Changes in tobacco/nicotine product use between Waves 1 and 4 in relation to onset of health condition in Waves 2 or 3a_ Note that initiation and quitting of cigarettes is regardless of e-cigarette use, and that initiation of e-cigarettes is regardless of smoking habits_
| Change in product use in relation to onset of health condition | OR for main analysisb | OR excluding other tobacco/nicotine product usersc | OR controlling for three more variablesd |
|---|---|---|---|
| Initiation of smoking | |||
| Any major respiratory condition | 1.11 (0.85–1.44) | 0.91 (0.65–1.27) | 1.01 (0.78–1.32) |
| Asthma | 1.14 (0.84–1.56) | 0.95 (0.63–1.43) | 1.08 (0.79–1.48) |
| Any respiratory condition | 1.05 (0.86–1.28) | 0.82 (0.63–1.07) | 0.98 (0.80–1.19) |
| Any cardiovascular condition | 1.65 (1.31–2.08) | 1.96 (1.49–2.59) | 1.61 (1.27–2.04) |
| High blood pressure | 1.34 (1.13–1.58) | 1.23 (0.99–1.52) | 1.28 (1.08–1.52) |
| High cholesterol | 1.05 (0.89–1.23) | 0.88 (0.71–1.08) | 1.03 (0.87–1.22) |
| Diabetes | 1.15 (0.95–1.38) | 1.17 (0.93–1.47) | 1.11 (0.92–1.33) |
| Cancer | 1.41 (0.96–2.05) | 1.55 (0.98–2.46) | 1.34 (0.92–1.97) |
| Any major smoking-related condition | 1.35 (1.12–1.62) | 1.51 (1.20–1.89) | 1.28 (1.06–1.54) |
| Quitting of smoking | |||
| Any major respiratory condition | 0.97 (0.75–1.24) | 1.86 (1.22–2.83) | 1.07 (0.83–1.39) |
| Asthma | 0.90 (0.64–1.27) | 0.96 (0.50–1.82) | 0.96 (0.68–1.36) |
| Any respiratory condition | 1.06 (0.86–1.32) | 1.47 (1.00–2.17) | 1.16 (0.93–1.44) |
| Any cardiovascular condition | 1.16 (0.87–1.54) | 0.98 (0.56–1.74) | 1.27 (0.95–1.69) |
| High blood pressure | 1.09 (0.87–1.37) | 1.84 (1.20–2.83) | 1.16 (0.92–1.45) |
| High cholesterol | 1.29 (1.02–1.62) | 1.75 (1.17–2.62) | 1.34 (1.06–1.70) |
| Diabetes | 1.08 (0.82–1.42) | 1.37 (0.86–2.18) | 1.17 (0.89–1.54) |
| Cancer | 0.77 (0.47–1.25) | 1.38 (0.59–3.23) | 0.81 (0.50–1.33) |
| Any major smoking-related condition | 1.05 (0.84–1.30) | 1.73 (1.18–2.56) | 1.16 (0.93–1.44) |
| Initiation of e-cigarettes | |||
| Any major respiratory condition | 2.86 (2.10–3.90) | 3.36 (1.76–6.42) | 2.02 (1.47–2.79) |
| Asthma | 1.57 (1.05–2.35) | 1.78 (0.75–4.22) | 1.29 (0.85–1.95) |
| Any respiratory condition | 2.08 (1.61–2.68) | 1.41 (0.71–2.83) | 1.67 (1.28–2.18) |
| Any cardiovascular condition | 1.67 (1.16–2.42) | 2.21 (1.08–4.55) | 1.42 (0.98–2.08) |
| High blood pressure | 1.55 (1.19–2.01) | 1.38 (0.74–2.57) | 1.28 (0.98–1.67) |
| High cholesterol | 1.33 (1.01–1.75) | 1.38 (0.76–2.49) | 1.33 (1.00–1.77) |
| Diabetes | 1.74 (1.31–2.32) | 2.32 (1.37–3.92) | 1.61 (1.20–2.16) |
| Cancer | 2.51 (1.52–4.14) | 3.67 (1.48–9.13) | 2.14 (1.27–3.60) |
| Any major smoking-related condition | 1.94 (1.48–2.55) | 2.61 (1.50–4.51) | 1.55 (1.17–2.06) |
Other changes in tobacco/nicotine habits between Waves 1 and 4 in relation to onset of health conditions in Waves 2 or 3 (main analyses)a_
| Health condition | ORs for change in tobacco/nicotine habits | |||||
|---|---|---|---|---|---|---|
| Re-initiating cigarettes | Initiating cigarettes in never e-cig users | Quitting cigarettes in never e-cig users | Re-initiating cigarettes in never e-cig users | Initiating e-cigarettes in never smokers | Smokers becoming dual users | |
| Any major respiratory condition | 1.22 (0.57–2.61) | 1.08 (0.83–1.41) | 0.97 (0.74–1.27) | 1.14 (0.48–2.70) | 3.36 (1.57–7.16) | 1.49 (0.98–2.27) |
| Asthma | 0.95 (0.41–2.30) | 1.15 (0.84–1.57) | 0.77 (0.52–1.14) | 0.93 (0.36–2.38) | 1.96 (0.79–4.83) | 0.65 (0.32–1.33) |
| Any respiratory condition | 0.98 (0.54–1.76) | 1.03 (0.85–1.26) | 1.06 (0.84–1.34) | 0.89 (0.45–1.76) | 1.99 (1.02–3.88) | 1.53 (1.06–2.21) |
| Any cardiovascular condition | 0.73 (0.35–1.51) | 1.64 (1.30–2.07) | 1.12 (0.82–1.52) | 0.60 (0.25–1.41) | 1.82 (0.77–4.32) | 1.42 (0.83–2.42) |
| High blood pressure | 1.17 (0.73–1.88) | 1.32 (1.11–1.57) | 0.97 (0.75–1.25) | 0.99 (0.57–1.73) | 1.33 (0.76–2.33) | 0.91 (0.58–1.42) |
| High cholesterol | 1.18 (0.76–1.84) | 1.04 (0.88–1.23) | 1.24 (0.96–1.59) | 1.29 (0.80–2.09) | 1.21 (0.65–2.25) | 1.45 (0.94–2.23) |
| Diabetes | 1.80 (1.09–2.98) | 1.14 (0.95–1.38) | 1.05 (0.78–1.41) | 2.02 (1.18–3.46) | 4.23 (2.45–7.29) | 1.02 (0.60–1.75) |
| Cancer | 0.81 (0.25–2.64) | 1.39 (0.94–2.05) | 0.66 (0.38–1.15) | 0.86 (0.24–3.12) | 2.36 (0.63–8.78) | 0.57 (0.19–1.74) |
| Any major smoking-related condition | 0.95 (0.52–1.74) | 1.33 (1.11–1.61) | 1.03 (0.81–1.31) | 0.94 (0.48–1.84) | 2.20 (1.17–4.14) | 0.95 (0.62–1.46) |
Change in amount smoked (cigs/day) between Waves 1 and 4 in relation to onset of health conditions in Waves 2 or 3_
| Health condition | Change (95% CI)a with 95% confidence interval and coded probability valuesb | ||
|---|---|---|---|
| Additional analysis E in continuing smokers at Waves 1 and 4 | Additional analysis F in smokers at Wave 1 (allowing for quitting only)c | Additional analysis G in the whole Wave 1 population (allowing for quitting and relapse)c | |
| Any major respiratory condition | −0.29 (−1.18 to +0.60) | −0.77 (−1.69 to +0.14) | −0.36 (−0.71 to −0.02) * |
| Asthma | −0.13 (−1.38 to +1.11) | +0.08 (−1.19 to +1.34) | −0.05 (−0.51 to +0.41) |
| Any respiratory condition | +0.06 (−0.71 to +0.84) | −0.43 (−1.21 to +0.36) | −0.23 (−0.51 to +0.04) |
| Any cardiovascular condition | −2.24 (−3.31 to −1.16) *** | −2.32 (−3.40 to −1.23) *** | −0.39 (−0.73 to −0.05) * |
| High blood pressure | −1.08 (−1.94 to −0.22) * | −1.03 (−1.88 to −0.17) * | −0.13 (−0.39 to +0.14) |
| High cholesterol | −0.48 (−1.35 to +0.39) | −0.64 (−1.52 to +0.24) | −0.11 (−0.37 to +0.15) |
| Diabetes | −0.43 (−1.43 to +0.56) | −0.21 (−1.22 to +0.79) | −0.07 (−0.37 to +0.23) |
| Cancer | +0.12 (−1.63 to +1.88) | +0.37 (−1.43 to +2.18) | +0.00 (−0.61 to +0.61) |
| Any major smoking-related condition | −0.36 (−1.16 to +0.44) | −1.18 (−1.99 to −0.36) ** | −0.21 (−0.47 to +0.06) |
Comparison of original results (adjusted for sex and age group) with those avoiding reverse causation (see footnote)_ Results not shown for analysis or combined analysis where number of changes following onset of the condition is less than 2_
| Health condition | Tobacco/nicotine habit change | Original results | Additional analysis C | Additional analysis D | Additional analyses C + D | |
|---|---|---|---|---|---|---|
| Any major respiratory condition | Initiating smoking | OR | 1.11 (0.85–1.44) | 1.22 (0.78–1.89) | – | – |
| n | 286 | 113 | 80 | 193 | ||
| Quitting smoking | OR | 0.97 (0.75–1.24) | 0.75 (0.47–1.20) | 1.78 (1.12–2.83) | 1.16 (0.84–1.61) | |
| n | 459 | 218 | 181 | 399 | ||
| Initiating e-cigarettes | OR | 2.86 (2.10–3.90) | 3.92 (2.39–6.45) | 1.74 (0.48–6.32) | 3.53 (2.22–5.61) | |
| n | 656 | 321 | 255 | 576 | ||
| Any respiratory condition | Initiating smoking | OR | 1.05 (0.86–1.28) | 1.15 (0.82–1.60) | 1.01 (0.32–3.20) | 1.14 (0.83–1.57) |
| n | 553 | 237 | 163 | 400 | ||
| Quitting smoking | OR | 1.06 (0.86–1.32) | 0.83 (0.57–1.23) | 1.56 (1.01–2.42) | 1.09 (0.82–1.46) | |
| n | 639 | 310 | 234 | 544 | ||
| Initiating e-cigarettes | OR | 2.08 (1.61–2.68) | 2.64 (1.73–4.05) | 2.18 (0.96–4.99) | 2.54 (1.74–3.70) | |
| n | 1092 | 543 | 437 | 980 | ||
| Any cardio-vascular condition | Initiating smoking | OR | 1.65 (1.31–2.08) | 2.29 (1.63–3.22) | 0.93 (0.16–5.57) | 2.22 (1.59–3.10) |
| n | 279 | 117 | 66 | 183 | ||
| Quitting smoking | OR | 1.16 (0.87–1.54) | 0.97 (0.57–1.64) | 1.22 (0.63–2.35) | 1.06 (0.70–1.60) | |
| n | 331 | 150 | 123 | 273 | ||
| Initiating e-cigarettes | OR | 1.67 (1.16–2.42) | 1.83 (0.95–3.53) | 1.26 (0.28–5.75) | 1.72 (0.94–3.15) | |
| n | 587 | 287 | 248 | 535 | ||
| Any major smoking-related condition | Initiating smoking | OR | 1.35 (1.12–1.62) | 2.03 (1.55–2.65) | 0.95 (0.24–3.87) | 1.98 (1.52–2.57) |
| n | 521 | 219 | 139 | 358 | ||
| Quitting smoking | OR | 1.05 (0.84–1.30) | 0.79 (0.53–1.19) | 1.61 (1.05–2.49) | 1.10 (0.82–1.48) | |
| n | 606 | 286 | 227 | 513 | ||
| Initiating e-cigarettes | OR | 1.94 (1.48–2.55) | 2.22 (1.39–3.55) | 0.93 (0.26–3.42) | 2.01 (1.29–3.12) | |
| n | 1048 | 526 | 412 | 938 |
Selection of health conditions for analysis and rules used for excluding individuals for analysis_
| Health condition considered initially | Reason for excluding conditions from analyses presented | Individuals excluded on the basis of health conditions present at Wave 1 | |
|---|---|---|---|
| 1 | COPD | Not clearly distinct from 2 or 3 | – |
| 2 | Chronic bronchitis | Not clearly distinct from 1 or 3 | – |
| 3 | Emphysema | Not clearly distinct from 1 or 2 | – |
| 4 | Any major respiratory disease (i.e., conditions 1, 2 or 3) | Included | Any of 1, 2 or 3 |
| 5 | Asthma | Included | 5 only |
| 6 | Other lung/respiratory condition | Not clearly defined | – |
| 7 | Any respiratory condition (i.e. conditions 1, 2, 3, 5 or 6) | Included | Any of 1, 2, 3, 5 or 6 |
| 8 | Congestive heart failure | Few changes | – |
| 9 | Stroke | Few changes | – |
| 10 | Heart attack | Few changes | – |
| 11 | Some other heart condition | Not clearly defined | – |
| 12 | Any cardiovascular condition (i.e. conditions 8, 9, 10 or 11) | Included | Any of 8, 9, 10 or 11 |
| 13 | High blood pressure | Included | 13 only |
| 14 | High cholesterol | Included | 14 only |
| 15 | Diabetes (sugar or borderline) | Included | 15 only |
| 16 | Cancer | Included | 16 only |
| 17 | Tobacco-related cancer | Few changes | – |
| 18 | Any major smoking-related condition (i.e., conditions 4, 7 or 12) | Included | Any of 4, 7 or 12 |