PLoS ONE (Jan 2021)

Association between electronic nicotine delivery systems and electronic non-nicotine delivery systems with initiation of tobacco use in individuals aged < 20 years. A systematic review and meta-analysis.

  • Sze Lin Yoong,
  • Alix Hall,
  • Heidi Turon,
  • Emily Stockings,
  • Alecia Leonard,
  • Alice Grady,
  • Flora Tzelepis,
  • John Wiggers,
  • Hebe Gouda,
  • Ranti Fayokun,
  • Alison Commar,
  • Vinayak M Prasad,
  • Luke Wolfenden

DOI
https://doi.org/10.1371/journal.pone.0256044
Journal volume & issue
Vol. 16, no. 9
p. e0256044

Abstract

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BackgroundThis systematic review described the association between electronic nicotine delivery systems and electronic non-nicotine delivery systems (ENDS/ENNDS) use among non-smoking children and adolescents aged MethodsWe searched five electronic databases and the grey literature up to end of September 2020. Prospective longitudinal studies that described the association between ENDS/ENNDS use, and subsequent tobacco use in those aged FindingsA total of 36 publications met the eligibility criteria, of which 25 were included in the systematic review (23 in the meta-analysis) after exclusion of overlapping studies. Sixteen studies had high to moderate risk of bias. Ever users of ENDS/ENNDS had over three times the risk of ever cigarette use (ARR 3·01 (95% CI: 2·37, 3·82; pConclusionThere is an urgent need for policies that regulate the availability, accessibility, and marketing of ENDS/ENNDS to children and adolescents. Governments should also consider adopting policies to prevent ENDS/ENNDS uptake and use in children and adolescents, up to and including a ban for this group.