title: Intentions to smoke cigarettes among never-smoking US middle and high school electronic cigarette users: National Youth Tobacco Survey, 2011-2013.
abstract: BACKGROUND
  Electronic cigarette (e-cigarette) use is increasing rapidly, and the impact on youth is unknown. We assessed associations between e-cigarette use and smoking intentions among US youth who had never smoked conventional cigarettes.
  
  
  METHODS
  We analyzed data from the nationally representative 2011, 2012, and 2013 National Youth Tobacco Surveys of students in grades 6-12. Youth reporting they would definitely not smoke in the next year or if offered a cigarette by a friend were defined as not having an intention to smoke; all others were classified as having positive intention to smoke conventional cigarettes. Demographics, pro-tobacco advertisement exposure, ever use of e-cigarettes, and ever use of other combustibles (cigars, hookah, bidis, kreteks, and pipes) and noncombustibles (chewing tobacco, snuff, dip, snus, and dissolvables) were included in multivariate analyses that assessed associations with smoking intentions among never-cigarette-smoking youth.
  
  
  RESULTS
  Between 2011 and 2013, the number of never-smoking youth who used e-cigarettes increased 3-fold, from 79,000 to more than 263,000. Intention to smoke conventional cigarettes was 43.9% among ever e-cigarette users and 21.5% among never users. Ever e-cigarette users had higher adjusted odds for having smoking intentions than never users (adjusted odds ratio = 1.70, 95% confidence interval = 1.24-2.32). Those who ever used other combustibles, ever used noncombustibles, or reported pro-tobacco advertisement exposure also had increased odds for smoking intentions.
  
  
  CONCLUSIONS
  In 2013, more than a quarter million never-smoking youth used e-cigarettes. E-cigarette use is associated with increased intentions to smoke cigarettes, and enhanced prevention efforts for youth are important for all forms of tobacco, including e-cigarettes.
authors.affiliation: Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA; rrb7@cdc.gov.
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Bunnell
authors.affiliation: Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA;
authors.forename: Israel T
authors.initials: IT
authors.lastname: Agaku
authors.affiliation: Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA;
authors.forename: René A
authors.initials: RA
authors.lastname: Arrazola
authors.affiliation: Office of Science, Center for Tobacco Products, US Food and Drug Administration, Rockville, MD;
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Apelberg
authors.affiliation: Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA;
authors.forename: Ralph S
authors.initials: RS
authors.lastname: Caraballo
authors.affiliation: Office of Science, Center for Tobacco Products, US Food and Drug Administration, Rockville, MD;
authors.forename: Catherine G
authors.initials: CG
authors.lastname: Corey
authors.affiliation: Office of Science, Center for Tobacco Products, US Food and Drug Administration, Rockville, MD;
authors.forename: Blair N
authors.initials: BN
authors.lastname: Coleman
authors.affiliation: Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, GA.
authors.forename: Shanta R
authors.initials: SR
authors.lastname: Dube
authors.affiliation: Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA;
authors.forename: Brian A
authors.initials: BA
authors.lastname: King
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services; D002648:Child; D066300:Electronic Nicotine Delivery Systems / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D033182:Intention; D008297:Male; D012572:School Health Services; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D013334:Students / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States