It is often used as an argument against liberating the vape market, but do electronic cigarettes inevitably lead teens into subsequent smoking (commonly known as the gateway effect)? Latest research conducted by Doctors Ruoyan Sun, David Mendez, and Kenneth Warner says it doesn’t result in young people taking up cigarette use.
Looking at adolescents in the United States, the trio say that 27.5% of high school and 10.5% of middle school students had tried vaping in 2019. That said, they noted the numbers for 2020 and 2021 showed a “substantial” drop.
People opposed to electronic cigarettes prefer to refer to those 2019 ever-tried figures, but it should be noted that this is far higher than the number of regular users according to researchers at University College London. These anti-ecig campaigners also claim vaping makes teens 3.5 times more likely to progress on to smoking tobacco products. The problem with their stance is that while the numbers of vapers has grown recently (before declining again), the numbers of teens actually smoking “has steadily decreased over the last quarter century”.
Sun, Mendez, and Warner say a “common liability theory” proposes that teens who go on to smoke would have probably taken up smoking anyway, regardless of vaping now being available. They say that this point of view is never mentioned by anti-vape activists.
Consequently, they returned to look at the data that supported the 3.5x claim, but adjusted their analysis to include peer and family influences, use of tobacco products, marijuana, and alcohol, and factored in sensation seeking or rebellious behaviour patterns.
They discovered that once they had factored in these “confounders”, looking at adolescents’ exposure to tobacco users, susceptibility to smoking, and behavioural risk factors, “we found that the association of ever e-cigarette use with subsequent smoking decreases substantially and even becomes non-significant”.
“We believe this is the first study to report any non-significant findings, likely the result of the more comprehensive set of risk factor variables we included. As we demonstrate, inclusion of logical risk factors is important to interpreting the association between adolescent vaping and subsequent smoking.”
In plain English: they failed to find any evidence that ever-trying vaping is linked to starting smoking as smoking is a choice of those who engage in other forms of risky behaviours.
The trio’s results mirror the findings from the annual study conducted by Action on Smoking and Health and Cancer Research UK.
Each year, ASH and CRUK produce a survey of 11–18-year-olds in Great Britain. The last survey found 77.7% had never tried vaping and 10.5% had never heard of electronic cigarettes. Those who had tried vaping has fallen from 13.9% to 11.2% – and concluded: “while some young
people experiment with e-cigarettes, particularly those who have tried smoking, regular use remains low.”