Nonsmoking teens who use e-cigarettes are more likely to turn to the real thing compared with their nonvaping counterparts, according to a new study that made for bold headlines Tuesday. The authors of the study also reported that vapers were more likely to become daily and heavy smokers, underscoring the potential danger.
At first glance, the findings appear to confirm fears that e-cigarettes act as a gateway to tobacco, potentially fixing life-long addictions in young people. Health organizations, such as the Centers for Disease Control and Prevention, have repeatedly raised red flags that the electronic smoking devices could undo the hard-won successes of decades-old anti-tobacco campaigns. Many experts have advocated for tight regulations.
But others argue that e-cigarettes should be kept easily accessible because they’re unquestionably less harmful than traditional cigarettes and could help smokers quit. Proponents also rightly point out that data backing the notion that e-cigarettes act as a gateway to tobacco has been thin at best. Cigarette use among teens has hit historic lows. And despite upticks in the number of kids experimenting with e-cigs, smoking has continued to decline.
The new study does little to sway the discussion—despite what the headlines will have you think. In short, the study was small, brief, and yielded mixed and impossible-to-interpret results.
The study was led by researchers at the University of Southern California and took place over just six months—a brisk timeline for deciphering whether habits are formed or kicked. At the start and end, researchers collected smoking and vaping data on 3,084 tenth-graders (average age of 15.5 at the start) from 10 schools in Los Angeles, California.
Around 33 percent (1,009) of the 3,084 student said they had tried e-cigarettes at least once—that’s on par with other studies’ findings. However, only 133 reported “infrequent” vaping (1-2 days in the past 30 days) and 146 reported “frequent” vaping (≥3 days in the past 30 days). At the end of the study, only 151 students said they smoked cigarettes either infrequently or frequently.
The researchers’ concerning conclusion comes from a focused look into the teens that said they were nonsmokers at the beginning of the study—by far the largest group with 2,966 students. At the six-month point, 94 of those kids had switched to frequent or infrequent smokers.
The researchers sorted the original 2,966 nonsmoking adolescents into bins based on whether the kids reported that they never (1) vaped, (2) vaped at some point but not in the last 30 days (prior vapers), (3) vaped infrequently, or (4) frequently. Then the researchers looked at the proportional shifts within each group from nonsmoker to smoker. The largest of those were in teens that said they vaped either frequently or infrequently. For instance, 15 percent of the frequent vapers switched from nonsmokers to smokers, while only 1.2 percent of the never vapers switched during the six months.
The finding led the researchers to conclude that vaping increased the chances of nonsmokers becoming smokers. But, it’s important to point out that the conclusion hinges on just 26 teens—less than one percent of the 3,084 students in the study. Plus, it’s impossible to tell why the kids tried out smoking; was it because they were vaping or that they would have tried smoking anyway?
The researchers also noted that the smokers who also vaped frequently were the most likely to smoke daily and have more than two cigarettes a day. That finding depends on just 30 students, and, again, it’s unclear how vaping and smoking are linked in those students.
The findings get murkier when zooming in on the kids that identified as infrequent and frequent vapers. Among the 146 frequent vapers, 93 of them said they were nonsmokers at the beginning of the study. By the end, 100 of them were—that is, seven of them stopped smoking. Likewise, of the 133 infrequent vapers, 112 started off saying they were nonsmokers and there were 114 in the end. Though the shifts are teeny, they run counter to the suggestion that e-cigs are a slippery slope to cigarettes. In fact, the students who initially said they smoked infrequently and vaped (once or infrequently) saw the largest shifts to nonsmokers (77.8 and 73.3 percent) by the end of the study.
Though the data is interesting, the findings could easily go up in smoke with larger and longer studies.