The research briefing is part of a series of monthly updates aiming to provide an overview of new studies on electronic cigarettes. The briefings are intended for researchers, policy makers, health professionals and others who may not have time to keep up to date with new findings and would like to access a summary that goes beyond the study abstract.

Association of initial e-cigarette and other tobacco product use with subsequent cigarette smoking in adolescents: a cross-sectional, matched control study

Lion Shahab, Emma Beard and Jamie Brown looked at whether vaping could lead to an increase in teen cigarette smoking in the United States. They concluded: “Less than 1% of US adolescents who use e-cigarettes first were established cigarette smokers. They were less likely to be smokers than adolescents who tried other combustible or non-combustible tobacco products first and propensity score matched adolescents without initial e-cigarette use.”

UKECRF said the study, “examines first product use without examining the extent of use. Therefore, it does not consider experimenting with the products versus regular use.” It added that “the survey did not report differences in the types of e-cigarettes used. Therefore, it cannot be determined if use of different brands, for example Juul, affects the relationship with future smoking.”

Is e-cigarette use in non-smoking young adults associated with later smoking? A systematic review and meta-analysis

Khouja, Suddell, Peters, Taylor, and Munafò also investigated whether e-cigarette use compared with non-use in young non-smokers is associated with subsequent cigarette smoking.

They concluded: “Although the association between e-cigarette use among non-smokers and subsequent smoking appears strong, the available evidence is limited by the reliance on self-report measures of smoking history without biochemical verification. None of the studies included negative controls which would provide stronger evidence for whether the association may be causal. Much of the evidence also failed to consider the nicotine content of e-liquids used by non-smokers meaning it is difficult to make conclusions about whether nicotine is the mechanism driving this association.”

UKECRF commented: “There was insufficient data to pool the results of regular cigarette use at follow - up. Therefore, the results cannot show that regular or occasional use of e-cigarettes leads to regular smoking.”

“Only one study considered the nicotine concentration of e-cigarettes. Therefore, the results do not show the effect of nicotine exposure in e-cigarettes on subsequent smoking.”

Cost-effectiveness of e-cigarettes compared with nicotine replacement therapy in stop smoking services in England (TEC study): a randomized controlled trial

Li, Hajek, Pesola, Phillips-Waller et al. evaluated the cost-effectiveness of vaping as a quit aid. They concluded that the use of vape products in stop-smoking services is likely to be more cost-effective than using traditional nicotine replacement therapy approaches.

UKECRF stated: “Participants self-reported their health care service use over a six-month period. Therefore, the results may be subject to recall bias.”

“The trial was conducted in three UK Stop Smoking Services and the predictions were based on a specific brand of e-cigarette. Therefore, the cost-effectiveness predictions may not be representative of the entire population.”

UKECRF’s recommended studies from March:

Patterns of use

Perception

Cessation

Youth

Harms and harm reduction

Marketing

Misc

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