E-Cigarette Use and Intentions to Smoke Among 10-11 Year Old Never Smokers in Wales

Introduction

E-cigarettes are seen by some as offering harm reduction potential, where used effectively as smoking cessation devices. However, there is also emerging international evidence of growing use among non-smokers, particularly children, amid concerns that this may increase tobacco uptake. Few UK studies examine prevalence of e-cigarette use in non-smoking children, or associations with intentions to smoke tobacco.

Methods

A  cross-sectional survey of Year 6 (10-11 year old) children in Wales. Approximately 1500 children completed questions on e-cigarette use, parental and peer smoking, and intentions to smoke. Logistic regression analyses among never-smoking children, adjusted for school-level clustering, examined associations of smoking norms with e-cigarette use, and associations of e-cigarette use with intentions to smoke tobacco within the next 2 years.

Results

Approximately 6% of Year 6 children, including 5% of never smokers, reported having used an e-cigarette. By comparison to children whose parents neither smoked nor used e-cigarettes, children were most likely to have used an e-cigarette if parents were dual users of both tobacco and used e-cigarettes (OR=3.40; 95% CI=1.73 to 6.69). Having used an e-cigarette was associated with intentions to smoke (OR=3.21; 95% CI=1.66 to 6.23). While few children reported that they would smoke in 2 years’ time, children who had used an e-cigarette were less likely to report that they definitely would not smoke tobacco in 2 years’ time, and more likely to say that they might.

Conclusion

E-cigarettes represent a new form of childhood experimentation with nicotine. Findings are consistent with a hypothesis that children use e-cigarettes to imitate parental and peer smoking behaviours, and that e-cigarette use is associated with weaker anti-smoking intentions.