• Pallav Pokhrel, Simone Schmid, and Ian Pagano.
• Cancer Prevention in the Pacific, University of Hawaii Cancer Center, Honolulu, Hawaii. Electronic address: ppokhrel@cc.hawaii.edu.
• Am J Prev Med. 2020 Apr 1; 58 (4): 580-583.

IntroductionPhysical activity is known to be inversely associated with cigarette smoking among young people. However, evidence is not clear about the association between physical activity and e-cigarette use. Young people who otherwise lead a healthy lifestyle are attracted to e-cigarettes for nicotine or flavor consumption given the low harm perceptions associated with e-cigarette use. This is of concern given the potentially serious adverse health consequences of some forms of e-cigarette use. This study tested the hypotheses that increased physical activity is associated with lower levels of cigarette and e-cigarette use, both cross-sectionally and prospectively.MethodsSelf-reported physical activity data and past-30-day cigarette smoking and e-cigarette use data were collected in 2018-2019 from 2,401 young adults (mean age=21.2 years, SD=2.2 years, 55% women) at 2 timepoints, 6 months apart. Data were analyzed between May and August 2019, using ordered logistic regression.ResultsHigher moderate or vigorous physical activity was inversely associated with cigarette and e-cigarette use cross-sectionally. Only higher moderate physical activity was statistically significantly associated with reduced cigarette smoking 6 months later, after adjusting for baseline cigarette smoking, sensation seeking, BMI, and demographic variables. Higher physical activity at baseline was associated with increased e-cigarette use at follow-up, adjusting for baseline e-cigarette use, sensation seeking, BMI, and demographic variables.ConclusionsThe prospective association between increased physical activity at baseline and higher e-cigarette use 6 months later is of concern. More research is needed to determine if this finding is replicable. Some plausible reasons for the observed associations are discussed.Copyright © 2019 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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