Smoking by family members and friends and electronic-cigarette use in adolescence: A systematic review and meta-analysis
Jian-Wei Wang 1,  
Ru-Ying Hu 2  
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Yidu Central Hospital of Weifang, Qingzhou, Shandong, China
Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
Publish date: 2018-02-27
Tob. Induc. Dis. 2018;16(February):5
Evidence suggests that smoking by family members and friends is a strong predictor of smoking uptake in adolescents, yet the influence on electronic cigarette (e-cigarette) use has not been systematically reviewed and quantified.

Relevant studies were identified by searches of the PubMed and ScienceDirect databases up to December 2016. The summary odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model.

A total of 21 studies were included in this meta-analysis. A positive association was observed between adolescent e-cigarette use and smoking by family members (OR=1.47, 95% CI=1.30-1.66) and friends (OR=2.72, 95% CI=1.87-3.95), even after adjusting for the individual smoking status. Stratified by family members, the association with smoking in siblings (OR=1.87, 95% CI=1.35-2.60) was more prominent than that in parents (OR=1.41, 95% CI=1.19- 1.68) and other family members (OR=1.39, 95% CI=1.12-1.72).

The present meta-analysis suggests that smoking by family members and friends is significantly associated with increased probability of e-cigarette use in adolescents.

Ru-Ying Hu   
Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China
1. World Health Organization. Electronic Cigarettes (E-Cigarettes) or Electronic Nicotine Delivery Systems. en/. Accessed January, 2017.
2. Grana R, Benowitz N, Glantz SA. E-cigarettes: a scientific review. Circulation. 2014;129:1972-1986. doi:10.1161/CIRCULATIONAHA.114.007667
3. Wang MP, Ho SY, Leung LT, Lam TH. Electronic Cigarette Use and Respiratory Symptoms in Chinese Adolescents in Hong Kong. JAMA. 2016;170:89-91. doi:10.1001/jamapediatrics.2015.3024
4. Cho JH, Paik SY. Association between Electronic Cigarette Use and Asthma among High School Students in South Korea. PLoS One. 2016;11:e0151022. doi:10.1371/journal.pone.0151022
5. Polosa R, Morjaria JB, Caponnetto P, Caruso M, Campagna D, Amaradio MD, et al. Persisting long term benefits of smoking abstinence and reduction in asthmatic smokers who have switched to electronic cigarettes. Discov Med. 2016;21:99-108.
6. Leventhal AM, Strong DR, Kirkpatrick MG, Unger JB, Sussman S, Riggs NR, et al. Association of Electronic Cigarette Use With Initiation of Combustible Tobacco Product Smoking in Early Adolescence. JAMA. 2015;314:700-707. doi:10.1001/jama.2015.8950
7. Dutra LM, Glantz SA. Electronic cigarettes and conventional cigarette use among U.S. adolescents: a cross-sectional study. JAMA Pediatr. 2014;168:610-617. doi:10.1001/jamapediatrics.2013.5488
8. Dautzenberg B, de Souza Moura MA, Rieu N, Dautzenberg MD, Birkui P. The e-cigarette disrupts other consumptions in Parisian teenagers (2012-2014). Rev Mal Respir. 2016;33:225-234. doi:10.1016/j.rmr.2015.05.010
9. Gautier S, Kinouani S, Raherison C. Do electronic cigarettes increase the risk of smoking among adolescents and young adults? Sante Publique. 2017;29:333-340. doi:10.3917/spub.173.0333
10. Carroll Chapman SL, Wu LT. E-cigarette prevalence and correlates of use among adolescents versus adults: a review and comparison. J Psychiatr Res. 2014;54:43-54. doi:10.1016/j.jpsychires.2014.03.005
11. Rennie LJ, Bazillier-Bruneau C, Rouëssé J. Harm Reduction or Harm Introduction? Prevalence and Correlates of E-Cigarette Use Among French Adolescents. J Adolesc Health. 2016;58:440-445. doi:10.1016/j.jadohealth.2015.12.013
12. Piñeiro B, Correa JB, Simmons VN, Harrell PT, Menzie NS, Unrod M, et al. Gender differences in use and expectancies of e-cigarettes: Online survey results. Addict Behav. 2016;52:91-97. doi:10.1016/j.addbeh.2015.09.006
13. Kinnunen JM, Ollila H, El-Amin Sel-T, Pere LA, Lindfors PL, Rimpelä AH. Awareness and determinants of electronic cigarette use among Finnish adolescents in 2013: a population-based study. Tob Control. 2015;24:e264-270. doi:10.1136/tobaccocontrol-2013-051512
14. Leonardi-Bee J, Jere ML, Britton J. Exposure to parental and sibling smoking and the risk of smoking uptake in childhood and adolescence: a systematic review and meta-analysis. Thorax. 2011;66:847-855. doi:10.1136/thx.2010.153379
15. El-Amin Sel-T, Nwaru BI, Ginawi I, Pisani P, Hakama M. The role of parents, friends and teachers in adolescents' cigarette smoking and tombak dipping in Sudan. Tob Control. 2011;20:94-99. doi:10.1136/tc.2010.038091
16. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097. doi:10.1371/journal.pmed.1000097
17. Wells GA, Shea B, O’Connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa Scale (NOS) for Assessing The Quality of Nonrandomised Studies in Meta-Analyses. Accessed January, 2017.
18. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557-560. doi:10.1136/bmj.327.7414.557
19. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629-634. doi:10.1136/bmj.315.7109.629
20. Moore GF, Littlecott HJ, Moore L, Ahmed N, Holliday J. E-cigarette use and intentions to smoke among 10-11-year-old never-smokers in Wales. Tob Control. 2016;25:147-152. doi:10.1136/tobaccocontrol-2014-052011
21. Liao Y, Huang Z, Huh J, Pentz MA, Chou CP. Changes in friends' and parental influences on cigarette smoking from early through late adolescence. J Adolesc Health. 2013;53:132-138. doi:10.1016/j.jadohealth.2013.01.020
22. Mays D, Gilman SE, Rende R, Luta G, Tercyak KP, Niaura RS. Parental smoking exposure and adolescent smoking trajectories. Pediatrics. 2014;133:983-991. doi:10.1542/peds.2013-3003
23. Okoli CT, Kodet J. A systematic review of secondhand tobacco smoke exposure and smoking behaviors: Smoking status, susceptibility, initiation, dependence, and cessation. Addict Behav. 2015;47:22-32. doi:10.1016/j.addbeh.2015.03.018
24. de Vries H, Candel M, Engels R, Mercken L. Challenges to the peer influence paradigm: results for 12-13 year olds from six European countries from the European Smoking Prevention Framework Approach study.Tob Control. 2006;15:83-89. doi:10.1136/tc.2003.007237
25. Hanewinkel R, Isensee B. Risk factors for e-cigarette, conventional cigarette, and dual use in German adolescents: a cohort study. Prev Med. 2015;74:59-62. doi:10.1016/j.ypmed.2015.03.006
26. Hughes K, Bellis MA, Hardcastle KA, McHale P, Bennett A, Ireland R, et al. Associations between e-cigarette access and smoking and drinking behaviours in teenagers. BMC Public Health. 2015;15:244. doi:10.1186/s12889-015-1618-4
27. White J, Li J, Newcombe R, Walton D. Tripling use of electronic cigarettes among New Zealand adolescents between 2012 and 2014. J Adolesc Health. 2015;56:522-528. doi:10.1016/j.jadohealth.2015.01.022
28. Jiang N, Wang MP, Ho SY, Leung LT, Lam TH. Electronic cigarette use among adolescents: a cross-sectional study in Hong Kong. BMC Public Health. 2016;16:202. doi:10.1186/s12889-016-2719-4
29. Khoury M, Manlhiot C, Fan CP, Gibson D, Stearne K, Chahal N, et al. Reported electronic cigarette use among adolescents in the Niagara region of Ontario. CMAJ. 2016;188:794-800. doi:10.1503/cmaj.151169
30. Dautzenberg B, Berlin I, Tanguy ML, Rieu N, Birkui P. Factors associated with experimentation of electronic cigarettes among Parisian teenagers in 2013. Tob Induc Dis. 2015;13:40. doi:10.1186/s12971-015-0065-4
31. Fotiou A, Kanavou E, Stavrou M, Richardson C, Kokkevi A. Prevalence and correlates of electronic cigarette use among adolescents in Greece: a preliminary cross-sectional analysis of nationwide survey data. Addict Behav. 2015;51:88-92. doi:10.1016/j.addbeh.2015.07.021
32. Thrasher JF, Abad-Vivero EN, Barrientos-Gutíerrez I, Pérez-Hernández R, Reynales-Shigematsu LM, Mejía R, et al. Prevalence and Correlates of E-Cigarette Perceptions and Trial Among Early Adolescents in Mexico. J Adolesc Health. 2016;58:258-265. doi:10.1016/j.jadohealth.2015.11.008
33. Best C, van der Sluijs W, Haseen F, Eadie D, Stead M, MacKintosh AM, et al. Does exposure to cigarette brands increase the likelihood of adolescent e-cigarette use? A cross-sectional study. BMJ Open. 2016;6:e008734. doi:10.1136/bmjopen-2015-008734
34. Cho JH, Shin E, Moon SS. Electronic-cigarette smoking experience among adolescents. J Adolesc Health. 2011;49:542-546. doi:10.1016/j.jadohealth.2011.08.001
35. Zhang X, Pu J. E-cigarette use among US adolescents: secondhand smoke at home matters. Int J Public Health. 2016;61:209-213. doi:10.1007/s00038-015-0784-6
36. Cardenas VM, Breen PJ, Compadre CM, Delongchamp RR, Barone CP, Phillips MM, et al. The smoking habits of the family influence the uptake of e-cigarettes in US children. Ann Epidemiol. 2015;25:60-62. doi:10.1016/j.annepidem.2014.09.013
37. Amrock SM, Zakhar J, Zhou S, Weitzman M. Perception of e-cigarette harm and its correlation with use among U.S. adolescents. Nicotine Tob Res. 2015;17:330-336. doi:10.1093/ntr/ntu156
38. Nădăşan V, Foley KL, Pénzes M, Paulik E, Mihăicuţă Ş, Ábrám Z, et al. Use of electronic cigarettes and alternative tobacco products among Romanian adolescents. Int J Public Health. 2016;61:199-207. doi:10.1007/s00038-015-0774-8
39. Barrington-Trimis JL, Berhane K, Unger JB, Cruz TB, Huh J, Leventhal AM, et al. Psychosocial Factors Associated With Adolescent Electronic Cigarette and Cigarette Use. Pediatrics. 2015;136:308-317. doi:10.1542/peds.2015-0639
40. Hwang JH, Park SW. Association between Peer Cigarette Smoking and Electronic Cigarette Smoking among Adolescent Nonsmokers: A National Representative Survey. PLoS One. 2016;11:e0162557. doi:10.1371/journal.pone.0162557
41. Jeon C, Jung KJ, Kimm H, Lee S, Barrington-Trimis JL, McConnell R, et al. E-cigarettes, conventional cigarettes, and dual use in Korean adolescents and university students: Prevalence and risk factors. Drug Alcohol Depend. 2016;168:99-103. doi:10.1016/j.drugalcdep.2016.08.636
42. Kaleta D, Wojtysiak P, Polańska K. Use of electronic cigarettes among secondary and high school students from a socially disadvantaged rural area in Poland. BMC Public Health. 2016;15:703. doi:10.1186/s12889-016-3417-y
43. Kinnunen JM, Ollila H, Lindfors PL, Rimpelä AH. Changes in Electronic Cigarette Use from 2013 to 2015 and Reasons for Use among Finnish Adolescents. Int J Environ Res Public Health. 2016;13:11. doi:10.3390/ijerph13111114