BACKGROUND Concerns have been raised regarding e-cigarette use as a potential stepping-stone to marijuana use. Based on Kandel's gateway hypothesis, this study investigated if e-cigarette use could lead to marijuana use by testing two hypotheses with a longitudinal national U.S. adult sample, including (1) primary hypothesis: e-cigarette use is a gateway to marijuana use; and (2) falsification hypothesis: marijuana use is not a gateway to e-cigarette use. METHODS Adults were extracted from the Population Assessment of Tobacco and Health Study Waves 1-3 (2013-2016). For primary hypotheses, based on baseline e-cigarette use statuses, three study groups were defined, and three logistic regressions were conducted to examine associations between baseline e-cigarette use and follow-up marijuana use initiation, reinitiation, and persistence, respectively. Similarly, for falsification hypotheses, three additional study groups were defined, and three logistic regressions were conducted to examine associations between baseline marijuana use and follow-up e-cigarette use behaviors. RESULTS Baseline e-cigarette use was associated with marijuana use initiation and reinitiation (ORs = 2.08, 1.37, respectively, both ps < .05) but not persistence at follow-up. Additionally, baseline marijuana use was associated with only e-cigarette use initiation (OR = 2.23, p < .01) but not reinitiation or persistence at follow-up. CONCLUSIONS Findings partially support the gateway hypothesis that e-cigarette use could be a steppingstone to marijuana use reinitiation among the U.S. adults. The mechanisms and behavioral characteristics, such as etiological and psychosocial factors, that may pertain to the progression from e-cigarette use to reinitiation of other substance use should be further investigated to inform effective behavioral, educational, and policy interventions.

中文翻译：

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电子香烟是否使用大麻的网关？电子烟和大麻使用的启动，重新启动和持续性的纵向检查。

背景技术已经提出了关于使用电子烟作为大麻使用的潜在垫脚石的担忧。基于坎德尔的门户假设，本研究通过对美国成人纵向样本的两个假设进行检验，研究了电子烟的使用是否会导致大麻的使用，其中包括：（1）主要假设：电子烟的使用是大麻使用的门户；（2）伪造假说：大麻的使用并非通往电子烟使用的门户。方法从烟草与健康研究波1-3（2013-2016）的人群评估中提取成年人。对于主要假设，根据基线电子烟的使用状况，定义了三个研究组，并进行了三个逻辑回归以检验基线电子烟的使用与后续大麻使用的启动，重新启动和持久性之间的关联，分别。同样，对于伪造假说，还定义了另外三个研究组，并进行了三个逻辑回归以检验基线大麻使用与后续电子烟使用行为之间的关联。结果基线电子烟的使用与大麻使用的启动和重新启动相关（OR分别为2.08、1.37，均为ps <.05），但在随访中没有持久性。此外，基线大麻的使用仅与电子烟使用的启动有关（OR = 2.23，p <.01），而与随访中的重新启动或持久性无关。结论结论部分支持了门户假说，即电子烟的使用可能是美国成年人中重新开始使用大麻的垫脚石。机制和行为特征，例如病因和社会心理因素，