Researchers at the University of California, San Francisco, examined the records of 13,651 adolescents enrolled in the Population Assessment of Tobacco and Health, a nationwide study begun in 2013 by the National Institutes of Health and the Food and Drug Administration.
"The estimated health risks of non-cigarette tobacco products should include the additional health consequences of future cigarette use", study authors wrote. Louisiana is 47th out of 50 states for tobacco use, with over 22-percent of adults light up, one of the highest percentages in the nation.
Among youth in the study who had tried more than one product at the start, 74 percent has used e-cigarettes and 65 percent had used a hookah. Additionally, polyuse of tobacco products was associated with a greater risk for cigarette smoking initiation (OR, 3.95; 95%CI, 2.65-5.90) and past 30-day cigarette use (OR, 3.81; 95%CI, 2.22-6.54). In contrast, only about 4% of participants who had not used these tobacco products at baseline reported subsequent cigarette use at follow-up.
Chaffee said one finding that was particularly striking was that all the different types of non-cigarette tobacco studied were associated with approximately the same increase in risk of future cigarette smoking.
"We've seen the prevalence of youth cigarette smoking decrease over the past 20 years, but the rising popularity of these non-cigarette products is a fairly recent development that poses new questions for tobacco control and youth smoking prevention", said lead study investigator, Benjamin Chaffee, PhD, of UCSF to CBS News.
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At the beginning of the study period, the teens, ages 12-17, had not smoked a cigarette, and a year later, a majority of them were still not tobacco users. "And even if kids use these products and don't convert to cigarette smoking, it's not the only relevant health concern".
And in another report released Tuesday, researchers said that almost 3 million American teens had been exposed to online marketing of tobacco, as cigarette manufacturers have shifted their marketing strategies from traditional forms of media to the internet. The majority of teens who use these products buy vapes and e-cigarettes with these kinds of flavorings, according another study from the University of MI in 2016.
"I'm perhaps surprised about how similar the relationships were for each product across the board", Watkins said.
He added that the smoking cessation community is split among people who say it is good that these products are less harmful than conventional cigarettes and those who prefer to focus on the harms that non-cigarette tobacco products do cause. It is also prohibited to sell tobacco products in casinos.