Table 3. Association Between Change in Cigarette Type and Suicidal Behaviorsa.
| Variable | Suicidal ideation | Suicide planning | Suicide attempt | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Male participants | Female participants | Male participants | Female participants | Male participants | Female participants | |||||||
| AOR (95% CI) | P value | AOR (95% CI) | P value | AOR (95% CI) | P value | AOR (95% CI) | P value | AOR (95% CI) | P value | AOR (95% CI) | P value | |
| Never smoking as reference | ||||||||||||
| Switched from e-cigarettes to conventional cigarettes (or used both after switching) | 2.54 (2.06-3.13) | <.001b | 2.75 (1.89-4.01) | <.001b | 3.56 (2.77-4.58) | <.001b | 4.58 (3.11-6.75) | <.001b | 4.05 (3.03-5.43) | <.001b | 6.91 (4.62-10.33) | <.001b |
| Initiated smoking using both e-cigarettes and conventional cigarettes (in same year) | 1.64 (1.48-1.82) | <.001b | 1.91 (1.61-2.25) | <.001b | 1.99 (1.73-2.29) | <.001b | 2.85 (2.30-3.53) | <.001b | 2.48 (2.09-2.95) | <.001b | 3.63 (1.53-2.16) | <.001b |
| Switched from conventional cigarettes to e-cigarettes (or used both after switching) | 1.35 (1.24-1.48) | <.001b | 1.50 (1.32-1.70) | <.001b | 1.56 (1.38-1.77) | <.001b | 2.06 (1.75-2.42) | <.001b | 2.14 (1.84-2.50) | <.001b | 2.93 (2.48-3.47) | <.001b |
| Used only e-cigarettes | 1.46 (1.27-1.68) | <.001b | 1.57 (1.26-1.95) | <.001b | 2.15 (1.79-2.57) | <.001b | 2.38 (1.82-3.12) | <.001b | 2.47 (1.96-3.11) | <.001b | 3.09 (2.31-4.15) | <.001b |
| Used only conventional cigarettes | 1.33 (1.25-1.43) | <.001b | 1.50 (1.39-1.62) | <.001b | 1.45 (1.30-1.61) | <.001b | 1.71 (1.53-1.91) | <.001b | 1.55 (1.34-1.78) | <.001b | 2.13 (1.89-2.40) | <.001b |
| Never smoked | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Switching from conventional cigarettes to e-cigarettes as reference | ||||||||||||
| Switched from e-cigarettes to conventional cigarettes (or used both after switching) | 1.88 (1.51-2.34) | <.001b | 1.84 (1.24-2.71) | .002b | 2.29 (1.76-2.97) | <.001b | 2.22 (1.47-3.36) | <.001b | 1.89 (1.39-2.57) | <.001b | 2.36 (1.53-3.64) | <.001b |
| Initiated smoking using both e-cigarettes and conventional cigarettes (in same year) | 1.21 (1.07-1.37) | .002b | 1.27 (1.03-1.57) | .02 | 1.28 (1.08-1.51) | .004 | 1.38 (1.06-1.80) | .02 | 1.16 (0.95-1.42) | .16 | 1.24 (0.95-1.62) | .12 |
| Switched from conventional cigarettes to e-cigarettes (or used both after switching) | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
Abbreviations: AOR, adjusted odds ratio; NA, not applicable.
a
Adjusted for school grade, economic status, living situation, academic achievement, alcohol use, physical activity level, self-reported health status, and perceived stress level.
b
Statistically significant after applying Bonferroni correction.