Have e-cigarettes renormalised or displaced youth smoking? Results of a segmented regression analysis of repeated cross sectional survey data in England, Scotland and Wales

Hallingberg, B., Maynard, O., Bauld, L., Brown, R., Gray, L. , Lowthian, E., MacKintosh, A. M., Moore, L. , Munafo, M. and Moore, G. (2020) Have e-cigarettes renormalised or displaced youth smoking? Results of a segmented regression analysis of repeated cross sectional survey data in England, Scotland and Wales. Tobacco Control, 29(2), pp. 207-216. (doi: 10.1136/tobaccocontrol-2018-054584) (PMID:30936390) (PMCID:PMC7036293)

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Abstract

Objectives: To examine whether during a period of limited e-cigarette regulation and rapid growth in their use, smoking began to become renormalised among young people. Design: Interrupted time-series analysis of repeated cross-sectional time-series data. Setting: Great Britain Participants: 248 324 young people aged approximately 13 and 15 years, from three national surveys during the years 1998–2015. Intervention Unregulated growth of e-cigarette use (following the year 2010, until 2015). Outcome measures: Primary outcomes were prevalence of self-reported ever smoking and regular smoking. Secondary outcomes were attitudes towards smoking. Tertiary outcomes were ever use of cannabis and alcohol. Results: In final models, no significant change was detected in the pre-existing trend for ever smoking (OR 1.01, CI 0.99 to 1.03). There was a marginally significant slowing in the rate of decline for regular smoking (OR 1.04, CI 1.00 to 1.08), accompanied by a larger slowing in the rate of decline of cannabis use (OR 1.21, CI 1.18 to 1.25) and alcohol use (OR 1.17, CI 1.14 to 1.19). In all models and subgroup analyses for smoking attitudes, an increased rate of decline was observed after 2010 (OR 0.88, CI 0.86 to 0.90). Models were robust to sensitivity analyses. Conclusions: There was a marginal slowing in the decline in regular smoking during the period following 2010, when e-cigarettes were emerging but relatively unregulated. However, these patterns were not unique to tobacco use and the decline in the acceptability of smoking behaviour among youth accelerated during this time. These analyses provide little evidence that renormalisation of youth smoking was occurring during a period of rapid growth and limited regulation of e-cigarettes from 2011 to 2015.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Gray, Dr Linsay and Moore, Professor Laurence
Authors: Hallingberg, B., Maynard, O., Bauld, L., Brown, R., Gray, L., Lowthian, E., MacKintosh, A. M., Moore, L., Munafo, M., and Moore, G.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
Journal Name:Tobacco Control
Publisher:BMJ Publishing Group
ISSN:0964-4563
ISSN (Online):1468-3318
Published Online:01 April 2019
Copyright Holders:Copyright © 2019 The Authors
First Published:First published in Tobacco Control 29(2): 207-216
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
727651Measuring and Analysing Socioeconomic Inequalities in HealthAlastair LeylandMedical Research Council (MRC)MC_UU_12017/13HW - MRC/CSO Social and Public Health Sciences Unit
727661Complexity in Health ImprovementLaurence MooreMedical Research Council (MRC)MC_UU_12017/14HW - MRC/CSO Social and Public Health Sciences Unit