A small study published in the Pediatrics medical journal concludes that American teens who use electronic cigarettes are about six times more likely to move on to tobacco cigarettes that youths who never tried the device. Interestingly, these findings contradict the results of the national Youth Risk Behavior Survey conducted by the CDC, which showed that smoking prevalence among teens has dropped by a staggering 31% between 2013 and 2015, while the use of electronic cigarettes in the same period has increased 24 times.
During this study, researchers surveyed about 300 11th and 12th graders, with an average age of 17, about use of e-cigarettes, cigarettes, cigars, pipes and hookahs. Of those, 146 used e-cigarettes and 152 had never tried them. None reported having smoked tobacco cigarettes. After 16 months, researchers found that 40 percent of e-cigarette users had begun smoking traditional cigarettes, compared to just 11 percent of those who had never vaped. Study authors determined that the vapers were just over six times more likely to have tried compared to teens who weren’t using e-cigarettes.
“Adolescents who had never smoked, but who had used e-cigarettes, were substantially more likely to begin smoking combustible cigarettes over the next year,” said study lead author Jessica Barrington-Trimis, a postdoctoral researcher with the University of Southern California’s Tobacco Center of Regulatory Science. “The increase in e-cigarette use, which may be followed by increases in cigarette use, could result in an erosion of the progress that has been made over the last several decades in tobacco control.”
“We can’t definitively conclude the e-cigarettes cause kids to smoke cigarettes,” Barrington-Trimis admitted, but that didn’t prevent her from concluding that those teens “who had used e-cigarettes at baseline were substantially more likely to begin smoking cigarettes.” The study also found that e-cigarette users were also more likely to try hookahs, pipes or cigars.
These are some pretty disturbing findings, especially when just last week the Youth Risk Behavior Survey showed the exact opposite. One of these two studies must be wrong, but the question is which. Well, judging by the scientific evidence regarding the gateway theory, I think it’s pretty obvious, but I’m going to explain why Barrington-Trimis and her team drew the wrong conclusion from their research.
The main fault of the “E-cigarettes and Future Cigarette Use” study lies in the way categories of teens were defined at baseline – e-cigarette users were defined as youth ever having taken even one puff of an e-cigarette, while smokers were similarly defined as ever having taken a puff from a cigarette. Since researchers failed to demonstrate whether “e-cig users” were actually using them regularly or simply took a puff from an e-cig at one point in their lives, all their study actually found is that the majority of teens surveyed had experimented with e-cigarettes and went on to experiment with tobacco cigarettes as well. As Dr. Michael Siegel of Tobacco Analysis explains, “it is entirely possible (and in fact likely) that the majority of these kids had experimented with e-cigarettes, failed to become vapers, and then turned to regular cigarettes. In fact, it’s entirely possible that had these kids been able to stick with vaping, they would never have become smokers.”
Also, based on the flawed way in which subject categories were defined, if one of the subjects had taken a single puff of an electronic cigarette and hated it, then went on to take just on puff of an analog cigarette and hated that too, they would be included in the category of teens who allegedly started smoking after first becoming addicted to e-cigarettes. Does that sounds like solid scientific evidence that e-cigarettes are a gateway to smoking for youths?
As was to be expected, this recent study has received mixed reviews. Peter Hajek, director of tobacco research with the Wolfson Institute of Preventive Medicine at Queen Mary, University of London had this to say: “The authors misinterpret their findings. Like several previous studies of this type, this one just shows that people who try things, try things. In fact, the decline in youth smoking over the past few years has been faster than ever before. This does not necessarily mean that e-cigarette experimentation prevents the uptake of smoking, although this is possible. But there is clear and strong evidence that such experimentation does not contribute to smoking uptake.”
Gregory Conley, president of the American Vaping Association, was also disappointed with the way researchers presented their findings. “The bottom line is that as more teens have experimented with vapor products, youth smoking has experienced massive and unprecedented declines that no one predicted just five years ago,” he said.
However, despite its obvious faults and misleading conclusion, the study also received praise from certain public health experts. For example, Thomas Wills, interim director of the Cancer Prevention and Control Program with the University of Hawaii Cancer Center, said the research “adds a lot of support” to the idea that e-cigarettes can cause cigarette smoking. He added that this study and others debunk the idea that since e-cigarettes are available they will prevent teenagers from smoking.
As we’ve gotten used to in recent years, mainstream media simply picked up the researchers’ conclusions and spread the misinformation using the most ominous titles. So nothing new on that front.