wayne D.</creator><creator>Leung, Janni</creator><general>Blackwell Publishing Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QG</scope><scope>7TK</scope><scope>8BJ</scope><scope>FQK</scope><scope>JBE</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6651-8035</orcidid><orcidid>https://orcid.org/0000-0001-5816-2959</orcidid><orcidid>https://orcid.org/0000-0003-1595-6307</orcidid><orcidid>https://orcid.org/0000-0002-7020-1196</orcidid><orcidid>https://orcid.org/0000-0002-3939-9499</orcidid><orcidid>https://orcid.org/0000-0002-7569-1948</orcidid><orcidid>https://orcid.org/0000-0003-1984-0096</orcidid></search><sort><creationdate>202104</creationdate><title>Gateway or common liability? A systematic review and meta‐analysis of studies of adolescent e‐cigarette use and future smoking initiation</title><author>Chan, Gary C. K. ; Stjepanović, Daniel ; Lim, Carmen ; Sun, Tianze ; Shanmuga Anandan, Aathavan ; Connor, Jason P. ; Gartner, Coral ; Hall, Wayne D. ; Leung, Janni</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3536-850a537793eec60c415eabc6fe726f6dd9398e04229a17a2533bf1f3749a6c8d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adjustment</topic><topic>Adolescent</topic><topic>Adolescents</topic><topic>Analysis</topic><topic>Attrition</topic><topic>Bias</topic><topic>cigarette</topic><topic>Cigarette smoking</topic><topic>Cigarettes</topic><topic>Dropping out</topic><topic>Ecological models</topic><topic>Ecological studies</topic><topic>Electronic cigarettes</topic><topic>e‐cigarette</topic><topic>Meta-analysis</topic><topic>Reviews</topic><topic>Smoking</topic><topic>Social development</topic><topic>Systematic review</topic><topic>Teenagers</topic><topic>tobacco</topic><topic>Vaping</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chan, Gary C. K.</creatorcontrib><creatorcontrib>Stjepanović, Daniel</creatorcontrib><creatorcontrib>Lim, Carmen</creatorcontrib><creatorcontrib>Sun, Tianze</creatorcontrib><creatorcontrib>Shanmuga Anandan, Aathavan</creatorcontrib><creatorcontrib>Connor, Jason P.</creatorcontrib><creatorcontrib>Gartner, Coral</creatorcontrib><creatorcontrib>Hall, Wayne D.</creatorcontrib><creatorcontrib>Leung, Janni</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Animal Behavior Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>International Bibliography of the Social Sciences (IBSS)</collection><collection>International Bibliography of the Social Sciences</collection><collection>International Bibliography of the Social Sciences</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Addiction (Abingdon, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chan, Gary C. K.</au><au>Stjepanović, Daniel</au><au>Lim, Carmen</au><au>Sun, Tianze</au><au>Shanmuga Anandan, Aathavan</au><au>Connor, Jason P.</au><au>Gartner, Coral</au><au>Hall, Wayne D.</au><au>Leung, Janni</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Gateway or common liability? A systematic review and meta‐analysis of studies of adolescent e‐cigarette use and future smoking initiation</atitle><jtitle>Addiction (Abingdon, England)</jtitle><addtitle>Addiction</addtitle><date>2021-04</date><risdate>2021</risdate><volume>116</volume><issue>4</issue><spage>743</spage><epage>756</epage><pages>743-756</pages><issn>0965-2140</issn><eissn>1360-0443</eissn><abstract>Background and Aims Studies have consistently found a longitudinal association between e‐cigarette use (vaping) and cigarette smoking. Many have interpreted such association as causal. This systematic review and meta‐analysis evaluated the plausibility of a causal interpretation by (1) estimating the effect of adolescent vaping on smoking initiation, adjusted for study quality characteristics, (2) evaluating the sufficiency of adjustment for confounding based on the social development model (SDM) and the social ecological model (SEM) and E‐value analyses and (3) investigating sample attrition and publication bias. Methods Systematic review and meta‐analysis of longitudinal studies that examined the association between e‐cigarette use at baseline and smoking at follow‐up. Participants were non‐smokers aged &lt; 18 at baseline. Results Meta‐analysis of 11 studies showed a significant longitudinal association between vaping and smoking [adjusted odds ratio (aOR) = 2.93, 95% confidence interval (CI) = 2.22, 3.87]. Studies with sample sizes &lt; 1000 had a significantly higher odds ratio (OR = 6.68, 95% CI = 3.63, 12.31) than studies with sample sizes &gt; 1000 (OR = 2.49, 95% CI = 1.97, 3.15). Overall, the attrition rate was very high (median = 30%). All but one study reported results from complete sample analysis, despite those dropping out having higher risk profiles. Only two studies comprehensively adjusted for confounding. The median E‐value was 2.90, indicating that the estimates were not robust against unmeasured confounding. Conclusions There is a longitudinal association between adolescent vaping and smoking initiation; however, the evidence is limited by publication bias, high sample attrition and inadequate adjustment for potential confounders.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>32888234</pmid><doi>10.1111/add.15246</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0002-6651-8035</orcidid><orcidid>https://orcid.org/0000-0001-5816-2959</orcidid><orcidid>https://orcid.org/0000-0003-1595-6307</orcidid><orcidid>https://orcid.org/0000-0002-7020-1196</orcidid><orcidid>https://orcid.org/0000-0002-3939-9499</orcidid><orcidid>https://orcid.org/0000-0002-7569-1948</orcidid><orcidid>https://orcid.org/0000-0003-1984-0096</orcidid></addata></record>
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ispartof Addiction (Abingdon, England), 2021-04, Vol.116 (4), p.743-756
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source Wiley Online Library Journals Frontfile Complete
subjects Adjustment
Adolescent
Adolescents
Analysis
Attrition
Bias
cigarette
Cigarette smoking
Cigarettes
Dropping out
Ecological models
Ecological studies
Electronic cigarettes
e‐cigarette
Meta-analysis
Reviews
Smoking
Social development
Systematic review
Teenagers
tobacco
Vaping
title Gateway or common liability? A systematic review and meta‐analysis of studies of adolescent e‐cigarette use and future smoking initiation
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